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Binge Drinking Moderates Unprotected Sex Among HIV Sero-Similar Same Sex Male Couples: An Actor-Partner Interdependence Model

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Abstract

Most new HIV diagnoses in the US occur among sexual minority men (SMM). The majority (69%) of new HIV diagnoses among US SMM are due to transmission from main sex partners. We identified multilevel correlates of unprotected anal intercourse (UAI; condomless anal intercourse while not using a biomedical strategy) among SMM couples using the Actor Partner Interdependence Model (APIM). Participants were US SMM over 18 years, with a primary male partner > 6 months. Couples were recruited online from April 2016 until June 2017 and interviewed using self-administered computer-assisted surveys. We used a series of APIM regressions to assess multilevel associations with UAI. We also tested the moderating role of an individual’s binge drinking on the relationship between HIV status similarity and UAI. Among 798 participants (n = 411 couples), 61% reported UAI in the past 6 months. Binge drinking (52%) and physical intimate partner violence (IPV; 34%) were considerably high within our sample. Actor’s binge drinking, reporting experiencing and/or perpetrating physical IPV, and partner’s trust were positively associated with UAI. Actor having other sexual partner(s), using illegal drugs (not marijuana), and length of relationship were negatively associated with UAI. Binge drinking positively moderated UAI among HIV serostatus similar partners. HIV prevention programming should integrate components on IPV and binge drinking reduction- especially among HIV serostatus similar couples.

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Availability of Data and Materials

Data can be made available upon request to Rob Stephenson on an individual case by case basis.

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Code can be made available upon request to Cho-Hee Shrader on an individual case by case basis.

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Funding

The research leading to these results received funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD078131; PI: Stephenson). Dr. Shrader’s effort on this project was funded by the National Institute of Allergy and Infectious Diseases (T32AI114398, PI: Howard) and National Institute on Drug Abuse (R25DA050687, PI: Valdez; P30DA011041, PIs: Hagan, Ompad). Dr. Moody was supported by the National Institute on Drug Abuse (T32DA031099, PI: Hasin) and a grant from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention to the Center for Injury Epidemiology and Prevention at Columbia University (R49CE003096, PI: Branas). Dr. Knox’s effort on this project was funded by the National Institute on Alcohol Abuse and Alcoholism (K01AA028199, PI: Knox) and the National Institute on Drug Abuse (R01DA054553, PI: Knox; R21DA053156, PI: Knox).

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Authors and Affiliations

  1. ICAP at Columbia University, New York, NY, USA

    Cho-Hee Shrader

  2. Department of Systems, Populations and Leadership, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA

    Rob Stephenson

  3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Raymond Moody

  4. Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, USA

    Justin Knox

  5. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, USA

    Justin Knox

  6. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA

    Justin Knox

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  1. Cho-Hee Shrader
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Contributions

RS, JK, CS, and RM conceptualized the design of the analysis. RS coordinated the collection of the data then contributed the data for this manuscript. CHS and JK performed the analysis. All authors contributed to writing, editing, and proofreading the manuscript. All authors approved the final manuscript.

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Correspondence to Justin Knox.

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Ethical approval for the present study was approved by the University of Michigan Institutional Review Board (HUM00182640). Participants provided online written informed consent.

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Appendix 1

Appendix 1

Correlation plot of variables of interest

figure a

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Shrader, CH., Stephenson, R., Moody, R. et al. Binge Drinking Moderates Unprotected Sex Among HIV Sero-Similar Same Sex Male Couples: An Actor-Partner Interdependence Model. AIDS Behav 27, 1824–1835 (2023). https://doi.org/10.1007/s10461-022-03914-z

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