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Acute Alcohol Consumption Directly Increases HIV Transmission Risk: A Randomized Controlled Experiment
Paul A Shuper1, Narges Joharchi, Peter M Monti
1*Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada; †Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; ‡Department of Behavioral and Social Sciences, Brown University Center for Alcohol and Addiction Studies, Brown University, Providence, RI; §Women's College Hospital, Toronto, Canada; ‖Department of Medicine, University of Toronto, Toronto, Canada; ¶Maple Leaf Medical Clinic, Toronto, Canada; #Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada; **Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; ††Centre for Addiction and Mental Health, PAHO/WHO Collaborating Centre for Mental Health and Addiction, Toronto, Canada; ‡‡Epidemiological Research Unit, Technische Universität Dresden, Dresden, Germany; §§Klinische Psychologie and Psychotherapie, Dresden, Germany; and ‖‖Graduate Department of Community Health and Institute of Medical Science, University of Toronto, Toronto, Canada.
Alcohol consumption significantly increases intentions for condomless sex among men who have sex with men (MSM), regardless of HIV status. These findings highlight the need for alcohol-focused HIV prevention strategies.
Area of Science:
- Behavioral science
- Public health
- Addiction research
Background:
- Alcohol consumption is linked to condomless sex and HIV transmission.
- Experimental evidence on alcohol's impact on risk-taking in HIV-positive populations is limited.
- This study investigates alcohol's causal effect on condomless sex intentions in HIV-positive and HIV-negative men who have sex with men (MSM).
Purpose of the Study:
- To determine if acute alcohol consumption causally impacts condomless sex intentions in HIV-positive MSM.
- To compare the effects of alcohol on condomless sex intentions between HIV-positive and HIV-negative MSM.
Main Methods:
- A randomized controlled alcohol administration experiment was conducted in a barroom laboratory setting.
- Participants (HIV-positive and HIV-negative MSM) were assigned to consume alcohol, placebo alcohol, or water.
- Intentions for condomless receptive and insertive anal sex were assessed after a sexual arousal manipulation.
Main Results:
- Participants who consumed alcohol reported significantly higher intentions for condomless sex compared to placebo or water groups.
- Alcohol's effect on condomless sex intentions did not differ between HIV-positive and HIV-negative MSM.
- A total of 282 MSM (141 HIV-positive, 141 HIV-negative) participated in the study.
Conclusions:
- Alcohol consumption has an independent, causal impact on intentions for sexual behaviors that can lead to HIV transmission.
- Findings support the integration of alcohol-focused interventions into HIV prevention efforts.
- This is the first risk-focused alcohol administration experiment involving an HIV-positive sample.