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Why Some but Not Others? Exploring Factors That Determine Whether Alcohol Intoxication Increases Sexual Risk Behavior
Neil Gleason1, Sharon S Wang2, Ange Vittone2
1University of Southern California.
Research Square
|November 24, 2025
Summary
Alcohol
Area of Science:
- Sexual health research
- Public health
- Behavioral science
Background:
- Alcohol intoxication is linked to increased condomless anal sex (CAS) likelihood in men who have sex with men (MSM).
- Previous research indicates MSM perceive alcohol influences sexual risk, but event-level data suggest this varies.
- Factors moderating alcohol's effect on sexual risk behaviors in MSM require further qualitative exploration.
Purpose of the Study:
- To qualitatively explore factors moderating the relationship between alcohol use and sexual risk behaviors in MSM.
- To understand individual perceptions of how alcohol influences sexual decision-making among MSM.
Main Methods:
- Conducted qualitative interviews with 26 men who have sex with men (MSM) reporting frequent casual sex and alcohol use.
- Employed thematic analysis to code interview transcripts and identify key themes.
- Focused on understanding participants' perceptions of alcohol's impact on sexual behaviors and risk.
Main Results:
- Participants perceiving alcohol effects (n=11) reported impacts on CAS, communication, and partner selection.
- Perception of sexually transmitted infection (STI) risk emerged as a key differentiator.
- Those who perceived alcohol effects linked it to higher perceived STI risk, especially with new partners.
Conclusions:
- Future research should examine alcohol's influence on a broader range of sexual behaviors beyond CAS.
- Partner familiarity and perceived STI risk are crucial moderating factors in the alcohol-sexual risk relationship.
- Understanding these nuances is vital for developing targeted sexual health interventions for MSM.
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