Binge Drinking Linked To Risky Sexual Behavior in MSM

MedicalResearch.com Interview with:
Kristen Hess  ORISE Fellow
Division of HIV/AIDS Prevention,
National Center for HIV, Viral Hepatitis, STD and TB Prevention
Centers for Disease Control and Prevention Atlanta, GA

MedicalResearch: What is the background for this study?

Response: Men who have sex with men (MSM) of all races continue to be the risk group most severely affected by HIV in the United States. CDC’s most recent HIV incidence data show that the number of new infections among MSM increased 12 percent between 2008 and 2010, with an even steeper increase among the youngest MSM. These data clearly show the urgent need to better understand the factors that affect their risk and to develop effective prevention interventions.

One specific factor is excessive alcohol use, which is responsible for 88,000 deaths in this nation each year, and cost the U.S. about $224 billion in 2006. Binge drinking (consuming ≥5 drinks for men on an occasion; ≥4 drinks for women) is the most common form of excessive alcohol consumption. The association between excessive alcohol consumption, including binge drinking, and risky sexual behaviors among MSM has had mixed results in the literature with some studies finding an association and others not. One limitation of previous work is that the definition of excessive alcohol consumption varies between studies, so results are not easily compared between studies and populations.

Our study examines the relationship between binge drinking and sexual risk behaviors among MSM who are current drinkers and who were either HIV-negative or unaware of their HIV status.

MedicalResearch: What are the main findings?

Response: We assessed the prevalence of binge drinking, using a standard definition, among a sample of MSM recruited from 20 cities across the U.S. We also examined the association between binge drinking and several risky sexual behaviors.

The findings show that 6 in 10 MSM reported binge drinking. Those who binge drank, in comparison to non-binge drinkers, were more likely to engage in risky sexual behaviors such as sex with an HIV-positive or unknown status partner and exchange sex for money or drugs at last sex, as well as more likely to have concurrent partners and more condomless sex partners in the past year.

We also found that the likelihood of risky sexual behaviors went up with increased frequency of binge drinking. In fact, MSM who reported 10 or more binge-drinking episodes in the past month were more likely to report risky behaviors. This is a critical point, especially given that, among those who binged, 22 percent reported 10 or more binge drinking episodes in the past month.

MedicalResearch: What should clinicians and patients take away from your report?

Response: The high prevalence of binge drinking among MSM and its association with risky behaviors suggests that it is important for clinicians to screen for excessive alcohol use. CDC recommends that clinicians screen patients for excessive alcohol use as this may affect sexual risk behavior, liver or renal health, or medication adherence, which may affect decisions about the appropriateness of prescribing pre-exposure prophylaxis (PrEP) medication.

HIV prevention programs could also incorporate the risks of excessive drinking into prevention messages. Evidence-based strategies for reducing excessive alcohol use, including binge drinking, may be important to help reduce risky sexual behavior among MSM and facilitate the use of other effective interventions.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response:  In the future, event-level studies would help to clarify the association between binge drinking and risky behaviors. It would also be helpful to have a similar analysis among HIV-positive MSM to add to our understanding of the impact of binge drinking on HIV transmission.

Citation:

Binge drinking and risky sexual behavior among HIV-negative and unknown HIV status men who have sex with men, 20 US cities

Kristen L. Hess , ,Pollyanna R. Chavez ,Dafna Kanny ,Elizabeth DiNenno,Amy Lansky ,Gabriela Paz-Bailey ,for the NHBS Study Group

 Drug and Alcohol Dependence Volume 147, 1 February 2015, Pages 46–52

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MedicalResearch.com Interview with:, & Kristen Hess ORISE Fellow (2015). Binge Drinking Linked To Risky Sexual Behavior in MSM MedicalResearch.com

Last Updated on February 14, 2015 by Marie Benz MD FAAD