The associations of binge alcohol use with HIV/STI risk and diagnosis among heterosexual African American men.

BACKGROUND

Studies on the mechanisms of the association between illicit drug use and HIV/STI provide important insight into why there are disproportionate rates of HIV/STI among heterosexual African American men; far less work has been conducted to examine the associations between binge alcohol use and HIV/STI risks in this population.

OBJECTIVE

To assess whether binge alcohol use is associated with risky sexual behaviors and recent HIV/STI diagnosis among heterosexual African American men reporting multiple sex partners in the past year.

METHODS

Participants (n=672) were heterosexually active African American men age 18-65 years recruited from urban health centers and clinics in Boston, MA, and who participated in a health survey. Logistic regression analyses were used to assess associations between past 30 day binge drinking and the following outcome variables: unprotected sex, six or more sex partners in the past year, sex trade involvement, and past 6 month HIV/STI diagnosis. Analyses were adjusted to control demographics, incarceration history, illicit drug use, and injection drug use.

RESULTS

Significant associations were observed between binge alcohol use and unprotected vaginal sex with non-main female partners (AOR=1.7, 95% CI=1.2-2.3), unprotected anal sex with non-main female partners (AOR=2.3, 95% CI=1.4-4.0), sex trade involvement (AOR=2.1, 95% CI=1.3-3.5), and recent HIV/STI diagnosis (AOR=1.9; 95% CI=1.05-3.6).

CONCLUSION

Heterosexual African American men engaging in binge alcohol use may be at increased risk for HIV/STI; findings support the need for integrating alcohol risk reduction into HIV prevention programs targeting this population.