Examining the Sexual Health Consequences of Alcohol Consumption Among Black Gay and Bisexual Men

Background: Black men who have sex with men (MSM) are disproportionately affected by HIV infection. Efforts are needed to understand correlates of HIV risk among this group. Alcohol consumption may have a role in HIV transmission given its association with condomless sex. This study aimed to examine the association between alcohol consumption (i.e., drinking before/during sex and levels of alcohol use problems) and condom use during lifetime, past 6 months, and the event (i.e., a specific sexual episode) level.

Methods: Black MSM (N = 102) reported sexual behavior and condom use for lifetime, past 6 months, and the most recent condom and condomless sex events. The Alcohol Use Disorders Identification Test (AUDIT) determined alcohol use problems.

Results: Ordinal and binary regression analyses analyzed associations between AUDIT scores and condomless sex (receptive and insertive). AUDIT scores were associated with a greater likelihood of condomless sex (lifetime receptive sex: OR = 1.06, p < 0.05; past 6 months insertive sex: odds ratio [OR] = 1.09, p < 0.01). At the event level, there was no greater likelihood of drinking during last condomless sex as compared to last condom sex, χ² (1) = 0.18, p = 0.39.

Conclusions: There was evidence that an increase in alcohol use problems was associated with a greater likelihood of risky sexual behavior. Drinking before/during sex was not related to condom use. These findings contribute to understanding the nuanced relationship between alcohol use and sexual risk.