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328352
Changes in alcohol use and changes in sexual risk behavior across four samples of STI clinic patients


Monday, November 2, 2015

Jennifer L. Walsh, PhD, Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
Lance S. Weinhardt, PhD, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Seth C. Kalichman, PhD, Department of Psychology, University of Connecticut, Storrs, CT
Michael P. Carey, PhD, Department of Psychiatry and Human Behavior, Brown University, PROVIDENCE, RI
  
Background. Patients in sexually transmitted infection (STI) clinics report high levels of alcohol use, which is associated with risky sexual behavior. However, no studies have examined how changes in alcohol use relate to changes in sexual risk behavior. We used parallel process latent growth modeling (PPLGM) to explore how changes in alcohol use related to changes in sexual behavior across four samples of clinic patients.

Methods. Patients participating in HIV prevention trials from urban clinics in the northeastern and midwestern U.S. (N=3,759, 59% male, 72% Black) completed measures at 3mo intervals over 9-12mo. Integrative data analysis was used to create composite measures of alcohol use across samples. Sexual risk measures were counts of partners and unprotected sex acts (past 1-3mo). PPLGMs tested whether alcohol use changes (slopes) were correlated with changes in number of partners and unprotected sex.

Results. LGMs with good fit showed decreases that slowed over time in sexual risk behaviors and alcohol use. PPLGMs showed positive correlations between levels of (rs=.20-.28, ps<.001) and changes in (rs=.37-.52, ps<.001) alcohol use and number of sexual partners across studies. There were strong associations between levels of (rs=.26-.43, ps<.001) and changes in (rs=.41-.73, ps<.01) alcohol use and unprotected sex only in one study recruiting hazardous drinkers. Intervention condition did not predict changes in alcohol use.

Conclusions. Across four samples, STI clinic patients who reduced alcohol use more also reduced number of sexual partners more. Interventions aiming to reduce number of partners to prevent HIV may be enhanced by addressing alcohol use.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe associations between changes in alcohol use and changes in sexual risk behavior among sexually transmitted infection clinic patients. Compare the relationship between alcohol use and sexual risk behavior in different samples of clinic patients.

Keyword(s): Sexual Risk Behavior, Alcohol Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have years of experience conducting research in the realm of HIV. I am the principal investigator of a federally-funded grant focusing on the integrative data analysis of HIV prevention trials conducted in STI clinics. This research examines factors associated with changes in sexual risk behavior among clinic patients. My scientific interests include HIV prevention and intervention, associations between multiple health behaviors, and advanced statistical methods.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: HIV and Substance Use