The relationship of alcohol use to sexual activity in a U.S. national sample.

Recent reports have indicated that the use of alcohol is related to sexual behavior (such as unprotected intercourse) that is high-risk for HIV infection. However, most of these studies have collected data from convenience samples, using measures of varying specificity. This paper describes a study designed to investigate the relationship of alcohol use to unsafe sexual activity in a representative sample of adults. Data were collected from 2058 respondents as part of a survey of a multi-stage area probability sample of the adult household population of the 48 contiguous United States. The interview instrument included measures of alcohol use, sexual activity and condom use. Logistic regression analyses showed that heavier drinkers were more likely to be sexually active, and if sexually active, were more likely to have had more than one sexual partner in the previous year. However, drinking variables were in general not significantly related to condom use. These results suggest that alcohol use may be more strongly related to lifestyle variables (general sexual activity and number of sexual partners) than to more concrete behavioral variables such as condom use. Because these data are correlational, the findings are also consistent with the notion of a general constellation of risk-taking or sensation-seeking activities that includes alcohol use and sexual activity.

Sex, alcohol and sexually transmitted diseases: a national survey.

The analysis of a representative national survey of households provides strong evidence that alcohol overshadows illicit drug use as a risk factor for sexually transmitted diseases (STDs). Men and women who report a history of STDs are significantly more likely to have a history of problem drinking, independent of high-risk sexual activities and demographic characteristics. However, a high rate of change in sexual partners over the past five years also increases the chance of STD infection. Sexual orientation is a major STD risk factor among men but not among women. Although both black men and black women are at greater risk of STDs than are those in other racial or ethnic groups, results indicate that black women's greater likelihood of having sex with men who have multiple partners, rather than their own rates of partner change, makes the crucial difference between their risk and that of white women.

The sexual behavior of US adults: results from a national survey.

OBJECTIVES: One consequence of the acquired immunodeficiency syndrome (AIDS) epidemic has been to highlight the need for population-based estimates of the number of individuals engaging in sexual behaviors that place them at risk for human immunodeficiency virus (HIV) infection. This paper describes the prevalence of various sexual behaviors in a nationally representative sample of adults in the United States. METHODS: Data were collected as part of a household probability survey of adults (n = 2058) in the United States. Data collected on sexual behavior included sexual orientation, frequency of intercourse, condom use, and number of sexual partners. RESULTS: Nearly all respondents were sexually experienced. Of those who were currently sexually active, 13% (1% of married respondents) had had sex with more than one partner in the previous year. Of those reporting having intercourse with more than one partner in the previous year, 7% used condoms consistently and 23% used condoms consistently with their casual partners. CONCLUSIONS: A significant proportion of individuals were found to have intercourse with multiple partners without using condoms. A minority of these respondents acknowledged that their behavior may place them at risk for HIV transmission.

Illicit drug use among young adults with genital herpes.

Although an association exists between illicit drug use and sexually transmitted diseases (STDs) in known high-risk populations such as prostitutes, gay men, and intravenous drug users, little is known with respect to middle-class, heterosexual populations thought to be at less risk. We examined findings related to illicit drug use among young adults with genital herpes from a larger study of young adults' adaptation to chronic disease. In this cross-sectional retrospective study, 70 subjects age 18 to 35 years were interviewed and asked to fill out questionnaires. The sample was predominantly white, heterosexual, employed, and college educated. Responses to open-ended questions related to illicit drug use were coded and compared with findings from two other surveys: a national household survey, Pacific region, metropolitan areas; and a household survey of a San Francisco Bay area county. All but eight subjects (88.6%) reported that they had used an illicit drug at some time in the past. The median number of drugs used was 4; the maximum number was 11. Only six drug-using subjects reported that they had restricted their use to marijuana. Those with genital herpes were more likely to report ever using an illicit drug at some time in the past, and, more specifically, in the past year, than subjects in the two comparison surveys. Such findings suggest that programs screen for illicit drug use as a risk factor in middle-class young adults with genital herpes and other STDs, and for STDs in persons referred for drug abuse treatment.

Behavioral risk factors for sexually transmitted diseases in American households.

The analysis of a representative survey of households (n = 968) in a San Francisco Bay Area county provides strong evidence for the role of problem drinking as a risk factor for sexually transmitted diseases independent of drinking patterns and drug use. Among women, age, race, early age at first intercourse, history of multiple partners, drinking patterns, as well as current symptoms of problem drinking were all associated with reported STD rates. Stepwise logistic regression analysis showed, however, that female problem drinkers are nearly four and a half times more likely (adjusted O.R. = 4.65, 95% C.I. = 1.30, 16.70) than other women to have had STDs independent of all these potential risk factors. Problem drinking puts women at a greater risk for STDs than a history of multiple sex partners (adjusted O.R. = 2.75, 95% C.I. = 0.98, 7.75). This finding is also observed among men, among whom STDs were associated with a history of multiple sex partners (adjusted O.R. = 4.12, 95% C.I. = 1.90, 8.94) and the lifetime prevalence of drinking problems (adjusted O.R. = 4.95, 95% C.I. = 2.13, 11.50). Frequent bar-going, drunkenness episodes, high volume drinking, feeling disinhibited while drinking and drug use increase the risk for STDs via their effects on the rate of sex partner change. Problem drinking determines STD rates independent of these factors. The implications of these findings for future research and health policy are discussed.

Alcohol consumption and unsafe sex: a comparison of heterosexuals and homosexual men.

Recent studies have suggested that drinking in conjunction with sexual activity is related to unsafe sexual activities known to increase the risk of AIDS transmission. However, these studies have used general measures of frequency of both drinking and sexual behavior, giving insufficient information to establish that drinking and risky sex occur in the same sexual encounters. This article presents data from a mail survey of the adult population of San Francisco in which respondents were queried about the circumstances of specific sexual encounters that took place in conjunction with alcohol consumption. The results showed that subjective intoxication was related to practice of unsafe sex among homosexual men and heterosexual women but not among heterosexual men. In addition, respondents whose sexual partners were met in locations construed as "pickup" environments were more likely to practice safe sex. A focus on specific sexual events can contribute to a better understanding of the dynamics of sexual encounters and of the predictors of risky sex in these encounters.