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).

Conclusions: 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.