Skip to main content

Advertisement

SpringerLink
Log in

Meta-Analysis of Alcohol and Serodiscordant Condomless Sex Among People Living with HIV

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

While observational studies have found that alcohol consumption is associated with serodiscordant condomless sex among people living with HIV (PLHIV), no meta-analysis has yet examined this trend. We conducted a meta-analysis to synthesize empirical evidence on the association between alcohol and condomless sex with partners at risk of HIV acquisition. To meet inclusion criteria, studies: (1) specifically targeted PLHIV or provided stratified data for HIV-infected participants; (2) provided a quantitative measure of alcohol use; (3) provided a quantitative measure of condomless sex with serodiscordant partners; and (4) reported the results of statistical tests examining the relationship between alcohol use and serodiscordant condomless sex. Using random-effects models, weighted effect sizes were calculated. Three separate analyses were conducted to examine serodiscordant condomless sex in association with any alcohol consumption, binge/problematic drinking, and alcohol in a sexual context. A total of 36 independent effect sizes from 27 studies (including 25,065 HIV-infected participants) were pooled in the meta-analysis. Any alcohol consumption, binge/problematic drinking, and alcohol use in a sexual context were each associated with condomless sex with serodiscordant partners [OR 1.64 (95% CI 1.46–1.85); OR 1.65 (95% CI 1.14–2.39); OR 2.88 (95% CI 2.01–4.12), respectively]. Meta-analytic findings demonstrate a consistent positive relationship between alcohol use and serodiscordant condomless sex among PLHIV. Future public health programming for HIV-infected individuals needs to address the role of alcohol consumption in sexual risk-taking behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

References marked with an asterisk indicate studies included in the meta-analysis

  • *Aidala, A. A., Lee, G., Garbers, S., & Chiasson, M. A. (2006). Sexual behaviors and sexual risk in a prospective cohort of HIV-positive men and women in New York City, 1994–2002: Implications for prevention. AIDS Education and Prevention, 18, 12–32.

    Article  PubMed  Google Scholar 

  • Azar, M. M., Springer, S. A., Meyer, J. P., & Altice, F. L. (2010). A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug and Alcohol Dependence, 112(3), 178–193.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baeten, J. M., Donnell, D., Ndase, P., Mugo, N. R., Campbell, J. D., Wangisi, J., … Partners PrEP Study Team. (2012). Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine, 367, 399–410.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bagby, G. J., Amedee, A. M., Siggins, R. W., Molina, P. E., Nelson, S., & Veazey, R. S. (2015). Alcohol and HIV effects on the immune system. Alcohol Research, 37(2), 287–297.

    PubMed  PubMed Central  Google Scholar 

  • Baggaley, R. F., White, R. G., & Boily, M. C. (2010). HIV transmission risk through anal intercourse: Systematic review, meta-analysis and implications for HIV prevention. International Journal of Epidemiology, 9(4), 1048–1063.

    Article  Google Scholar 

  • Bajunirwe, F., Bangsberg, D. R., & Sethi, A. K. (2013). Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda. BMC Public Health, 13, 430.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baliunas, D., Rehm, J., Irving, H., & Shuper, P. (2010). Alcohol consumption and risk of incident human immunodeficiency virus infection: A meta-analysis. International Journal of Public Health, 55(3), 159–166.

    Article  PubMed  Google Scholar 

  • *Beckett, M., Burnam, A., Collins, R. L., Kanouse, D. E., & Beckman, R. (2003). Substance use and high-risk sex among people with HIV: A comparison across exposure groups. AIDS and Behavior, 7(2), 209–219.

    Article  PubMed  Google Scholar 

  • Begg, C. B., & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4), 1088–1101.

    Article  PubMed  Google Scholar 

  • *Benotsch, E. G., Kalichman, S. C., & Pinkerton, S. D. (2001). Sexual compulsivity in HIV-positive men and women: Prevalence, predictors, and consequences of high-risk behaviors. Sexual Addiction & Compulsivity, 8, 83–99.

    Article  Google Scholar 

  • Blair, J. M., Fagan, J. L., Frazier, E. L., Do, A., Bradley, H., Valverde, E. E., … Skarbinski, J. (2014). Behavioral and clinical characteristics of persons receiving medical care for HIV infection—Medical Monitoring Project, United States, 2009. Morbidity and Mortality Weekly Report, 63(Suppl. 5), 1–22.

  • *Bouhnik, A. D., Préau, M., Lert, F., Peretti-Watel, P., Schiltz, M. A., Obadia, Y., … VESPA Study Group. (2007a). Unsafe sex in regular partnerships among heterosexual persons living with HIV: Evidence from a large representative sample of individuals attending outpatients services in France (ANRS-EN12-VESPA Study). AIDS, 21(Suppl. 1), S57–S62.

    Article  PubMed  Google Scholar 

  • *Bouhnik, A. D., Préau, M., Schiltz, M. A., Lert, F., Obadia, Y., Spire, B., & VESPA Study Group. (2007b). Unprotected sex in regular partnerships among homosexual men living with HIV: A comparison between sero-nonconcordant and seroconcordant couples (ANRS-EN12-VESPA Study). AIDS, 21(Suppl. 1), S43–S48.

    Article  PubMed  Google Scholar 

  • *Brennan, D. J., Welles, S. L., Miner, M. H., Ross, M. W., Rosser, B. R., & Team, Positive Connections. (2010). HIV treatment optimism and unsafe anal intercourse among HIV-positive men who have sex with men: Findings from the positive connections study. AIDS Education and Prevention, 22, 26–37.

    Google Scholar 

  • *Bruce, D., Kahana, S., Harper, G. W., & Fernández, M. I. (2013). Alcohol use predicts sexual risk behavior with HIV-negative or partners of unknown status among young HIV-positive men who have sex with men. AIDS Care, 25, 559–565.

    Article  PubMed  Google Scholar 

  • Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Retrieved from http://www.samhsa.gov/data.

  • Chander, G., Lau, B., & Moore, R. D. (2006). Hazardous alcohol use: A risk factor for non-adherence and lack of suppression in HIV infection. Journal of Acquired Immune Deficiency Syndromes, 43, 411–417.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chen, Y. H., Vallabhaneni, S., Raymond, H. F., & McFarland, W. (2012). Predictors of serosorting and intention to serosort among men who have sex with men, San Francisco. AIDS Education and Prevention, 24(6), 564–573.

    Article  PubMed  Google Scholar 

  • *Chin-Hong, P. V., Deeks, S. G., Liegler, T., Hagos, E., Krone, M. R., Grant, R. M., & Martin, J. N. (2005). High-risk sexual behavior in adults with genotypically proven antiretroviral-resistant HIV infection. Journal of Acquired Immune Deficiency Syndromes, 40, 463–471.

    Article  PubMed  Google Scholar 

  • *Clarke, A., Kerr, S., Honeybrook, A., Cooper, D. A., Avihingsanon, A., Duncombe, C., … Kaldor, J. (2012). Adherence and risk behaviour in patients with HIV infection receiving antiretroviral therapy in Bangkok. Open Virology Journal, 6, 23–28.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., … HPTN 052 Study Team. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365, 493–505.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cook, R. L., & Clark, D. B. (2005). Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually Transmitted Diseases, 32, 156–164.

    Article  PubMed  Google Scholar 

  • Crepaz, N., Marks, G., Liau, A., Mullins, M. M., Aupont, L. W., Marshall, K. J., … HIV/AIDS Prevention Research Synthesis (PRS) Team. (2009). Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: A meta-analysis. AIDS, 23, 1617–1629.

    Article  PubMed  Google Scholar 

  • Davey, D. J., Kilembe, W., Wall, K. M., Khu, N. H., Brill, I., Vwalika, B., … Gorbach, P. M. (2017). Risky sex and HIV acquisition among HIV serodiscordant couples in Zambia, 2002–2012: What does alcohol have to do with it? AIDS and Behavior, 21, 1892–1903. doi:10.1007/s10461-017-1733-6.

    Article  Google Scholar 

  • Dia, A., Marcellin, F., Bonono, R. C., Boyer, S., Bouhnik, A. D., Protopopescu, C., … EVAL Study Group. (2010). Prevalence of unsafe sex with one’s steady partner either HIV-negative or of unknown HIV status and associated determinants in Cameroon (EVAL ANRS12-116 survey). Sexually Transmitted Infections, 86, 148–154.

    Article  PubMed  Google Scholar 

  • Doyle, J. S., Degenhardt, L., Pedrana, A. E., McBryde, E. S., Guy, R. J., Stoové, M. A., … Hellard, M. E. (2014). Effects of HIV antiretroviral therapy on sexual and injecting risk-taking behavior: A systematic review and meta-analysis. Clinical Infectious Diseases, 59, 1483–1494.

    Article  PubMed  Google Scholar 

  • Eaton, L. A., & Kalichman, S. C. (2009). Changes in transmission risk behaviors across stages of HIV disease among people living with HIV. Journal of the Association of Nurses in AIDS Care, 20, 39–49.

    Article  PubMed  PubMed Central  Google Scholar 

  • Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315, 629–634.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fisher, J. C., Cook, P. A., & Kapiga, S. H. (2010). Alcohol use before sex and HIV risk: Situational characteristics of protected and unprotected encounters among high-risk African women. Sexually Transmitted Diseases, 37, 571–578.

    Article  PubMed  Google Scholar 

  • Fox, J., White, P. J., Macdonald, N., Weber, J., McClure, M., Fidler, S., & Ward, H. (2009). Reductions in HIV transmission risk behaviour following diagnosis of primary HIV infection: A cohort of high-risk men who have sex with men. HIV Medicine, 10, 432–438.

    Article  PubMed  Google Scholar 

  • *Friedman, M. S., Marshal, M. P., Stall, R., Kidder, D. P., Henny, K. D., Courtenay-Quirk, C., … Holtgrave, D. R. (2009). Associations between substance use, sexual risk taking and HIV treatment adherence among homeless people living with HIV. AIDS Care, 21, 692–700.

    Article  PubMed  Google Scholar 

  • Gerbi, G. B., Habtemariam, T., Tameru, B., Nganwa, D., & Robnett, V. (2011). A comparative study of substance use before and after establishing HIV infection status among people living with HIV/AIDS. Journal of Substance Use, 16, 464–475.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Golin, C., Marks, G., Wright, J., Gerkovich, M., Tien, H. C., Patel, S. N., … Quinlivan, E. B. (2009). Psychosocial characteristics and sexual behaviors of people in care for HIV infection: An examination of men who have sex with men, heterosexual men and women. AIDS and Behavior, 13, 1129–1142.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gorbach, P. M., Weiss, R. E., Jeffries, R., Javanbakht, M., Drumright, L. N., Daar, E. S., & Little, S. J. (2011). Behaviors of recently HIV-infected men who have sex with men in the year postdiagnosis: Effects of drug use and partner types. Journal of Acquired Immune Deficiency Syndromes, 56, 176–182.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., … iPrEx Study Team. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363, 2587–2599.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Hasse, B., Ledergerber, B., Hirschel, B., Vernazza, P., Glass, T. R., Jeannin, A., … Swiss HIV Cohort Study. (2010). Frequency and determinants of unprotected sex among HIV-infected persons: The Swiss HIV Cohort Study. Clinical Infectious Diseases, 11, 1314–1322.

    Google Scholar 

  • *Hatfield, L. A., Horvath, K. J., Jacoby, S. M., & Simon Rosser, B. R. (2009). Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men. Journal of Addictive Diseases, 28, 208–218.

    Article  PubMed  PubMed Central  Google Scholar 

  • Heijman, T., Geskus, R. B., Davidovich, U., Coutinho, R. A., Prins, M., & Stolte, I. G. (2012). Less decrease in risk behaviour from pre-HIV to post-HIV seroconversion among MSM in the combination antiretroviral therapy era compared with the pre-combination antiretroviral therapy era. AIDS, 26, 489–495.

    Article  PubMed  Google Scholar 

  • Hess, K. L., Chavez, P. R., Kanny, D., DiNenno, E., Lansky, A., Paz-Bailey, G., & NHBS Study Group. (2015). Binge drinking and risky sexual behavior among HIV-negative and unknown HIV status men who have sex with men, 20 US cities. Drug and Alcohol Dependence, 147, 46–52.

    Article  PubMed  Google Scholar 

  • Higgins, J. P. T., & Green, S. (Eds.). (2006). Cochrane handbook for systematic reviews of interventions. Chichester, UK: Wiley.

    Google Scholar 

  • Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557–560.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jin, F., Jansson, J., Law, M., Prestage, G. P., Zablotska, I., Imrie, J. C., … Wilson, D. P. (2010). Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS, 24, 907–913.

    Article  PubMed  PubMed Central  Google Scholar 

  • Julio, R. S., Friedman, R. K., Cunha, C. B., De Boni, R. B., Cardoso, S. W., Torres, T., … Grinsztejn, B. (2015). Unprotected sexual practices among men who have sex with women and men who have sex with men living with HIV/AIDS in Rio de Janeiro. Archives of Sexual Behavior, 44, 357–365.

    Article  PubMed  Google Scholar 

  • *Kahler, C. W., Wray, T. B., Pantalone, D. W., Kruis, R. D., Mastroleo, N. R., Monti, P. M., & Mayer, K. H. (2015a). Daily associations between alcohol use and unprotected anal sex among heavy drinking HIV-positive men who have sex with men. AIDS and Behavior, 19, 422–430.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kahler, C. W., Wray, T. B., Pantalone, D. W., Mastroleo, N. R., Kruis, R. D., Mayer, K. H., & Monti, P. M. (2015b). Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men. Psychology of Addictive Behaviors, 29, 247–253.

    Article  PubMed  Google Scholar 

  • *Kalichman, S. C., Cherry, C., Kalichman, M. O., Amaral, C., White, D., Grebler, T., … Schinazi, R. F. (2011). Sexual HIV transmission and antiretroviral therapy: A prospective cohort study of behavioral risk factors among men and women living with HIV/AIDS. Annals of Behavioral Medicine, 42, 111–119.

    Article  PubMed  Google Scholar 

  • *Kalichman, S. C., Simbayi, L. C., & Cain, D. (2010). HIV transmission risk behaviours among HIV seropositive sexually transmitted infection clinic patients in Cape Town, South Africa. European Journal of Public Health, 20, 202–206.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Weinhardt, L., DiFonzo, K., Austin, J., & Luke, W. (2002). Sensation seeking and alcohol use as markers of sexual transmission risk behavior in HIV-positive men. Annals of Behavioral Medicine, 24, 229–235.

    Article  PubMed  Google Scholar 

  • Kelly, C., Lohan, M., Alderdice, F., & Spence, D. (2011). Negotiation of risk in sexual relationships and reproductive decision-making amongst HIV sero-different couples. Culture, Health, & Sexuality, 13(7), 815–827.

    Article  Google Scholar 

  • Khosropour, C. M., Dombrowski, J. C., Kerani, R. P., Katz, D. A., Barbee, L. A., & Golden, M. R. (2016). Changes in condomless sex and serosorting among men who have sex with men after HIV diagnosis. Journal of Acquired Immune Deficiency Syndromes, 73, 475–481.

    Article  PubMed  Google Scholar 

  • Kutner, B. A., Nelson, K. M., Simoni, J. M., Sauceda, J. A., & Wiebe, J. S. (2017). Factors associated with sexual risk of HIV transmission among HIV-positive Latino men who have sex with men on the U.S.-Mexico border. AIDS and Behavior, 21(3), 923–934.

    Article  PubMed  PubMed Central  Google Scholar 

  • Levy, M. E., Phillips, G., II, Magnus, M., Kuo, I., Beauchamp, G., Emel, L., … Mayer, K. (2017). A longitudinal analysis of treatment optimism and HIV acquisition and transmission risk behaviors among black men who have sex with men in HPTN 061. AIDS and Behavior. doi:10.1007/s10461-017-1756-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lipsey, M., & Wilson, D. (2001). Practical meta-analysis. Thousand Oaks, CA: Sage.

    Google Scholar 

  • *Long, C. A., Vance, D. E., & Antia, L. A. (2009). A descriptive study of empowerment and sexual decision making in HIV-positive African-American women. Psychological Reports, 104, 482–488.

    Article  PubMed  Google Scholar 

  • Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., & Schum, J. L. (2004). Effects of alcohol and expectancies on HIV-related risk perception and behavioral skills in heterosexual women. Experimental and Clinical Psychopharmacology, 12, 288–297.

    Article  PubMed  PubMed Central  Google Scholar 

  • Maisto, S. A., McGinnis, K., Cook, R., Conigliaro, J., Bryant, K., & Justice, A. C. (2010). Factor structure of Leigh’s (1990) alcohol sex expectancies scale in individuals in treatment for HIV disease. AIDS and Behavior, 14, 174–180.

    Article  PubMed  Google Scholar 

  • Maisto, S. A., Palfai, T., Vanable, P. A., Heath, J., & Woolf-King, S. E. (2012). The effects of alcohol and sexual arousal on determinants of sexual risk in men who have sex with men. Archives of Sexual Behavior, 41, 971–986.

    Article  PubMed  Google Scholar 

  • *Martin, A. M., Benotsch, E. G., Perschbacher Lance, S., & Green, M. (2013). Transmission risk behaviors in a subset of HIV-positive individuals: The role of narcissistic personality features. Personality and Individual Differences, 54, 256–260.

    Article  Google Scholar 

  • McKirnan, D. J., Vanable, P. A., & Ostrow, D. G. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13(1–2), 137–154.

    Article  PubMed  Google Scholar 

  • *Metsch, L. R., Bell, C., Pereyra, M., Cardenas, G., Sullivan, T., Rodriguez, A., … del Rio, C. (2009). Hospitalized HIV-infected patients in the era of highly active antiretroviral therapy. American Journal of Public Health, 99, 1045–1049.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mitchell, J. W. (2013). HIV-negative and HIV-discordant gay male couples’ use of HIV risk-reduction strategies: Differences by partner type and couples’ HIV-status. AIDS and Behavior, 17(4), 1557–1569.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mizuno, Y., Purcell, D. W., Latka, M. H., Metsch, L. R., Ding, H., Gomez, C. A., & Knowlton, A. R. (2010). Is sexual serosorting occurring among HIV-positive injection drug users? Comparison between those with HIV-positive partners only, HIV-negative partners only, and those with any partners of unknown status. AIDS and Behavior, 14, 92–102.

    Article  PubMed  Google Scholar 

  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLOS Medicine, 6, e1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Morin, S. F., Steward, W. T., Charlebois, E. D., Remien, R. H., Pinkerton, S. D., Johnson, M. O., … Chesney, M. A. (2005). Predicting HIV transmission risk among HIV-infected men who have sex with men: Findings from the healthy living project. Journal of Acquired Immune Deficiency Syndromes, 40, 226–235.

    Article  PubMed  Google Scholar 

  • National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health. (2005). Helping patients who drink too much. A clinician’s guide. Washington, DC: National Institutes of Health, US Department of Health and Human Services.

    Book  Google Scholar 

  • National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health. (2008). Alcohol research: A lifespan perspective. Retrieved from http://pubs.niaaa.nih.gov/publications/AA74/AA74.htm.

  • O’Dell, B. L., Rosser, B. R., Miner, M. H., & Jacoby, S. M. (2008). HIV prevention altruism and sexual risk behavior in HIV-positive men who have sex with men. AIDS and Behavior, 12, 713–720.

    Article  PubMed  Google Scholar 

  • O’Leary, A., & Hatzenbuehler, M. (2009). Alcohol and AIDS. In P. Korsmeyer & H. R. Kranzler (Eds.), Addictive behaviors (3rd ed., pp. 104–111). Detroit, MI: Macmillan.

    Google Scholar 

  • Pantalone, D. W., Tomassilli, J. C., Starks, T. J., Golub, S. A., & Parsons, J. T. (2015). Unprotected anal intercourse with casual male partners in urban gay, bisexual, and other men who have sex with men. American Journal of Public Health, 105, 103–110.

    Article  PubMed  PubMed Central  Google Scholar 

  • Parks, K. A., Hsieh, Y. P., Collins, R. L., & Levonyan-Radloff, K. (2011). Daily assessment of alcohol consumption and condom use with known and casual partners among young female bar drinkers. AIDS and Behavior, 15, 1332–1341.

    Article  PubMed  PubMed Central  Google Scholar 

  • Patel, P., Borkowf, C. B., Brooks, J. T., Lasry, A., Lansky, A., & Mermin, J. (2014). Estimating per-act HIV transmission risk: A systematic review. AIDS, 28, 1509–1519.

    Article  PubMed  Google Scholar 

  • Perry, N. S., Taylor, S. W., Elsesser, S., Safren, S. A., & O’Cleirigh, C. (2016). The predominant relationship between sexual environment characteristics and HIV-serodiscordant condomless anal sex among HIV-positive men who have sex with men (MSM). AIDS and Behavior, 20, 1228–1235.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prestage, G., Mao, L., Kippax, S., Jin, F., Hurley, M., Grulich, A., … Zablotska, I. (2009). Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS and Behavior, 13, 645–651.

    Article  PubMed  Google Scholar 

  • Przybyla, S., Golin, C., Widman, L., Grodensky, C., Earp, J. A., & Suchindran, C. (2014). Examining the role of serostatus disclosure on unprotected sex among people living with HIV. AIDS Patient Care & STDS, 28, 677–684.

    Article  Google Scholar 

  • *Purcell, D. W., Moss, S., Remien, R. H., Woods, W. J., & Parsons, J. T. (2005). Illicit substance use, sexual risk, and HIV-positive gay and bisexual men: Differences by serostatus of casual partners. AIDS, 19(Suppl. 1), S37–S47.

    Article  PubMed  Google Scholar 

  • *Purcell, D. W., Parsons, J. T., Halkitis, P. N., Mizuno, Y., & Woods, W. J. (2001). Substance use and sexual transmission risk behavior of HIV-positive men who have sex with men. Journal of Substance Abuse, 13, 185–200.

    Article  PubMed  Google Scholar 

  • Rehm, J., Probst, C., Shield, K. D., & Shuper, P. A. (2017). Does alcohol use have a causal effect on HIV incidence and disease progression? A review of the literature and a modeling strategy for quantifying the effect. Population Health Metrics, 15(1), 4. doi:10.1186/s12963-017-0121-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Riley, R. D., Higgins, J. P., & Deeks, J. J. (2011). Interpretation of random effects meta-analyses. British Medical Journal, 342, d549.

    Article  PubMed  Google Scholar 

  • Rosenberg, E. S., Millett, G. A., Sullivan, P. S., Del Rio, C., & Curran, J. W. (2014). Understanding the HIV disparities between black and white men who have sex with men in the USA using the HIV care continuum: A modeling study. Lancet HIV, 1(3), e112–e118.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sales, J. M., Brown, J. L., Vissman, A. T., & DiClemente, R. J. (2012). The association between alcohol use and sexual risk behaviors among African American women across three developmental periods: A review. Current Drug Abuse Reviews, 5, 117–128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scott-Sheldon, L. A., Carey, K. B., Cunningham, K., Johnson, B. T., Carey, M. P., & MASH Research Team. (2016). Alcohol use predicts sexual decision-making: A systematic review and meta-analysis of the experimental literature. AIDS and Behavior, 20(Suppl. 1), 19–39.

    Article  PubMed Central  Google Scholar 

  • Scott-Sheldon, L. A., Walstrom, P., Carey, K. B., Johnson, B. T., Carey, M. P., & MASH Research Team. (2013). Alcohol use and sexual risk behaviors among individuals infected with HIV: A systematic review and meta-analysis 2012 to early 2013. Current HIV/AIDS Reports, 10, 314–323.

    Article  PubMed  PubMed Central  Google Scholar 

  • Seth, P., Wingood, G. M., DiClemente, R. J., & Robinson, L. S. (2011). Alcohol use as a marker for risky sexual behaviors and biologically confirmed sexually transmitted infections among young adult African-American women. Women’s Health Issues, 21, 130–135.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shuper, P. A., Joharchi, N., Irving, H., & Rehm, J. (2009). Alcohol as a correlate of unprotected sexual behavior among people living with HIV/AIDS: Review and meta-analysis. AIDS and Behavior, 13, 1021–1036.

    Article  PubMed  Google Scholar 

  • Shuper, P. A., Joharchi, N., & Rehm, J. (2014). Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: A systematic review. AIDS and Behavior, 18, 398–410.

    Article  PubMed  Google Scholar 

  • Shuper, P. A., Joharchi, N., & Rehm, J. (2016). Protocol for a controlled experiment to identify the causal role of acute alcohol consumption in condomless sex among HIV-positive MSM: Study procedures, ethical considerations, and implications for HIV prevention. AIDS and Behavior, 20, 173–184.

    Article  PubMed Central  Google Scholar 

  • Shuper, P. A., Neuman, M., Kanteres, F., Baliunas, D., Joharchi, N., & Rehm, J. (2010). Causal considerations on alcohol and HIV/AIDS—A systematic review. Alcohol and Alcoholism, 45(2), 159–166.

    Article  PubMed  Google Scholar 

  • *Sikkema, K. J., Hansen, N. B., Meade, C. S., Kochman, A., & Fox, A. M. (2009). Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood. Archives of Sexual Behavior, 38, 121–134.

    Article  PubMed  Google Scholar 

  • Skarbinski, J., Rosenberg, E., Paz-Bailey, G., Hall, H. I., Rose, C. E., Viall, A. H., & Mermin, J. H. (2015). Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Internal Medicine, 175(4), 588–596.

    Article  PubMed  Google Scholar 

  • *Skeer, M. R., Mimiaga, M. J., Mayer, K. H., O’Cleirigh, C., Covahey, C., & Safren, S. A. (2012). Patterns of substance use among a large urban cohort of HIV-infected men who have sex with men in primary care. AIDS and Behavior, 16, 676–689.

    Article  PubMed  PubMed Central  Google Scholar 

  • Starks, T. J., Millar, B. M., & Parsons, J. T. (2015). Predictors of condom use with main and casual partners among HIV-positive men over 50. Health Psychology, 34, 1116–1122.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steele, C. M., & Josephs, R. A. (1990). Alcohol myopia: Its prized and dangerous effects. American Psychologist, 45, 921–933.

    Article  PubMed  Google Scholar 

  • Sterne, J. A. C., Newton, H. J., & Cox, N. J. (2009). Meta-analysis in Stata: An updated collection from the Stata journal. College Station, TX: Stata Press Publications.

    Google Scholar 

  • Steward, W. T., Remien, R. H., Higgins, J. A., Dubrow, R., Pinkerton, S. D., Sikkema, K. J., … Morin, S. F. (2009). Behavior change following diagnosis with acute/early HIV infection-a move to serosorting with other HIV-infected individuals: The NIMH Multisite Acute HIV Infection Study: III. AIDS and Behavior, 13, 1054–1060.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Tieu, H. V., Nandi, V., Frye, V., Stewart, K., Oquendo, H., Bush, B., … NYC M2M Study Team. (2014). Concurrent partnerships and HIV risk among men who have sex with men in New York City. Sexually Transmitted Diseases, 41, 200–208.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Tieu, H. V., Xu, G., Bonner, S., Spikes, P., Egan, J. E., Goodman, K., … Koblin, B. A. (2011). Sexual partner characteristics, serodiscordant/serostatus unknown unprotected anal intercourse and disclosure among human immunodeficiency virus-infected and uninfected black men who have sex with men in New York City. Sexually Transmitted Diseases, 38, 548–554.

    PubMed  Google Scholar 

  • UNAIDS. (2016). Fact Sheet November 2016. Retrieved from http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf.

  • Van Den Boom, W., Stolte, I. G., Witlox, R., Sandfort, T., Prins, M., & Davidovich, U. (2013). Undetectable viral load and the decision to engage in unprotected anal intercourse among HIV-positive MSM. AIDS and Behavior, 17, 2136–2142.

    Article  PubMed Central  Google Scholar 

  • Venkatesh, K. K., De Bruyn, G., Lurie, M. N., Modisenyane, T., Triche, E. W., Gray, G. E., … Martinson, N. A. (2012). Sexual risk behaviors among HIV-infected South African men and women with their partners in a primary care program: Implications for couples-based prevention. AIDS and Behavior, 16, 139–150.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vosburgh, H. W., Mansergh, G., Sullivan, P. S., & Purcell, D. W. (2012). A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS and Behavior, 16, 1394–1410.

    Article  PubMed  Google Scholar 

  • Wen, X. J., Balluz, L., & Town, M. (2012). Prevalence of HIV risk behaviors between binge drinkers and non-binge drinkers aged 18- to 64-years in US, 2008. Journal of Community Health, 37, 72–79.

    Article  PubMed  Google Scholar 

  • Widman, L., Golin, C. E., Grodensky, C. A., & Suchindran, C. (2013a). Do safer sex self-efficacy, attitudes toward condoms, and HIV transmission risk beliefs differ among men who have sex with men, heterosexual men, and women living with HIV? AIDS and Behavior, 17, 1873–1882.

    Article  PubMed  PubMed Central  Google Scholar 

  • Widman, L., Golin, C. E., & Noar, S. M. (2013b). When do condom use intentions lead to actions? Examining the role of sexual communication on safer sexual behavior among people living with HIV. Journal of Health Psychology, 18, 507–517.

    Article  PubMed  Google Scholar 

  • Wilson, P. A., Kahana, S. Y., Fernandez, M. I., Harper, G. W., Mayer, K., Wilson, C. M., & Hightow-Weidman, L. B. (2015). Sexual risk behavior among virologically detectable human immunodeficiency virus-infected young men who have sex with men. JAMA Pediatrics, 7, 1–7.

    Google Scholar 

  • Woolf-King, S. E., Rice, T. M., Truong, H. M., Woods, W. J., Jerome, R. C., & Carrico, A. W. (2013). Substance use and HIV risk behavior among men who have sex with men: The role of sexual compulsivity. Journal of Urban Health, 90(5), 948–952.

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organization. (2014). Global status report on alcohol and health. Retrieved from http://apps.who.int/iris/bitstream/10665/112736/1/9789240692763_eng.pdf.

  • *Yaya, I., Saka, B., Landoh, D. E., Makawa, M. S., Senanou, S., Idrissou, D., … Pitche, P. (2014). Sexual risk behavior among people living with HIV and AIDS on antiretroviral therapy at the regional hospital of Sokodé, Togo. BMC Public Health, 14, 636.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (T32-AA007583, PI: Leonard). The sponsor had no role in the study design, writing of the report, or collection, analysis, and interpretation of the data.

Author information

Authors and Affiliations

  1. Department of Community Health and Health Behavior, University at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA

    Sarahmona M. Przybyla & Gabriela Krawiec

  2. Department of Psychology, Rochester Institute of Technology, Rochester, NY, USA

    Stephanie A. Godleski

  3. Biomedical Sciences, Rochester Institute of Technology, Rochester, NY, USA

    Cory A. Crane

Authors
  1. Sarahmona M. Przybyla
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gabriela Krawiec
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie A. Godleski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cory A. Crane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarahmona M. Przybyla.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Appendix: Search Terms

Appendix: Search Terms

For PubMed, search terms were: (“alcohol drinking”[mh] OR liquor OR alcohol[tiab] OR “substance use”[tiab] OR binge[tiab] OR drink*[tiab]) AND AIDS[sb] AND (sex[tiab] OR condom*[tiab] OR “unprotected sex”[tiab] OR “unsafe sex”[tiab] OR “risky sex”[tiab] OR sexual partner*[tiab] OR sexual behavior[tiab] OR “condomless sex”[tiab] OR “serodiscordant”[tiab] OR discordant[tiab] OR intercourse[tiab]).

For EMBASE, search terms were: (“alcohol drinking” OR liquor OR alcohol OR “substance use” OR binge OR drink*) AND (AIDS OR HIV OR “acquired immune deficiency syndrome” OR “Human immunodeficiency virus”) AND (sex OR condom* OR “unprotected sex” OR “unsafe sex” OR “risky sex” OR sexual partner* OR sexual behavior OR “condomless sex” OR “serodiscordant” OR discordant).

For PsycINFO, search terms were: AB (hiv OR AIDS OR human immunodeficiency virus OR acquired immune deficiency syndrome) AND AB (alcohol OR drink* OR binge OR substance use) AND (sex OR unprotected OR unsafe OR risk* OR “sexual partner*” OR “condomless sex” OR intercourse OR condom* OR serodiscordant OR discordant).

For CINAHL, search terms were: S1: AB hiv OR AB aids OR AB human immunodeficiency virus OR AB acquired immune deficiency syndrome; S2: AB alcohol OR AB binge OR AB drink* OR AB substance use; S3: (S1 AND S2); S4: (S3) AND AB sex OR AB unprotected OR AB unsafe OR AB risk* OR AB sexual partner* OR AB “condomless sex” OR AB condom* OR AB serodiscordant OR AB discordant OR intercourse; S5: (S3 AND S4).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Przybyla, S.M., Krawiec, G., Godleski, S.A. et al. Meta-Analysis of Alcohol and Serodiscordant Condomless Sex Among People Living with HIV. Arch Sex Behav 47, 1351–1366 (2018). https://doi.org/10.1007/s10508-017-1050-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-017-1050-1

Keywords

Search

Navigation