Safe sexual behavior among HIV-positive individuals is key to preventing the spread of HIV. With currently available treatments, those infected with the virus are living longer lives, and sexual activity is a part of those lives. Most sexually active individuals living with the virus have only safer sex (i.e., use condoms for vaginal and anal intercourse), but it is estimated that approximately 1 in 3 has sex without a condom at least once in any six month period. A key correlate of unprotected sex in the HIV-positive population (and the general population) is alcohol consumption. Although causal effects are uncertain, drinking, and particularly drinking in conjunction with sexual activity, may decrease the likelihood that a condom is used. Because alcohol prices, taxes, and policies (""""""""structures"""""""") influence both drinking and negative outcomes from drinking, it is likely that they also influence the probability of unprotected sex. We propose to examine this issue in a unique national sample of 1421 adults across the U.S., living with HIV. Participants were part of the HIV Cost and Services Utilization Study (HCSUS). They were interviewed in fall of 1998 as part of the Risk and Prevention (R&P) follow-up to HCSUS. R&P collected detailed data regarding sexual behavior and condom use, including participants' and their partners' use of alcohol before or during sex and a wider range of individual characteristics associated with sexual risk and safety. Data concerning alcohol consumption patterns were collected in an additional interview. We propose to merge the HCSUS and R&P data with information on geographic variations in alcohol structures at multiple levels (State, MSA, and ZIPcode) and use multi-level modeling to test whether variations in these alcohol structures can explain regional variations in sexual risk and alcohol consumption among people with HIV. Because of the unique R&P sample which allows estimates for a national population in treatment for HIV, results will provide an unparalleled opportunity to estimate the effects of alcohol policy on the behavior of thousands of HIV-positive individuals.
| Taylor, Stephanie L; Collins, Rebecca L; Elliott, Marc N et al. (2010) The relationships between states' DUI penalties and HIV-positive adults' drinking behaviors. AIDS Behav 14:870-7 |
| Collins, Rebecca L; Taylor, Stephanie L; Elliott, Marc N et al. (2010) Off-premise alcohol sales policies, drinking, and sexual risk among people living with HIV. Am J Public Health 100:1890-2 |
| Galvan, Frank H; Collins, Rebecca L; Kanouse, David E et al. (2007) Religiosity, denominational affiliation and sexual behaviors among people with HIV in the United States. J Sex Res 44:49-58 |
