HIV-positive men who seek new experiences and think alcohol improves sex are more likely to have unprotected sex, according to a new study. Most HIV prevention programs target risk-takers who are not already infected. Many of the same factors that motivate risky behavior in the uninfected may be present in those who could potentially infect them, says Seth C. Kalichman, Ph.D., who conducted the study while at the Medical College of Wisconsin.
The research by Kalichman, now a professor of social psychology at the University of Connecticut, and his colleagues appears in the August issue of the Annals of Behavioral Medicine.
"In general populations there is evidence that the relationship between substance use and sexual risk behavior is at least in part explained by personality dispositions that motivate multiple risk-taking behaviors," Kalichman says. He uses the term "sensation seeking" to describe the tendency to seek out highly arousing sensory stimulation.
In their study, Kalichman and colleagues found that HIV-positive men who were sensation seekers were more likely to have unprotected sex, regardless of alcohol use, while alcohol use also predicted unsafe sex, independent of sensation seeking.
Alcohol did play a role in driving sensation seekers to engage in risky sex if they believed that drinking would enhance their sexual experience, the researchers report.
The latter finding may offer insight into improving tactics for reducing risky behavior in HIV-positive men. "Cognitive approaches to challenging beliefs about the effects of alcohol on sexual performance and arousal can be incorporated into existing risk reduction interventions," the researchers say.
Study data was collected on 197 HIV-positive men in Atlanta. The majority of the men were black and 66 percent said they were gay.
Statements such as "I would like to try bungee jumping" and "I get bored seeing the same old faces" were used to assess sensation-seeking tendencies. Statements like "sex is better after I have been drinking" and "drinking helps me relax about having sex" were used to assess men's beliefs about alcohol and sex.
Twenty-eight percent of the men reported engaging in unprotected sex in the previous three months. Eleven percent of the men had unprotected sex with multiple partners during that period.
"There are several reasons why associations among sensation seeking, alcohol use and sexual risk behaviors observed in HIV-negative populations may not generalize to HIV-infected populations," Kalichman says. "The social context of sexual behavior and substance use is markedly different for people who know that they are HIV infected."
"Even if sensation seeking were a prevalent characteristic in populations of people living with HIV/AIDS, the influence of sensation seeking on risk behavior may be dampened by health circumstances of living with HIV/AIDS," he says.
