8th International AIDS Conference Amsterdam, Netherlands — July 19-24, 1992

Int Conf AIDS 1992 Jul 19-24; 8:We50 (abstract no. WeC 1029)
Weatherburn P, Davies PM, Hunt AJ, Hickson F, Coxon AP, McManus TJ; South Bank Polytechnic, London, UK.

OBJECTIVES: To test the hypothesis that alcohol use causes, or contributes towards engagement in 'unsafe' sex in a sample of homosexually active men in England & Wales.

METHOD: In 1991 430 homosexually active men were interviewed and asked to recall each sexual encounter and each drinking episode in the previous week. Detailed information included when and where sex occurred, with causal or regular partners, what precise sex acts were involved, and whether condoms were used for anal intercourse. For drinking episodes the time was noted, with the number of units of alcohol and the perceived effect. Data were recorded during face-to-face interviews using a weekly diary for both alcohol use and sexual behaviour.

RESULTS: The 3010 days of diary data (430 persons at 7 days each) include 1564 drinking sessions and 812 dyadic sexual sessions. Of the 812 dyadic sexual sessions 23.2% (n = 188) involve anal intercourse: 11.1% (n = 90) receptive anal intercourse and 12.1% (n = 98) insertive. There are 250 sessions where drinking and sexual behaviour co-occur, that is, sex is directly preceded by alcohol consumption. Of these 250 sexual sessions 23.2% (n = 58) include anal intercourse: 11.9% (n = 30) receptive anal intercourse and 11.2% (n = 28) insertive. The proportion of men who engaged in receptive or insertive anal intercourse when under the influence of alcohol was statistically indistinguishable from those who did so when sober. Overall data on incidence of condom use reveal that 48% use a condom for receptive anal intercourse and 46% use one for insertive. In comparison when drinking and anal intercourse co-occur 57% use condoms for receptive and 46% use for insertive.

CONCLUSIONS: This study shows that alcohol use does not increase engagement in anal intercourse, or decrease condom use. It also highlights the very low incidence of anal intercourse with causal partners.

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