Effects alcoholism

Alcohol and sexsual

Sexual practices considered to be high risk for acquiring HIV from an infected individual include vaginal or anal intercourse without a condom; other sexual practices that facilitate exchange of blood, semen, or other body secretions; and unprotected sexual activities with multiple partners. The frequency with which sexual partners engage in such practices also influences the risk for exposure to HIV. Alcohol's relationship to high-risk sexual behavior may be explained in two ways. First, alcohol use may be a marker for a risk-taking temperament: those who drink alcohol may also engage in a variety of high-risk activities, including unsafe sexual practices, as a part of a "problem behavior syndrome". Second, alcohol may influence high-risk behaviors at specific sexual encounters by affecting judgment and disinhibiting socially learned restraints. These are not mutually exclusive interpretations. In addition, these two explanations have different implications for the prevention of high-risk sexual behavior. Among people who have a risk-taking temperament, reducing alcohol consumption may not reduce high-risk sexual behavior. However, among those who are more likely to take sexual risks when they are drinking than when they are not, reducing alcohol consumption should also reduce high-risk sexual behavior.

There are two approaches to studying alcohol's relationship to sexual behavior that may result in HIV infection . One approach examines whether alcohol use in general is correlated with sexual risk-taking behavior in general. In this approach, an observed association between drinking and high-risk sexual activity could imply that these two behaviors are part of a larger risk-taking tendency, or that alcohol itself influences sexual risk-taking, or both. Another approach examines the consequences of alcohol use during specific sexual encounters.
An observed connection between alcohol use and sexual risk-taking during specific encounters suggests a direct influence of alcohol on such behavior. A number of studies have identified associations between drinking and high-risk sexual activity. These studies also have found that an absence of or a reduction in alcohol use is associated with a decrease in high-risk sexual behavior. A study of heterosexual drinking habits and sexual behavior found that women and men who frequently combined alcohol use with sexual encounters were generally less likely to use condoms during intercourse. Similarly, a study of homosexual men found alcohol or other drug use combined with sexual activity to be strongly associated with high-risk sexual behavior: even those who drank only occasionally at the time of sexual encounters were twice as likely to be categorized as "high risk," based on the frequency of involvement in a range of sexual practices within nonmonogamous relationships, than were those who did not drink . Further, those men who did not drink during sexual encounters were three times more likely to be classified in a "no risk" category than were men who combined drinking with sexual activity. Recently, a reduction in alcohol use among homosexual men has been associated with a reduction in high-risk sexual behavior . Other studies that examine the consequences of alcohol use at specific sexual encounters also have demonstrated a connection between alcohol use and high-risk sexual behavior. Scottish adolescents who drank at the time of first intercourse were less likely to have used a condom than those who did not drink . A survey of adolescents in M assachusetts revealed that teens were less likely to use condoms if sexual activity followed drinking or other drug use . Similarly, adult homosexual men and heterosexual women (but not heterosexual men) reported that they were less likely to use a condom during those sexual encounters in which they felt intoxicated . These reports of simultaneous alcohol use and high-risk sexual behavior suggest that alcohol can directly influence sexual risk-taking. However, these combined behaviors may still reflect a risk-taking tendency in some individuals. Further research is needed to define conditions under which alcohol use is linked to high-risk sexual activity. Information generated from such studies will be vital for developing and improving programs to prevent HIV transmission.