Using Integrative Data Analysis to Examine Changes in Alcohol Use and Changes in Sexual Risk Behavior Across Four Samples of STI Clinic Patients.

Abstract

Patients in sexually transmitted infection (STI) clinics report high levels of alcohol use, which are associated with risky sexual behavior. However, no studies have examined how changes in alcohol use relate to changes in sexual risk behavior. We used parallel process latent growth modeling to explore how changes in alcohol use related to changes in sexual behavior across four samples of clinic patients. Patients participating in HIV prevention trials from urban clinics in the Northeastern and Midwestern USA (N = 3761, 59% male, 72% Black) completed measures at 3-month intervals over 9-12months. Integrative data analysis was used to create composite measures of alcohol use across samples. Sexual risk measures were counts of partners and unprotected sex acts. Parallel process models tested whether alcohol use changes were correlated with changes in the number of partners and unprotected sex. Growth models with good fit showed decreases that slowed over time in sexual risk behaviors and alcohol use. Parallel process models showed positive correlations between levels of (rs = 0.17-0.40, ps < 0.001) and changes in (rs = 0.21-0.80, ps < 0.05) alcohol use and number of sexual partners across studies. There were strong associations between levels of (rs = 0.25-0.43, ps < 0.001) and changes in (rs = 0.24-0.57, ps < 0.01) alcohol use and unprotected sex in one study recruiting hazardous drinkers. Across four samples of clinic patients, reductions in alcohol use were associated with reductions in the number of sexual partners. HIV prevention interventions may be strengthened by addressing alcohol use.