Alcohol-involved sexual risk behavior among heavy drinkers living with HIV/AIDS: negative affect, self-efficacy, and sexual craving

Abstract

Evidence of the effects of negative affect (NA) and sexual craving on unprotected sexual activity remains scant. We hypothesized that NA and sexual craving modify the same day association between low self-efficacy to use condoms and unprotected anal or vaginal sex, and the same-day association between alcohol use during the 3 hours prior to sexual activity and unprotected sex. We used an electronic daily diary, drawing on a sample of 125 men and women recruited from an agency serving economically disadvantaged persons living with HIV/AIDS. Casual or steady partner type designation and perceived partner HIV serostatus were also examined. Findings support the hypothesized moderating effects of high NA and sexual craving on the association between low self-efficacy and unprotected sex, and the association between alcohol use and unprotected sex. Implications are discussed.

Figure 1

Casual Partner Type: Self-Efficacy and Sexual Craving. The effect of self-reported self-efficacy to use condoms (SE) “in the next 24 hours” on same-day frequency of unprotected anal or vaginal sex acts is most pronounced on days distinguished by both strong sexual craving and high NA. Here, the averaged upper and lower quartiles of sexual craving are shown.

Figure 2

Casual Partner Type: Negative Affect and Alcohol Use. The effect of self-reported self-efficacy to use condoms (SE) “in the next 24 hours” on same-day frequency of unprotected anal or vaginal sex acts is most pronounced on days in which relatively strong negative affect (NA) is reported. This is particularly true on days in which participants report alcohol use in the 3 hour period prior to sexual activity.