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Review
. 1993 Oct;48(10):1035-45.
doi: 10.1037//0003-066x.48.10.1035.

Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention

B C Leigh  1 , R Stall
Affiliations
Review

Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention

B C Leigh et al. Am Psychol. 1993 Oct.

Abstract

Recent reports have suggested that the use of alcohol or drugs is related to sexual behavior that is high risk for HIV infection. If substance use leads to unsafe sexual activity, understanding the dynamics of this relationship can contribute to research and preventive and educational efforts to contain the spread of AIDS. In this article, we review research on the relationship between substance use and high-risk sexual behavior. We then consider the inherent limitations of the research designs used to study this relationship, outline some methodological concerns including measurement and sampling issues, and comment on causal interpretations of correlational research findings. We end with a consideration of potential avenues for future research and a discussion of implications of these findings for current AIDS prevention policies.

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Appendix

Studies that include an analysis of the relationship of substance use to high-risk sexual activity
I. Global association studies: Relationship of general alcohol or drug use to risky sex
    1. Allen JP, Leadbeater BJ, Aber JL. The relationship of adolescents' expectations and values to delinquency, hard drug use, and unprotected sexual intercourse. Development and Psychopathology. 1990;2:85–98.
    1. Arya OP, Alergant CD, Annels EH, Carey PB, Ghosh AK, Goddard AD. Management of non-specific urethritis in men. British Journal of Venereal Diseases. 1978;54:414–421. - PMC - PubMed
    1. Biglan A, Metzler CW, Wirt R, Ary D, Noell J, Ochs L, French C, Hood D. Social and behavioral factors associated with high-risk sexual behavior among adolescents. Journal of Behavioral Medicine. 1990;13:245–261. - PubMed
    1. Bolton R, Vincke , Mak R, Dennehy E. Alcohol and risky sex: In search of an elusive connection. Medical Anthropology. 1992;14:323–363. - PubMed
    1. Chitwood DD, Comerford M. Drugs, sex, and AIDS risk: Cocaine users vs. opiate users. American Behavioral Scientist. 1990;33:465–477.
II. Situational association studies: Relationship of alcohol or drug use with sexual activity to risky sex
    1. Bagnall G, Plant M, Warwick W. Alcohol, drugs and AIDS-related risks: Results from a prospective study. AIDS Care. 1990;2:309–317. - PubMed
    1. Bolton R, Vincke , Mak R, Dennehy E. Alcohol and risky sex: In search of an elusive connection. Medical Anthropology. 1992;14:323–363. - PubMed
    1. Fisher JD, Misovich SJ. Evolution of college students" AIDS-related behavioral responses, attitudes, knowledge, and fear. AIDS Education and Prevention. 1990;2:322–337. - PubMed
    1. Gillmore MR, Butler SS, Lohr MJ, Gilchrist L. Substance use and other factors associated with risky sexual behavior among pregnant adolescents. Family Planning Perspectives. 1992;24:255–268. - PubMed
    1. Hingson RW, Strunin L, Berlin BM, Heeren T. Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. American Journal of Public Health. 1990a;80:295–299. - PMC - PubMed
III. Event analyses: Relationship of alcohol or drug use in sexual encounter to risky sex
    1. Cooper ML, Peirce RS, Huselid RF. Substance use and sexual risk taking among black and white adolescents. Health Psychology. in press. - PubMed
    1. Flanigan BJ, Hitch MA. Alcohol use, sexual intercourse, and contraception: An exploratory study. Journal of Alcohol and Drug Education. 1986;31(3):6–40. - PubMed
    1. Freimuth VS, Hammond SL, Edgar T, McDonald DA, Fink EL. Factors explaining intent, discussion and use of condoms in first-time sexual encounters. Health Education Research. 1992;7:203–215.
    1. Gold RS, Karmiloff-Smith A, Skinner MJ, Morton J. Situational factors and thought processes associated with unprotected intercourse in heterosexual students. AIDS Care. 1992;4:305–323. - PubMed
    1. Gold RS, Skinner MJ. Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS. 1992;6:1021–1030. - PubMed

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