Alcohol Consumption and the Intention to Engage in Unprotected Sex: Systematic Review and Meta-Analysis of Experimental Studies in Canada

To assess whether alcohol could have an independent effect on incidence of HIV/STIs, the authors conducted a systematic review and meta-analysis of randomized controlled studies that examined the association of blood alcohol content (BAC) and self-perceived likelihood of condom use during intercourse. The meta-analysis included an estimate of dose-response effect, tests for publication bias, and sensitivity analyses.

For the 12 studies included in the pooled analysis, an increase in BAC of 0.1 mg/ml resulted in an increase of 5.0 percent (95 percent confidence interval: 2.8-7.1 percent) in the Likert scale-indicated likelihood of engaging in unprotected sex. Adjusting for potential publication bias, the estimate dropped to 2.9 percent (95 percent CI: 2.0-3.9 percent)

"Thus, the larger the alcohol intake and the subsequent level of BAC, the higher the intentions to engage in unsafe sex," the researchers reported. "The main results were homogenous, persisting in sensitivity analyses and after correction for publication bias."

"Alcohol use is an independent risk factor for intentions to engage in unprotected sex, and as risky sex intentions have been shown to be linked to actual risk behavior, the role of alcohol consumption in the transmission of HIV and other STIs may be of public health importance," concluded the authors.

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