Drinking in Control

“HIV researchers have called alcohol the ‘forgotten drug’ in the HIV epidemic,” explains Sarah Woolf-King, PhD, MPH. “It’s so ubiquitous and normative, people tend to forget that when it’s overused or misused, it can still have significant negative consequences.”

Woolf-King, Assistant Professor at the University of California, San Francisco, has devoted the past decade of her research career investigating the role of alcohol in sexual decision making and HIV transmission—with an eye on ultimately being able to help people be healthier and make safer choices when they drink.

She explained that, without a doubt, alcohol has played some part in contributing to the HIV epidemic. “The association between alcohol, sex without condoms, and HIV transmission is ubiquitous. In nearly every country, in every subpopulation where it has been studied, people who use alcohol are more likely to be HIV positive, and they’re more likely to have unprotected sex,” notes Woolf-King.

But, alcohol doesn’t always equate to unprotected sex—alcohol’s causal role is more nuanced. The relationship between alcohol and unprotected sex is moderated by other factors, such as how long a person has been with their current sex partner. Alcohol is more likely to influence a person’s decision to have unprotected sex if he or she is with a first time—versus longer term—sexual partner. People with longer-term partners are more likely to have established sexual routines, and thus more likely to do the same thing whether or not they’ve been drinking.

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