The LGBT Health & Development Program

Research Blog > Does Alcohol Use Lead to Unprotected Sex?

Posted on May 10th, 2013 by Michael in Featured, Research Blog. No Comments

photo of green bottlesMany research studies have examined whether alcohol predicts unprotected sex. There have been an especially large number of studies looking at this effect in men who have sex with men (MSM) [1]. Theoretically, drinking could lead to unprotected sex because it limits our brain’s ability to process information. As a result, we are less likely to consider the consequences of our behaviors. However, research in this area has been mixed [1,2]. Some studies report links between drinking and unprotected sex in MSM, but others have found no relationship. These mixed findings have led some researchers to conclude that there may be developmental differences in this effect. This means that the link between drinking and unprotected sex might change across the lifespan.

A recent study in AIDS and Behavior by IMPACT’s Dr. Michael Newcomb examined age differences in the association between alcohol use and unprotected sex [3]. One hundred forty-three MSM ages 16–40 completed weekly online sexual behavior diaries for 12 weeks. Sexual diary studies follow participants over time, and they map episodes of alcohol use directly onto sexual encounters. This makes sexual diary studies an ideal method for examining drinking and unprotected sex. Averaging across all participants in this study, alcohol use before sex was not associated with unprotected sex. However, the study found some important differences by age. Alcohol use before sex was associated with more unprotected sex in younger MSM, but not adult MSM.

Newcomb’s study [3] is one of the few studies on drinking and unprotected sex to survey both young and adult MSM. Because of this, the study likely had more power to examine developmental differences. What is becoming clearer is that drinking is probably linked to unprotected sex for some but not all MSM. Knowing about these links will help researchers to develop interventions that reduce alcohol use and unprotected sex. Ultimately, these efforts will hopefully reduce health problems and decrease the likelihood of HIV infection. If these risk behaviors do co-occur among young MSM, then it may be impossible to reduce sexual risk without also addressing alcohol use, drug use, and various other psychosocial concerns experienced by this group.


1. Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. Journal of sex research. Mar 2011;48(2-3):218-253.

2. Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A Review of the Literature on Event-Level Substance Use and Sexual Risk Behavior Among Men Who Have Sex with Men. AIDS and behavior. Feb 10 2012.

3. Newcomb ME. Moderating Effect of Age on the Association Between Alcohol Use and Sexual Risk in MSM: Evidence for Elevated Risk Among Younger MSM. AIDS and behavior. Apr 4 2013.


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