Sensation seeking and alcohol use as markers of sexual transmission risk behavior in HIV-positive men.

Alcohol use and sensation-seeking personality characteristics are commonly associated with sexual risk behavior in populations at risk for HIV infection. However, these associations are not well understood and have not yet been examined in people living with HIV-AIDS. We used path analyses to test a model of sensation seeking, alcohol use expectancies, and sexual risk behaviors among 197 HIV seropositive men. Results showed that alcohol use outcome expectancies and alcohol used in sexual contexts were closely associated with unprotected intercourse and that sensation seeking was significantly related to alcohol use expectancies. Sensation seeking did not mediate the association between alcohol use and unprotected sexual behavior. Further analyses showed that the association between sensation seeking and alcohol use in unprotected sexual contexts was accounted for by expectancies that alcohol use improves sexual performance and enhances sexual pleasure. Analyses also indicated that men living with HIV-AIDS who used alcohol in sexual contexts were characterized by greater overall frequency and quantity of drinking. Prevention interventions may be improved by tailoring them for alcohol-using HIV-infected men, particularly by challenging beliefs and expectations that alcohol enhances sexual performance and sexual pleasure.