The prevention of HIV infection associated with drug and alcohol use during sexual activity.

The effort to prevent further HIV infection for high risk populations has been largely limited, in practice, to health education efforts. Prevention policy must utilize techniques which, in combination with health education efforts, works to decrease behaviors which are implicated in HIV transmission. It is argued that this approach to prevention will work best if it is designed with an understanding of the conditions under which individuals decline to comply with risk-reduction guidelines. It appears that the use of drugs and alcohol during sexual contact is one such condition. Three prevention strategies are suggested which, in addition to health education efforts, might be used to minimize HIV transmission related to the use of drugs and alcohol during sexual activity among gay men. It is hoped that the approach suggested in this paper for the prevention of further HIV infection might also be adopted to develop prevention strategies for other populations at risk of HIV infection.