Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta‐analysis of experimental studies

Rehm, Jürgen; Shield, Kevin D.; Joharchi, Narges; Shuper, Paul A.

doi:10.1111/j.1360-0443.2011.03621.x

Cited by 344Substance Abuse Treatment and OutcomesHIV, Drug Use, Sexual RiskHIV/AIDS Research and Interventions

Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta‐analysis of experimental studies

Rehm, Jürgen, Shield, Kevin D., Joharchi, Narges, Shuper, Paul A.·2012·Addiction

DOI 10.1111/j.1360-0443.2011.03621.x

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Abstract

Aims To review and analyse in experimentally controlled studies the impact of alcohol consumption on intentions to engage in unprotected sex. To draw conclusions with respect to the question of whether alcohol has an independent effect on the incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Methods A systematic review and meta‐analysis of randomized controlled studies examined the association between blood alcohol content (BAC) and self‐perceived likelihood of using a condom during intercourse. The systematic review and meta‐analysis were conducted according to internationally standardized protocols (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses: PRISMA). The meta‐analysis included an estimate of the dose–response effect, tests for publication bias and sensitivity analyses. Results Of the 12 studies included in the quantitative synthesis, our pooled analysis indicated that an increase in BAC of 0.1 mg/ml resulted in an increase of 5.0% (95% CI: 2.8–7.1%) in the indicated likelihood (indicated by a Likert scale) of engaging in unprotected sex. After adjusting for potential publication bias, this estimate dropped to 2.9% (95% CI: 2.0–3.9%). Thus, the larger the alcohol intake and the subsequent level of BAC, the higher the intentions to engage in unsafe sex. The main results were homogeneous, persisted in sensitivity analyses and after correction for publication bias. Conclusions 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.

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Systematic reviews and meta-analyses of experimental trials clearly indicated the causal impact of acute alcohol use (clearly shown for a blood alcohol concentration of 0.07 g/dl or more, but possibly even below) on decisions/intentions about condomless sex, above and beyond expectations about alcohol and underlying risk-relevant personality traits.
“Systematic reviews and meta‐analyses of the results of these experimental trials clearly indicated the causal impact of acute alcohol use (clearly shown for a blood alcohol concentration of 0.07 g/dl or more, but possibly even below) use on decisions/intentions about condomless sex, above and beyond the influence of expectations about alcohol and of underlying risk‐relevant personality traits 113,”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [114]

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Authors: Rehm, J., Shield, K. D., Joharchi, N., & Shuper, P. A.
Affiliations: Centre for Addiction and Mental Health (CA)
Corresponding author: Shield, Kevin D.
ORCID: Rehm, Jürgen
Shield, Kevin D.
Shuper, Paul A.
Venue: Addiction
Publisher: Wiley
Published: 2011-12-12
Volume: 107
Issue: 1
Pages: 51-59
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1111/j.1360-0443.2011.03621.x
OpenAlex: W2108531713
Cited by: 344
References: 51
Citations by year: 2026: 11 · 2025: 9 · 2024: 15 · 2023: 21 · 2022: 22 · 2021: 21 · 2020: 33 · 2019: 19 · 2018: 36 · 2017: 36 · 2016: 37 · 2015: 34 · 2014: 23 · 2013: 20 · 2012: 7
FWCI: 1.89
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: alcohol consumption, unprotected sex, condom use intentions, blood alcohol concentration, HIV transmission, sexually transmitted infections, sexual risk behavior, dose-response relationship, publication bias
MeSH terms: Alcohol Drinking, Ethanol, Data Interpretation, Statistical, Dose-Response Relationship, Drug, Female, Humans, Male, Motivation, Risk Factors, HIV Infections, Linear Models, Randomized Controlled Trials as Topic, Condoms, Intention, Unsafe Sex

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Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta‐analysis of experimental studies

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