The relationship between homosexuality laws, alcohol use and HIV risk behavior of men who have sex with men in 16 cities of the United States
B.R.S. Rosser1, M. Oakes1, R. Jones-Webb1, S. Brady1, K. Horvath1, D. Carpenter2, D. Smolenski1, G. Kilian1, R. Morgan1
1University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, United States, 2University of Minnesota, Law School, Minneapolis, United States
Background: Structural factors research has not previously examined whether laws related to homosexuality impact the risk behavior of men who have sex with men (MSM) in the United States. The Structural Interventions to Lower Alcohol-related STI/HIV risk (SILAS) study was designed to explore the relationship between legislation on homosexuality and three behavioral risk factors for MSM: alcohol use, unsafe sexual behavior and alcohol-related unsafe sex.
Methods: Sixteen U.S. cities were selected based upon laws regarding recognition of same-sex relationships, gay adoption, anti-discrimination in employment and recognition of hate crimes. Eight cities with pro-homosexual laws and 8 with anti-homosexual laws were pair-matched on population, demographic composition and region. Banners advertisements on the nation’s two largest gay websites were used to recruit 1,725 MSM participants; 1,038 from the pro-cities and 687 from the anti-cities.
Results: Overall, participants reported significantly higher alcohol use than the national average for males. Compared to participants in the anti-cities, participants in the pro-cities reported significantly less heavy alcohol use (AOR = 0.73, p = 0.006), but no differences in at-risk drinking, unsafe sex, or alcohol-related unsafe sex were observed.
Conclusions: Except for heavy drinking, results suggest little association between negative legislation concerning homosexuality and alcohol use or risky sexual behavior. Results will be replicated over time to determine whether the relationships observed in this study persists.
Acknowledgement: NIH-NIAAA award number R01AA016270-01A1 funded this study.