Structural Alcohol/HIV Risk Intervention in Gay Bar Patrons
Edwin D. Charlebois
University of California, San Francisco – Center for AIDS Prevention Studies
Social and Behavioral Sciences
The impact of alcohol consumption on HIV transmission among gay men has been greatly underappreciated. An extensive body of research documents elevated rates of alcohol and use among gay men and evidence links alcohol consumption with unsafe sexual behavior decreased safer sex negotiation, condom failure, and risks for becoming HIV infected. Gay bar patrons are at higher risk for alcohol associated HIV risks arising from several factors; increased frequent/heavy alcohol consumption and problems, socializing centered around gay bars, and higher rates of un-safe sex behaviors than those who do not frequent gay bars. However, there has been very little research on alcohol consumption interventions and HIV risk in gay men. In our preliminary research in San Francisco we have found that gay bar attendance is very common along with high rates of heavy alcohol use and that consumption of water in bars is the most frequent tactic used to decrease alcohol intoxication. However gay bar patrons report several barriers to availability and accessibility of water.
We propose to develop and pilot test an intervention to alter the environment where alcohol consumption occurs by installing a free, self-service filtered water dispenser to help bar patrons pace their alcohol use along with a bar poster campaign focusing on alcohol and HIV risks and to reduce individual level alcohol consumption and HIV risk behaviors through showing exiting bar patrons their blood alcohol levels as compared to others exiting the bar as measured by hand-held breathalyzer. To evaluate the potential effectiveness of this intervention we will compare data from an exit sample 1,200 gay bar patrons taken from 4 gay bars in San Francisco (2 with the water tap and posters and 2 with no water tap or posters) and web-based follow-up alcohol and sexual behavior survey. Specifically we would like to see if: 1) The intervention makes a difference in the measured blood alcohol concentration (BAC) level measured by breathalyzer by comparing the average BAC in people exiting the bars with the free water tap and posters to the average BAC in people exiting the bars without the water tap and posters. 2) Gay bar patrons find measuring their BAC is acceptable to them and if they think it is useful information for them to have. 3) What the size of the effect the intervention has on the number of people who have unsafe sex while intoxicated by comparing the amount of unsafe sex reported in by people exiting the bars with the free water tap and posters to the amount of unsafe sex reported in by people exiting the bars without the water tap and posters.
To our knowledge this will be the first study targeted at reducing alcohol use associated HIV risks in gay bar patrons. Results from this study will be used to design a large-scale community-wide test of the multi-level intervention.