Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence (2006)

Appendix B Literature Search Stategy

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Sampling and Proximal Similarity

I leave this topic to tomorrow, or later….

Some studies ascertained that participants who use alcohol, and those who use alcohol more heavily, are more likely to engage in sexual HIV-risk behavior (Weinhardt, Lance S and Carey, Michael P, 2000). This opinion is supported by both economists and psychologists.

Economists have used a variety of methods to provide evidence on the relationship between alcohol use and risky sexual behavior. One recent approach taken by researchers in this field involves estimation of the reduced form relationship between the price of alcohol — usually beer taxes — and some measure of sexual behavior such as the state gonorrhea rate. A statistically significant coefficient on the beer tax — which is presumed to reduce alcohol consumption — is taken as suggestive evidence for a causal relationship between alcohol consumption and the outcome variable of interest. Chesson, Harrison, and Kassler (henceforth CHK) use state panel data on STD rates over a 16-year period and estimate that increases in the beer tax are associated with statistically significant reductions in a state’s gonorrhea rate for 15–19-year-old males after controlling for state and year effects.

Psychologist used the alcohol myopia model (Steele & Josephs, 1990) to explain the effects of alcohol on social behavior. According to this model, alcohol reduces cognitive capacity and causes people to focus on the cues that are most salient in the environment. And in many HIV-risk-reduction programs, substance use prior to sexual behavior is discussed as a risk behavior and is assessed as an outcome (e.g., Carey et al., 1997a; Fullilove, Fullilove, Bowser, & Gross, 1990). Theory and experimental research provide support for this association.

Some studies indicate that people who use condoms when they are sober also tend to use them when drinking; people who fail to use condoms when drinking probably also fail to use them when sober (George, William H and Stoner, Susan A, 2000).

Other studies proved that both excessive drinking and risky sexual behaviour are determined by psychological or emotional factors and drinking is not necessarily lead to risky sexual behaviour or more risky sexual behaviour. The causal-effect relationship between drinking and risk sexual behaviour could be rather weak.

Surprisingly, it’s also possible that men tend to become physically more sexually aroused when they think they have been drinking alcohol, even when they haven’t. Women report feeling more sexually aroused when they falsely believe the beverages they have been consuming contain alcohol, although a measure of their physological arousal shows that they are physically becoming less aroused.
Men become more aggressive in laboratory studies in which they are drinking only tonic water but believe that it contains alcohol. They also become relatively less aggressive when they think they are drinking only tonic water, but are actually drinking tonic containing alcohol.Thus, much sexual behavior as well as aggression associated with alcohol may be more a result of our beliefs than of the alcohol we consume (David J. Hanson). The causality is more emotional and psychological rather than physical and clinical.

How messy it is!

1, Understanding acute alcohol effects on sexual behavior

Annual Review of Sex Research,  2000  by George, William H,  Stoner, Susan A

2, Does alcohol lead to sexual risk behavior? Findings from event-level research

Annual Review of Sex Research,  2000  by Weinhardt, Lance S,  Carey, Michael P

3, Alcohol myopia. Its prized and dangerous effects

Am Psychol. 1990 Aug;45(8):921-33 by Steele CM, Josephs RA.

4, Alcohol and sexual violence: key findings from the re s e a rc h, HOME OFFICE

http://www.homeoffice.gov.uk/rds/pdfs04/r215.pdf

5, Youth alcohol use and risky sexual behavior: evidence from underage drunk driving laws

Journal of Health Economics 24 (2005) 613–628, Christopher Carpenter

AND MORE AND MORE……………