Gender Differences in Alcohol Use and Risky Sexual Behaviors and STDs among STD Clinic Patients

Background:
Binge drinking is associated with risky sexual behaviors and STDs. Few studies have investigated this by gender or in an STD clinic.

Objective:
To determine the prevalence and factors associated with binge drinking among female and male STD clinic patients.

Method:
671 STD clinic patients were tested for STDs, and queried about recent alcohol/drug use and risky sexual behaviors using audio computer-assisted self-interview. Association between alcohol use(binge drinking, alcohol use but no binge drinking, or no alcohol use), sexual behaviors and STDs was analyzed using logistic regression adjusting for age, employment, and drug use.

Result:
Binge drinking was reported by 33% of females and 44% of males. Female binge drinkers were more than twice as likely to engage in anal sex as females who drank but didn't binge(33% vs. 15.9%; p<.05) and non-drinking females (11.1%;p<.05). Female binge drinkers were also more than twice as likely to have multiple sex partners as non-drinking females(40.5% vs. 16.8%;p<.05). Unprotected sex was not associated with alcohol use. Among males, rates of all risky sexual behaviors were high, but did not differ by alcohol use. Drug abuse(heroin/cocaine/marijuana) was more common among female and male binge drinkers, but unrelated to sexual risk behaviors(p's>.10).
Gonorrhea was 6 times higher among female binge drinkers compared to non-drinking females(13.5% vs.2.2%; p<.05). Among males, no association was found between alcohol use and STDs. No gender differences were found in rates of sexual behaviors or STDs.

Conclusion:
Binge drinking was high among female STD clinic patients and associated with risky sexual behaviors and STDs. Binge drinking presents greater health risks for females, and is related to anal sex, multiple sex partners, and gonorrhea.

Implications:
Alcohol screening and brief intervention are needed at STD clinics. Developing gender-specific models may reduce prevalence of binge drinking, risky sexual behaviors, and STDs.