HIV Risk and Protective Factors in the Context of Alcohol and Substance Use During Pride

This investigation sought to identify HIV-risk and -protective factors among men-who-have-sex-with-men (MSM) who engaged in anal sex following alcohol or substance use during an international Pride Festival. MSM attending World Pride were surveyed regarding (1) alcohol, substance use, and sex during the past 24 h; and (2) HIV-risk and -protective factors. Valid data were provided by 1123 MSM. Anal sex was reported by 195 MSM, among whom the majority (n = 105) consumed alcohol or substances prior to sex. Among MSM aware of their HIV status who consumed alcohol or substances prior to sex (n = 99), those who engaged in serodiscordant condomless anal sex (n = 22) were more likely to be HIV+ (AOR = 10.14, 95% CI 1.48–69.35); report multiple sex partners (AOR = 9.05, 95% CI 1.70–48.12); and possess lower condom efficacy (AOR = 0.47, 95% CI 0.23–0.93) and social support (AOR = 0.08, 95% CI 0.01–0.46). Bolstering condom negotiation skills and social support could potentially reduce HIV acquisition/transmission-risk behavior, even when under the influence of alcohol or substances.