Quantitative studies of HIV-positive MSM have confirmed this connection between alcohol use and unprotected sexual practices (Dolezal, Meyer-Bahlburg, Remien, & Petkova, 1997; Kalichman, Kelly, & Rompa, 1997; Purcell, Parsons, Halkitis, Mizuno, & Woods, 2001).
Other studies, however, have failed to demonstrate an association between alcohol use and unsafe sex among samples of MSM (Crosby, Stall, Paul, Barrett, & Midanik, 1996; Parsons et al., 2003; Weatherburn, Davies, Hickson, & Hunt, 1994).
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Prevention interventions for HIV-positive MSM are urgently needed to reduce these sexual risk behaviors and prevent a resurgence of HIV infections among seronegative MSM (Di Clemente, Wingood, del Rio, & Crosby, 2002; Wolitski, Valdeserri, Denning, & Levine, 2001), especially among MSM of color (CDC, 2000).
In addition to potential transmission of HIV to sexual partners, HIV-positive MSM who engage in unprotected sexual behaviors risk infection with other sexually transmitted diseases and more virulent strains of HIV (Blackard, Cohen, & Mayer, 2002; Hecht et al., 1998).
These levels of scripting are intertwined but can be individually distinguished in terms of their salience in specific situations.
For instance, the cultural level of scripts is likely to be most salient when the status quo is disrupted (e.g., an individual exhibits behavior that contradicts or clashes with what are considered to be socially desirable norms).
As such, it is important to better understand the sexual experiences of HIV-positive MSM so we can tailor interventions that are effective in reducing unsafe sex.