(PS1-42) Predicting Risky Sexual Behavior by Posttraumatic Symptoms and Binge Drinking in Veterans Seeking Treatment for Alcohol Use

Veterans in the United States are at an elevated risk for trauma exposure, substance use, and risky sexual behaviors. Despite this, the connection between these factors remains understudied. The purpose of this study is to use general linear models to examine direct and interactive effects on risky sexual behavior in a sample of treatment-seeking Veterans.

We examined screening data from a larger randomized controlled trial of 834 Veterans (93.4% male, 71.6% White, mean age 48.3 years) seeking treatment to reduce substance use behaviors and aggression. Veterans were assessed for various symptoms in the past month, including days of binge drinking, posttraumatic symptoms via the PTSD Checklist for DSM-5 (PCL-5) and frequency of risky sexual behavior (e.g., condomless sex, number of sexual partners). In the past 30 days, 50.5% of Veterans had sex and 57.3% of Veterans reported at least one day of binge drinking. Inconsistent condom use in the past month was reported by 84.9% of Veterans with a regular partner and 77.1% of Veterans with a casual partner. Multiple regression analyses showed that binge drinking was significantly and positively associated with having sex while intoxicated from alcohol and/or drugs, OR = 5.35, p < .001. Nevertheless, binge drinking was not significantly associated with the number of sexual partners nor condom use. Further, PTSD symptoms were neither directly associated with risky sexual behaviors nor did they significantly interact with binge drinking. Analyses also showed that White Veterans reported significantly fewer sexual partners and less frequent condom use, while non-White Veterans were significantly more likely to have sex while intoxicated.

Despite the high prevalence of risky sexual behaviors and binge drinking in our sample of treatment-seeking Veterans, our findings suggest these behaviors may be explained by other unexplored factors. Future research is necessary to explore alternative explanations for these behaviors to inform early interventions. Clinicians treating alcohol use among Veterans are also encouraged to screen for risky sexual behaviors and adopt harm reduction and protective strategies within a cognitive-behavioral framework to improve overall health outcomes. Culturally informed adaptations may also be appropriate to explore elevated risk for specific risky sexual behaviors in Veterans.