Sensation seeking, alcohol use and sexual risk behaviors among men receiving services at a clinic for sexually transmitted infections.

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Abstract
Objective: Risk-prone personality dispositions are asso- ciated with alcohol use and high-nsk sexual behaviors; however, the na- ture of these associations and their implications for sexual risk reduction interventions are not clear. This study examined a conceptual model of sensation seeking personality and alcohol expectancies as correlates of sex-related alcohol use and sexual nsk behaviors. Method: Men (N= 350) seeking services from an innercity clinic that treats sexually trans- mined infections (STI) completed measures of demographic character- istics, sensation seeking, alcohol outcome expectancies, alcohol use in sexual contexts and sexual behaviors, administered onsite at the clinic using audio-computer-assisted interviewing. Results: Path analyses showed that sensation seeking was related to engaging in unprotected sexual intercourse with casual or one-time sex partners (i.e., high-risk sex). Sensation seeking was also associated with stronger expectancies that alcohol use enhances sex. This association was related to alcohol use in sexual contexts which, in tum, was related to high-risk sex. Analy- ses also showed that alcohol outcome expectancies mediated the asso- ciation between sensation seeking and alcohol use in sexual contexts. Conclusions: Alcohol use plays important roles in risks for sexually transmitted infections, particularly among high sensation seekers. Cog- nitive restructuring of alcohol outcome expectancies may offer an in- road for developing HIV-STI risk reduction interventions. (J Stud. Alcohol 64: 564-569, 2003) A LCOHOL IS THE MOST PREVALENT SUB- stance used in sexual contexts, but research linking alcohol use to sexual risks has yielded mixed results. In some studies heavy drinking is associated with higher rates of sexual risk behaviors, whereas other studies do not find a relationship between heavy drinking and sexual risks (for reviews see Logan et al., 2002; Weinhardt and Carey, 2000). Inconsistent findings in the alcohol and sexual risk behav- ior literature may be due, in part, to individual differences that exert influence on both alcohol use and sexual risk taking. Leigh and Stall (1993) suggested that additional vari- ables (e.g., personality dispositions, including sensation seeking) may play important roles in predicting covariation in alcohol use and sexual risk practices. A meta-analysis of 53 studies that examined predictors of sexual risk behav- iors found that sensation seeking accounted for 64% of the observed effects of personality dispositions on numbers of sex partners, numbers of first-time sex partners and fre- quency of engaging in unprotected sexual intercourse (Hoyle et al., 2000). Sensation seeking is also related to alcohol

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