Grant: New Investigator Award-PA:Ontario HIV Treatment Network-Health Serv/ Pop Health

Human immunodeficiency virus (HIV) is a significant public health concern in Canada, and sexual behaviour remains the primary method through which HIV is transmitted among Canadians. Within this context, the consumption of alcohol is frequently seen as a key driver of unprotected sex. However, the evidence for a direct association between alcohol and unprotected sex tends to be mixed, which not only limits our understanding of alcohol's potential causal role in condom use decisions and subsequent HIV acquisition/transmission, but it also adds complexity to the development of effective behavioural interventions aimed at reducing unprotected sex among at-risk populations. The primary stream of the proposed research program will therefore employ a multi-method approach to investigate alcohol's direct causal and/or indirect interactive impact on high-risk sexual behaviour among gay and bisexual men, who continue to be overrepresented in the Canadian HIV epidemic. Study 1 and Study 2 will employ a unique, alcohol-focused experimental paradigm to assess alcohol's causal role in risky sex intentions among HIV-negative and HIV-positive gay and bisexual men, respectively. Study 3 will consist of a field investigation to identify "real-world" linkages between alcohol/substance use and risky sex. Study 4 will build on the findings from these initial studies, and will involve collaborating with clinic- and community-based partners to develop and evaluate an alcohol-focused HIV prevention initiative. A smaller set of complementary initiatives will form the basis of the secondary stream of research, focusing on broader aspects of alcohol, substance use, and HIV prevention. Overall, the proposed program of research could prove to play a key role in future public health initiatives that target the Canadian HIV epidemic on a wide-scale level.