Background: Men who have sex with men (MSM) have high rates of binge drinking (>50% in San Francisco (SF)), which can lead to increased sexual risk and other negative health outcomes. Heavy alcohol use is a recognized driver of the HIV epidemic in SF and gay bars have been identified as important venues for interventions addressing alcohol-related HIV risk. We sought to evaluate the impact on alcohol intake and blood alcohol concentration (BAC) of a pilot structural intervention to increase the availability of free water, coupled with messaging on pacing alcohol intake and normative feedback about blood alcohol concentration in a convenience sample of gay bars in San Francisco, CA., USA.
Methods: From January 2012 to August 2014, study participants (n=1293) were recruited among exiting patrons of 4 gay bars in SF (2 intervention bars and 2 control bars). Participants answered a brief survey regarding alcohol intake and sexual risk behaviors then completed a breathalyzer test to measure their BAC. Individuals'' measured BAC was displayed graphically in relation to others exiting the bar. Alcohol intake and measured BAC of participants were compared at baseline and post-intervention between control and intervention bar patrons using Pearson χ2.
Results: No significant differences between intervention and control bars were found at baseline. Participants were 69% Caucasian, 11% Latino, 5% African-American, 7% API, 8% other race; mean age was 37.5 years. We found high levels of alcohol use and sexual risk across all participants (56% reported condomless sex with a potentially serodiscordant partner at last sex). Post-intervention there were significant differences on measures of alcohol consumption: 30% of intervention bar participants had BAC levels over the legal limit (.08g/dL) compared to 43% of control bar participants, p< .0001 and 78% of intervention bar participants were above the AUDIT-C cut-off for problematic drinking compared to 87% in control bars, p< .001.
Conclusions: It is feasible to partner with bar owners to implement a structural intervention to reduce BAC levels of customers. Increasing the availability of free water and alcohol intake pacing messaging in gay bars can decrease patron alcohol intake and may impact alcohol related sexual risks for HIV.