Is There a Connection Between STDs and Alcohol Use?

Alcohol can alter someone’s sexual decision-making or place them at increased risk of engaging in unprotected sex. Studies show that there is a correlation between the risk of contracting STDs and alcohol use, primarily due to changes in sexual behavior while drinking.1, 2

What Is an STD/STI?

An STI is a sexually transmitted infection. STIs are also called sexually transmitted diseases (STDs).3 STIs are passed from person to person through exposure to bodily fluids. There are several different types of STIs. Some common STIs include:2

  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Herpes
  • Human papilloma virus (HPV)
  • Hepatitis B
  • Trichomoniasis
  • HIV

Anyone who engages in sexual activity risks contracting an STI, including people of any gender, of any race, and from any socioeconomic background.

There are about 20 million sexually transmitted diseases diagnosed in the United States each year.

Does Alcohol Make Your Body More Vulnerable to Infection?

Alcohol use is associated with higher rates of sexually transmitted infections.3 However, having alcohol in your system does not make you more vulnerable to contracting an STI.

Rather, the impact of alcohol on your body over time can make you more susceptible to getting sick from any infectious disease.

This is because chronic alcohol misuse, such as binge drinking, can weaken the immune system, making it more difficult to fight off infection and illness.4 Immunodeficiency increases the odds that someone could become sick with any infection, whether an STI, the common cold, or the seasonal flu.

Can You Get an STD Without Having Sex?

Sexually transmitted diseases like Hepatitis B and C and HIV can be transmitted through contact with blood. One of the most common ways people contract these specific STDs is by using syringes and needles that are not sterile. For example, by cleaning and reusing a syringe or by using a syringe that someone else has already used.

While alcohol is not used as an injectable drug, because alcohol affects risk-taking behavior and because alcohol is sometimes mixed with other substances, there is a possibility that a person may be more likely to use other substances while drinking alcohol.

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If you are in contact with viral hepatitis or HIV through blood, you can contract these STDs without any sexual contact.

Does Alcohol Impact Sexual Decisions?

Higher rates of STDs with alcohol use are related to behavior.The primary connection between higher rates of STDs and alcohol use is due to changes in decision-making when intoxicated. 2

Alcohol can impact the decisions you make, including sexual decisions. Research shows that alcohol use is linked to impulsive sexual behavior.2 Impaired decision-making skills can also increase the likelihood of a person engaging in behaviors (e.g., overt flirting) or sex acts they would not typically participate in if they weren’t drinking.

Alcohol use can affect sexual decisions in a few different ways, for example:

  • Increased intent to have unprotected sex and less consistent condom use
  • Riskier sexual acts, such as anal sex or sex with multiple partners, which increase exposure to bodily fluids and bacteria that can transmit STIs
  • Weakened communication skills that decrease the likelihood of partners asking about each other’s’ STI history
  • Increased sexual arousal

Consent is enthusiastic permission and agreement to do a certain activity.

Because alcohol skews decision-making, it also removes your ability to consent.

If you are intoxicated, you can’t give sexual consent.6 The mind-altering effects of alcohol may lead to high-risk sexual behavior even if you know there is an increased likelihood of contracting an STI by engaging in a certain act.

It is vital to recognize that alcohol does not cause sexual violence or absolve any person from responsibility for sexual harassment or assault. However, sexual violence is often culturally associated with heavy alcohol use because:

  • Offenders who already engage in predatory sexual behavior may take advantage of someone else’s inability to consent to sex while intoxicated.
  • Alcohol intoxication is used as an excuse for “bad behavior” by offenders as a way to downplay the seriousness of sexual violence and their personal responsibility for their actions.
  • Consent can be misunderstood if both parties are intoxicated.

If you have experienced sexual abuse, harassment, or violence, call the National Sexual Assault Hotline at 1-800-656-4673. The hotline provides help 24/7. A confidential online chat service is also available.7

Who Is Most Likely to Contract an STD While Drinking?

No one is immune from STIs. Anyone who participates in sexual activity can get one. However, research indicates that certain groups are at higher risk.

Which Age Group Is Most Likely to Contract an STI?

People ages 21-29 are statistically more likely to acquire an STI than any other age group.2 Research also shows that age influences drinking patterns, and people in this age group are more likely to binge drink than other age demographics.2

Binge drinking in adolescents and young adults is linked to impulsive sexual decisions. In fact, this age group is more likely to have sex with multiple partners and practice riskier sex.2 While this may be because alcohol influences decision-making, some youth may drink for other reasons.

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Some adolescents and young adults may drink so they feel comfortable enough to participate in sexual activities that they normally would feel uncomfortable with.

Which Gender Is Most Likely to get an STI While Drinking?

Unprotected penetrative sex has the highest risk of transmitting STIs. Anal sex has the highest risk of transmitting an STI, regardless of gender, followed by vaginal sex.3

One study indicates that between men and women with diagnosed STDs, women who binge drink are more than 2 times more likely to participate in anal sex than women who do not. Women who binge drink are also 2 times as likely to have multiple sex partners. These women binge drinkers in the studies exhibited a rate of gonorrhea 5 times higher than their counterparts who did not binge drink.8

In the study, even though 42% of men reported binge drinking, both men binge drinkers and their counterparts who did not binge drink had the same rate of engaging in anal sex and the same approximate rates of other risky sexual behaviors.8

Researchers report that while the rates of risky sexual behaviors and diagnosed STDs were high for men in the study, the rates were not connected to alcohol use in the same way that they were for women.8

Should I Get Tested for STDs?

You should be tested for STDs if alcohol use affects how you have sex.For some people, the stress or shame associated with sexually transmitted diseases can keep them from getting tested. There is a stigma associated with STIs, but most STIs are curable using antibiotics or other therapies. Many STIs only cause significant health issues if left untreated for long periods of time. For this reason, the earlier you get tested and treated, the better.9

There are a few methods for testing someone for an STD. These methods include:3

  • Physical exam, which is used to look for external signs of an STI (e.g., sores)
  • Pelvic exam, which is used to identify discharge that may indicate an infection an infection
  • Blood test
  • Urine test
  • Fluid or tissue sample

Health professionals recommend getting tested if any of the following are true:9

  • You have had unprotected sex.
  • You have symptoms of an STI, including:
    • Pain when urinating or ejaculating
    • Discharge from the penis or vagina
    • Pain during sex
    • Blisters or sores on genitals
    • Itching or rash in the genital area
    • Bleeding during or after sex
  • You have a new partner. Many STIs go undetected, which means you or your partner may not know they have an STI if you have not been recently tested.
  • A previous sexual partner let you know that they have an STI.
  • You are sexually active with more than one partner. If you are sexually active with more than one partner, you should schedule regular STI testing regardless of you or your partners’ previous STI history

Once your doctor has your results, they can recommend the appropriate treatment.

Who Should Consider Treatment for Alcohol Misuse?

If alcohol use negatively impacts your life, it is vital to get evaluated for alcohol use disorder (AUD).10

These criteria center around whether someone’s alcohol use negatively impacts their life in a significant way or causes emotional distress. Some signs that screening for AUD is warranted include:9

  • Inability to stop drinking, regardless of the negative consequences. For example, if you know that you have engaged in sexual behaviors that you are potentially harmful to you (e.g., unprotected sex) when intoxicated, but you do not feel you can stop.
  • Alcohol use negatively impacts areas of your life, including relationships, work, or school. Impulsive sexual behavior due to alcohol use could be harmful to relationships.

These symptoms indicate that an assessment for AUD is needed. Any continual behavior that causes harm should be evaluated to see if treatment is necessary.

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What Is the Difference Between Binge Drinking and AUD?

Binge drinking is when you drink a large amount of alcohol in a short amount of time. A binge brings someone’s blood alcohol concentration (BAC) to 0.08 g/dl or more.11

This typically happens if men have more than five drinks in two hours. Four drinks in two hours is likely a binge for women.11

You can binge drink without having an alcohol use disorder.11 An estimated 90% of people who engage in this drinking behavior likely would not meet the criteria for AUD. Only a trained mental health professional can evaluate and diagnose alcohol use disorder. 12

If you are concerned about your alcohol use and need help finding treatment, please call 800-948-8417 Info iconCalls are forwarded to paid advertisers to speak with a treatment specialist.

Resources

  1. Scott-Sheldon, L.A., Carey, K.B., Cunningham, K., Johnson, B.T., Carey, M.P, & MASH Research Team. (2016). Alcohol use predicts sexual decision-making: Review and meta-analysis of the experimentation. AIDS and Behavior, 20, 19-39.
  2. Brown, J.L., Gause, N.K., & Northern, N. (2016). The association between alcohol and sexual risk behaviors among college students: A review. Current Addiction Reports, 3(4), 349-355.
  3. Office on Women’s Health. (2019, June 11). Sexually transmitted infections.
  4. Sarkar, D., Jung, M.K, & Wang, H.J. (2015). Alcohol and the Immune System. Alcohol Research: Current Reviews, 37(2), 153-155.
  5. Satterwhite, C.L, Torrone, E., Meites, E., Dunne, E.F., Mahajan, R., Bañez Ocfemia, M.C., Su, J., Xu, F., & Weinstock, H. (2013). Sexually transmitted infections among US women and men: Prevalence and incidence updates, 2008. Sexually Transmitted Diseases, 40(3), 187-193.
  6. San Francisco State University. Sexual Communication & Consent. Health Promotion & Wellness.
  7. Rape, Abuse & Incest National Network. Crisis Support Service.
  8. Hutton, H.E., McCaul, M.E., Santora, P.B., & Erbelding, E.J. (2008). The relationship between recent alcohol use and sexual behaviors: Gender differences among sexually transmitted disease clinic patients. Alcoholism, clinical and experimental research, 32(11), 1-16.
  9. Sexual Health Scotland. Do I Need a Test?
  10. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing.
  11. Centers for Disease Control and Prevention. (2019, December 30). Binge Drinking.
  12. Centers for Disease Control and Prevention. (2021, February 16). Alcohol Basics: Frequently Asked Questions.
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