Substance Use and Disparities in Teen Dating Violence Victimization by Sexual Identity Among High School Students

Factors affecting the risk of gender-based violence among 2SLGBTQIA+ adolescents and youth: a scoping review of climate change-related vulnerabilities

Gender-based violence (GBV) is a pervasive and growing issue that affects diverse populations worldwide. This study aimed to synthesize the factors affecting the risk of GBV among 2SLGBTQIA+ adolescents and youth. A scoping review was conducted using international databases (Web of Science, Scopus, Proquest, PubMed, Embase, EBSCOhost) since 2009. The studies were independently appraised by two reviewers guided by the PRISMA approach. Ninety-nine articles focusing on the 2SLGBTQIA+ community, GBV, and adolescents or youth were included for the review. The factors affecting the risk of GBV among 2SLGBTQIA+ adolescents and youth were categorized into (1) Wellbeing and mental health; (2) Disparities compared to cisgender youth; (3) Perpetration and victimization; (4) Different types of violence; and (5) Differences among 2SLGBTQIA+ subgroups. The studies further showed relevance to climate-related stressors such as displacement and resource scarcity, and how those can further amplify the vulnerabilities of 2SLGBTQIA+ youth to GBV. The findings revealed the necessity for multi-level strategies that account for the compounded risks faced by 2SLGBTQIA+ adolescents and youth, including those introduced by environmental crises. These five factors related to GBV among 2SLGBTQIA+ adolescents and youth should be considered by social work professionals when working with at-risk populations. Due to limited robust evidence (from countries outside the US) and the diverse contexts of the selected studies, future research is needed to minimize GBV among 2SLGBTQIA+ adolescents and youth, especially as climate change introduces new layers of vulnerability.

Systematic review registration

10.37766/inplasy2024.4.0008.

Healthcare for Sexual and Gender Minority Adolescents

Primary care providers have a unique opportunity to provide high-quality care to lesbian, gay, bisexual, transgender, queer, intersex, asexual and other identities not encompassed (LGBTQIA+) adolescents. Providers should be familiar with the various identities and definitions in the LGBTQIA + community, as well as social determinants of health and health disparities amongst LGBTQIA + adolescents. Providers should also understand how to foster a welcoming clinical environment, address gender affirming care to adolescents, and demonstrate clinical comfort with pre-exposure human immunodeficiency virus prophylaxis.

Teen dating violence and the COVID-19 pandemic: trends from a longitudinal study in Texas

PURPOSE

Teen dating violence (TDV) is a global public health and safety issue causing health impacts to youth people. This study aimed to examine: (1) the impact of the pandemic on TDV victimisation rates and (2) socioecological factors associated with sustained risk for TDV victimisation during the first year of COVID-19.

METHODS

Data are from an ongoing randomised controlled trial of a TDV prevention programme in Texas (n=2768). We conducted annual assessments in 2019-2021. We used regression modelling to assess demographic, individual, peer and family factors associated with TDV risks.

RESULTS

TDV rates declined from 11.9% in 2019 to 5.2% in 2021. While demographic, peer and family/household factors were not associated with TDV victimisation during the pandemic, individual-level factors (ie, early sexual debut, substance use, acceptance of violence and prior TDV involvement) were related to COVID-era risks. Only early sexual debut was uniquely linked to TDV victimisation risk the first year of COVID-19.

CONCLUSIONS

While TDV rates declined during the pandemic, previous victimisation, substance use and early sexual debut remained potent risks for relationship harm.

Daily associations between resilience factors, substance use, and affect among sexual minority youth

OBJECTIVE

Past research has highlighted that sexual minority youth (SMY) are at particular risk for heightened substance use compared to their heterosexual peers; however, few studies have investigated the associations between resilience factors and substance use among SMY. In the present preregistered study, we examined the associations among three different forms of resilience factors (i.e., general social support, lesbian, gay, bisexual, transgender, and queer (LGBTQ)-identity affirmation, LGBTQ community involvement) and alcohol, nicotine, and cannabis use, as well as on positive and negative affect.

METHOD

SMY (n = 82, ages 15-19, 56.1% cisgender women, 84.4% White) completed a baseline assessment then a 30-day ecological momentary assessment study. Multilevel regression models evaluated within-day and between-person associations between resilience factors and odds of substance use (alcohol, nicotine, cannabis), substance use quantity on use days (alcohol, cannabis), positive affect, and negative affect.

RESULTS

On the day level, general social support was associated with greater positive affect, lesser negative affect, and greater drinks on drinking days. LGBTQ-identity affirmation was associated with greater positive affect, lesser negative affect, and greater odds of nicotine use. LGBTQ community involvement was associated with greater positive affect.

CONCLUSIONS

These results highlight the nuanced ways that resilience may engender more positive affect and reduce negative affect while simultaneously promoting substance use. Future research disentangling the mechanisms connecting resilience and substance use among SMY is necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Measuring the prevalence and impact of adverse childhood experiences in the lives of LGBTQ individuals: A much-needed expansion

BACKGROUND

Numerous studies indicate that LGBTQ people have extensive experiences with adverse childhood experiences (ACEs), more so than their heterosexual and cisgender counterparts. Research also shows that LGBTQ youth endure traumatic experiences with victimization, including bullying, harassment, and violence, based on their non-hetero-cis-normative genders and/or sexual identities. Yet, most ACE measurement strategies fail to: (1) explicitly link the risk of ACE exposure to the discrimination and stigmatization of LGBTQ people, and (2) account for the breadth of potential ACE exposure in LGBTQ populations.

OBJECTIVE

In the current article, we develop and present a more comprehensive ACE measurement strategy for understanding the cumulative and deleterious impacts of ACEs in the lives of LGBTQ individuals.

METHODS

Here, we offer three expansions to the current ACE framework: (1) the inclusion of an LGBTQ-specific ACE in addition to the standard ACE measures, (2) the addition of LGBTQ qualifiers for current ACE items (when applicable), and (3) the expansion of ACE measures to capture the unique ACE experiences of LGBTQ individuals in family life, schools, and faith communities.

CONCLUSIONS

The implementation of a more comprehensive ACE measurement strategy will assist scholars and policymakers in better understanding the impacts of ACEs in the lives of LGBTQ individuals. In all, ACE measurement strategies that capture the breath of exposure of ACEs in the lives of LGBTQ individuals will assist in ACE screening, public health policy, and clinical intervention efforts.

Measurement of Adolescent Dating Violence in Sexual Minority Youth: A Scoping Review

Effectively addressing adolescent dating violence rests on the quality of its measurement, as that has substantial implications for our understanding of prevalence, correlates, outcomes. Although dating violence is highly prevalent among sexual minority youth, the state of measurement in this population has scarcely been explored. This scoping review presents information on the measurement of adolescent dating violence in exiting studies conducted with sexual minority youth. Three databases were searched, and the ancestry approach was used to identify relevant literature published in the United States between 1992-2022 that included sexual minority adolescents aged 19 years or younger. Twenty-one articles were identified. Five enrolled entirely sexual minority samples. Sexual minority distribution ranged from 2.1%-100%. All studies operationalized sexual identity as an orientation (not sexual behavior, attraction). Nineteen studies focused on measuring dating violence behavior. Twelve reported on female and male victimization, 4 on female and male perpetration and victimization, 2 on female perpetration and victimization, and 2 on female victimization-only. Most commonly used items were from the Youth Risk Behavior Survey (11 studies) and the Conflict in Adolescent Dating Relationships Inventory (3 studies). Two studies assessed knowledge of and attitudes toward dating violence. Domains explored included rape myth acceptance, victim empathy, bystander opportunity, and dating abuse knowledge. Only two scales had undergone previous systematic psychometric evaluation. There was no evidence of cross-cultural validation in sexual minority populations. Rigorous research on adolescent dating violence measurement among sexual minority youth is greatly needed and should be given priority among researchers.

Looking Within: An Analysis of Intimate Partner Violence Victimization Among Sexual Minority Youth

Sexual minority youth are at increased risk of intimate partner violence (IPV) victimization compared to their heterosexual peers. However, the sexual minority population is not a homogenous group and risk of IPV victimization varies by LGB+ subgroup (e.g., gay/lesbian, bisexual, and unsure). Using two waves of data (2017, 2019) from the National Youth Risk Behavior Survey (YRBS), this study analyzes (a) differences in physical and sexual IPV victimization between heterosexual and sexual minority youth, (b) within group differences among sexual minority youth, and (c) if the relationship between IPV victimization and sexual identity is attenuated after controlling for sociodemographic characteristics and theoretically relevant risk factors. Results indicate that sexual minority youth are at elevated risk of IPV victimization compared to their heterosexual peers. Within-LGB+ analyses show that bisexual youth are more likely than gay/lesbian youth to be victims of sexual IPV. The association between physical and sexual IPV victimization and sexual identity is partially attenuated by sociodemographic variables and observed risk factors. Findings indicate that intervention and prevention programming should be tailored to identify, and treat, the risks and needs of unique, at-risk populations.

Is Trauma Exposure More Harmful for Sexual Minority Youth? Differences in Trauma-Suicide Associations in a Nationally Representative Sample of U.S. Youth and Implications for Suicide Prevention

Purpose

Lesbian, gay, and bisexual (LGB) youth experience disproportionately high rates of suicidality and exposure to traumatic events, such as sexual violence and teen dating violence. Rates of suicidality and exposure to traumatic events also vary by sexual minority subgroup. The purpose of this study was to: (1) explore the impact of LGB identity on the relationship between violence exposure and suicide; and (2) to examine variations by sexual identity.

Method

A subsample of respondents who reported on their sexual identity in the Youth Risk Behavior Survey (n = 14,690) was used to examine if the associations between sexual and dating violence with suicide outcomes (suicidal ideation, planning, and suicide attempt) depended on the sexual identity of the respondent. Logistic regression models were fitted with an interaction effect to quantify heterogeneity of associations across identity strata.

Results

Overall interaction tests mostly indicated heterogeneity of associations between sexual violence and physical dating violence. Several contrast of strata associations suggested substantive probability differences between sexual minority respondents and their heterosexual peers.

Conclusion

While exposure to violence was broadly associated with increased probability of experiencing any type of suicidality, LGB and questioning youth were significantly more likely to experience suicidality compared to their heterosexual peers. Gay and lesbian youth demonstrated the strongest probability of experiencing suicidal thoughts and behaviors among survivors of sexual violence, while bisexual youth may be more at risk following dating violence. Implications for future research and suicide prevention are discussed.

Alcohol and Other Substance Use Before and During the COVID-19 Pandemic Among High School Students - Youth Risk Behavior Survey, United States, 2021

Adolescence is a critical phase of development and is frequently a period of initiating and engaging in risky behaviors, including alcohol and other substance use. The COVID-19 pandemic and associated stressors might have affected adolescent involvement in these behaviors. To examine substance use patterns and understand how substance use among high school students changed before and during the COVID-19 pandemic, CDC analyzed data from the nationally representative Youth Risk Behavior Survey. This report presents estimated prevalences among high school students of current (i.e., previous 30 days) alcohol use, marijuana use, binge drinking, and prescription opioid misuse and lifetime alcohol, marijuana, synthetic marijuana, inhalants, ecstasy, cocaine, methamphetamine, heroin, and injection drug use and prescription opioid misuse. Trends during 2009-2021 were assessed using logistic regression and joinpoint regression analyses. Changes in substance use from 2019 to 2021 were assessed using prevalence differences and prevalence ratios, stratified by demographic characteristics. Prevalence of substance use measures by sexual identity and current co-occurring substance use were estimated using 2021 data. Substance use prevalence declined during 2009-2021. From 2019 to 2021, the prevalence of current alcohol use, marijuana use, and binge drinking and lifetime use of alcohol, marijuana, and cocaine and prescription opioid misuse decreased; lifetime inhalant use increased. In 2021, substance use varied by sex, race and ethnicity, and sexual identity. Approximately one third of students (29%) reported current use of alcohol or marijuana or prescription opioid misuse; among those reporting current substance use, approximately 34% used two or more substances. Widespread implementation of tailored evidence-based policies, programs, and practices likely to reduce risk factors for adolescent substance use and promote protective factors might further decrease substance use among U.S. high school students and is urgently needed in the context of the changing marketplaces for alcohol beverage products and other drugs (e.g., release of high-alcohol beverage products and increased availability of counterfeit pills containing fentanyl).

Advanced Categorical Data Analysis in Prevention Science

A variety of health and social problems are routinely measured in the form of categorical outcome data (such as presence/absence of a problem behavior or stages of disease progression). Therefore, proper quantitative analysis of categorical data lies at the heart of the empirical work conducted in prevention science. Categorical data analysis constitutes a broad dynamic field of methods research and data analysts in prevention science can benefit from incorporating recent advances and developments in the statistical evaluation of categorical outcomes in their methodological repertoire. The present Special Issue, Advanced Categorical Data Analysis in Prevention Science, highlights recent methods developments and illustrates their application in the context of prevention science. Contributions of the Special Issue cover a wide variety of areas ranging from statistical models for binary as well as multi-categorical data, advances in the statistical evaluation of moderation and mediation effects for categorical data, developments in model evaluation and measurement, as well as methods that integrate variable- and person-oriented categorical data analysis. The articles of this Special issue make methodological advances in these areas accessible to the audience of prevention scientists to maintain rigorous statistical practice and decision making. The current paper provides background and rationale for this Special Issue, an overview of the articles, and a brief discussion of some potential future directions for prevention research involving categorical data analysis.

Interpersonal Victimization, Substance Use, and Mental Health Among Sexual and Gender Minority Youth: The Role of Self-concept Factors

Reducing substance use and negative mental health outcomes of interpersonal victimization among sexual and gender minority youth (SGMY) represents a critical public health priority. Victimized individuals often develop cognitive schemas, or organized knowledge structures consisting of traits, values, and memories about the self, such as self-concept factors, in response to interpersonal victimization. Prior studies demonstrate the role of self-concept factors (e.g., mastery, control, and self-esteem) in explaining the relationship between victimization and substance use and mental health. However, mastery, control, and self-esteem have not been explored as mediators of interpersonal victimization and health among SGMY. This study is among the first to apply cognitive schema models of trauma-related health symptoms using a large sample of SGMY to examine (a) whether interpersonal victimization is associated with substance use (i.e., alcohol use, cannabis use, and cigarette use) and mental health problems (i.e., depressive symptoms, self-perceived stress, self-rated health issues) and (b) whether diminished sense of mastery and control and lower self-esteem can partially explain elevated rates of substance use and mental health problems in this population. We used the U.S.-based 2017 LGBTQ National Teen Survey (n = 17,112; Mage = 15.57, SD = 1.27); 6,401 (37.4%) identified as gay or lesbian, 7,396 (43.2%) as cisgender women, and 10,245 (59.9%) as White. Substance use and mental health variables were positively associated with interpersonal victimization variables and negatively associated with self-concept factors. Self-concept factors partially mediated the relationship between interpersonal victimization and mental health. This model explained 74.2% of the variance in mental health and 28.4% of the variance in substance use. Cognitive coping may represent an important modifiable factor that can be targeted by trauma-focused interventions in efforts to improve victimized SGMY's mental health. Findings call for the development of identity-affirmative, evidence-based, and trauma-focused interventions for SGMY to improve this populations' overall health.

Understanding Associations Between Exposure to Violent Pornography and Teen Dating Violence Among Female Sexual Minority High School Students

Previous research indicates that teen dating violence (TDV) is more common among sexual minority than heterosexual adolescents, with approximately half of female sexual minority adolescents (SMA) endorsing TDV victimization in the last year. In samples of adolescents without regard to sexual orientation, exposure to violent pornography is associated with TDV, but this relationship has not been assessed in female SMA. The current study sample consisted of 10th-grade high school students aged 14-17 who identified as cisgender females (N = 1,276). Data were collected from a baseline survey prior to the delivery of a sexual assault prevention intervention. Female SMA had 2.54 times the odds (95%CI [1.75, 3.69]) of being exposed to violent pornography and 2.53 times the odds (95%CI [1.72, 3.70)]) of TDV exposure compared to heterosexual girls. Exposure to violent pornography was not associated with involvement in TDV among female SMA, controlling for episodic heavy drinking (aOR = 2.25, 95%CI [0.88,6.22]).Given the relatively higher rates of violent pornography and TDV exposure among female SMA compared to heterosexual girls, it is critical that sex education curricula address these experiences and meet the needs of adolescents of all sexual orientations. Future research can assess how these TDV interventions might be tailored for female SMA. Although we did not find that exposure to violent pornography was associated with TDV among female SMA, these investigations should be replicated with larger data sets, given that the association between exposure to violent pornography and engagement in TDV was in the expected direction.

Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression

BACKGROUND

Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts.

METHODS

A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity.

RESULTS

Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men.

CONCLUSIONS

These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.

Positive Trends in School-Based Practices to Support LGBTQ Youth in the United States Between 2010 and 2018

PURPOSE

The present study tests the hypothesis that there has been a significant increase in the implementation of six LGBTQ-supportive school practices in US states between 2010 and 2018.

METHODS

Data were drawn from the publicly available School Health Profiles reports published by the Centers for Disease Control and Prevention, Division of Adolescent and School Health. We conducted unadjusted linear regression models separately for each practice to examine state-specific linear trends in the percentage of secondary schools reportedly engaging in six LGBTQ-supportive practices across all 50 states. In addition, we conducted an unadjusted linear regression on the trend to estimate changes in the median percentage of schools across all states engaging in each of the six practices through time.

RESULTS

In 2010, 5.7% of schools reported implementing all six practices, which increased to 15.3% in 2018. In the period from 2010 to 2018, the implementation of four of six key practices increased significantly in more than half of US states. Most states experienced a mix of either increases in practices or no change in practice prevalence, with no state experiencing a significant decrease.

DISCUSSION

There have been significant gains in the percentage of schools implementing LGBTQ-supportive practices. Yet, despite increases in the examined practices, the median percentage of schools in the United States that implement all six remains low. There is considerable room to improve on the use of these practices in schools across the United States, including increased attention to the quality of implementation and the barriers and facilitators to their instantiation.

Directionality of Dating Violence Among High School Youth: Rates and Correlates by Gender and Sexual Orientation

Sexual minority adolescents are at greater risk for experiencing teen dating violence (TDV) in their dating relationships. Although adolescents in dating relationships often report experiencing and perpetrating various forms of TDV, the directionality of TDV based on youth's reported gender and sexual orientation is not known. A sample of 10th-grade students (N = 1,622) recruited from high schools in the Northeastern United States completed assessments of TDV victimization and perpetration and reported their past-month heavy alcohol use and marijuana use. Sexual minority girls (58%) and boys (36%) were more likely to experience TDV than heterosexual girls (38%) and boys (25%), respectively. Sexual minority boys were less likely, although the confidence intervals included one, to engage in dual-role physical TDV (odds ratio [OR] = 0.14, 95% confidence interval [CI] [0.00, 1.26]) and threatening TDV (OR = 0.14, 95% CI [0.00, 1.02]), and instead were more likely to be victimized. In contrast, the profiles of TDV were similar for girls, with sexual minority girls only being more likely than heterosexual girls to report dual-role physical TDV (OR = 2.23, 95% CI [1.07, 4.66]). Compared with unidirectional TDV, bidirectional TDV was significantly associated with sexual minority girls' substance use, but not with heterosexual girls' substance use. Sexual minority youth report higher rates of TDV, with sexual minority boys being distinctly at-risk for being victimized within their dating relationships. Engagement in both TDV victimization and perpetration was distinctly associated with substance use for sexual minority girls, highlighting the need for integrated prevention efforts and support.

Forced sex and its predictors among students attending university: a cross-sectional study

BACKGROUND

Forced sex is associated with negative psychological health outcomes. This study aimed to determine the prevalence of forced sex and its predictors.

METHODS

This cross-sectional study was performed on 800 students of a university in USA using a random sampling method. Reproductive health electronic questionnaire was used for data collection. Due to the sensitive nature of the questionnaires and for anonymity, Qualtrics software was used. To estimate the extent of the effect of each of the independent variables (knowledge, attitude, as well as socio-demographic characteristics) on the dependent variable (forced sex), multivariate logistic regression was used.

RESULTS

About one-fifth of students (16.9%) had experienced forced sex. The variables of gender, knowledge about sexually transmitted diseases (STD), and sexual attitude were among the predictors of forced sex. This kind of sexual relationship was more likely to occur in girls than in boys (OR = 2.94, 95%CI: 1.20 to 1.71). Further, the chance of forced sex significantly increased with growing knowledge of STD (OR = 1.41, 95%CI: 1.61 to 1.71), and sexual attitude (OR = 1.23, 95%CI: 1.04 to 1.21).

CONCLUSION

Considering the impact of gender, knowledge about STD, and sexual attitude on forced sex, educational interventions among the youth especially girls are required to provide complete and proper information about sexual and reproductive health and rights and correct the sexual attitudes of the youth.

Risk and Protective Factors for Adolescent Relationship Abuse across Different Sexual and Gender Identities

Little is known about the characteristics and context of adolescent relationship abuse victimization across youth of different sexual and gender minority identities. This study sought to examine this in a national sample of 14-15-year-old youth. The sample comprised 3296 youth who reported having been in a relationship, of which 36% (n = 1197) were exclusively cisgender heterosexual; 41% (n = 1, 349) cisgender sexual minority; and 23% (n = 750) gender minority, the majority of whom were also sexual minority. More than half of all youth who had been in a relationship, dated or hooked up with someone had experienced some form of adolescent relationship abuse victimization. Gender minority youth, in particular transgender boys and non-binary youth assigned female at birth, were more likely to be victims of multiple types of adolescent relationship abuse compared to cisgender youth. Perpetrator gender varied for sexual and gender minorities and was more homogenous for cisgender heterosexual youth. Several factors were associated with adolescent relationship abuse for all youth, although alcohol use, and parental trust and communication emerged as particularly important for sexual and gender minority youth. Overall, findings address multiple gaps in the literature and contribute to the understanding of adolescent relationship abuse across different sexual and gender identities.

Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder

Opioid use disorder (OUD) among adolescents and young adults (youth) is associated with drug use and sexual HIV-related risk behaviors and opioid overdose. This mixed methods analysis assesses risk behaviors among a sample of 15-21-year-olds (N = 288) who were being treated for OUD in a residential drug treatment program in Baltimore, Maryland. Participants were enrolled in a parent study in which they received either extended-release naltrexone (XR-NTX) or Treatment as Usual (TAU), consisting of outpatient counseling with or without buprenorphine, prior to discharge. At baseline, participants were administered the HIV-Risk Assessment Battery (RAB), and clinical intake records were reviewed to determine participants' history of sexual, physical, or other abuse, as well as parental and partner substance use. A sub-sample of study participants completed semi-structured qualitative interviews (N = 35) at baseline, three-, and six-month follow-up periods. This analysis identified gender (e.g., female IRR = 1.63, CI 1.10-2.42, p = .014), the experience of dependence (e.g., previous detoxification IRR = 1.08, CI 1.01-1.15, p = .033) and withdrawal (e.g., severe withdrawal symptoms IRR = 1.41, CI 1.08-1.84, p = .012), and the role of relationships (e.g., using with partner IRR = 2.45, CI 1.15-5.22, p = .021) as influencing high-risk substance use behaviors. Similarly, high-risk sex was influenced by gender (e.g., female IRR = 1.43, CI 1.28-1.59, p < .001), and the role of relationships (e.g., using with partner IRR = 0.78, CI 0.62-0.98, p = .036). These are key targets for future prevention, treatment, and intervention.

The Association of Asthma, Sexual Identity, and Inhaled Substance Use among U.S. Adolescents

Rationale: Minority sexual identity appears to confer asthma risks. Although associations between inhaled substances and asthma are established, these have not been examined among sexual minority youths. Given sexual minority adolescents' disproportionately high rates of substance use, research is needed to fill this important gap.Objectives: Using a representative sample of adolescents from the United States, we 1) examined associations among asthma, sexual identity, and inhaled substance use and tested 2a) whether sexual identity moderates relationships between asthma and inhaled substance use and 2b) whether inhaled substance use mediates associations between sexual identity and asthma.Methods: Data are from the 2015 and 2017 Youth Risk Behavior Surveillance Survey. Adolescents (n = 30,113) reported if they were ever diagnosed with asthma, current use of cigarettes, cigars and/or cigarillos, marijuana, and electronic vapor products and if they ever used inhalants or synthetic marijuana. We used logistic regression to examine associations between asthma, sexual identity, and inhaled substance use controlling for age, race or ethnicity, and body mass index percentile, stratified by sex.Results: Lesbian, gay, and bisexual respondents had higher relative risks for asthma than heterosexual youth. Sexual minority female youths had significantly higher relative risks than heterosexual female youths for use of every inhaled substance. There were few sexual identity differences in inhaled substance use among male youths. Inhaled substance use was significantly associated with higher risks for asthma. In general, associations between each individual inhaled substance and asthma did not differ between sexual minority and heterosexual youths. However, when all inhaled substances were added into the models concurrently, inhaled substance use appeared to mediate associations with asthma among lesbian and bisexual female youths, and partially mediated these associations among sexual minority male youths.Conclusions: Sexual identity and inhaled substance use appear to play important roles in asthma risk. However, these variables do not fully explain the risk, suggesting that other unmeasured variables (e.g., stress and victimization) may be implicated in risks for both inhaled substance use and asthma. It is important that clinicians providing care to adolescents ask about sexual identity and inhaled substance use. Effective approaches to reducing inhaled substance use among adolescents, especially sexual minorities, are needed.

Design and Validation of the Scale TDV-VP Teen Dating Violence: Victimisation and Perpetration [Violencia en Parejas Adolescentes: Victimización y Perpetración] for Spanish Speakers

Background: This study offers the design and validation of a scale for measuring violence in adolescent couples from the perspective of victimisation and perpetration for young Spanish speakers. Method: Validation study using exploratory and confirmatory factor analysis with online self-selected sampling and the participation of 422 subjects who met the requirements of being between 13 and 21 years old and currently or recently having a partner. Results: A scale of victimisation in adolescent partner relationships was obtained with 25 items and a scale of violence perpetration with 22 items. Both scales presented five factors: psychological violence, verbal violence, control, jealousy, and sexual violence. Significant differences were found between men and women in victimisation and perpetration of sexual violence. Conclusions: The Teen Dating Violence—Victimisation and Perpetration (TDV)—VP complies with the reliability and validity indices, constituting a very useful instrument for the detection and measurement of violence in Spanish-speaking adolescent couples in health-promotion work.

Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students - Youth Risk Behavior Survey, United States, 2019

Adolescence is an important period of risk for substance use initiation and substance use-related adverse outcomes. To examine youth substance use trends and patterns, CDC analyzed data from the 2009-2019 Youth Risk Behavior Survey. This report presents estimated prevalence of current (i.e., previous 30-days) marijuana use, prescription opioid misuse, alcohol use, and binge drinking and lifetime prevalence of marijuana, synthetic marijuana, cocaine, methamphetamine, heroin, injection drug use, and prescription opioid misuse among U.S. high school students. Logistic regression and Joinpoint analyses were used to assess 2009-2019 trends. Prevalence of current and lifetime substance use by demographics, frequency of use, and prevalence of co-occurrence of selected substances among students reporting current prescription opioid misuse are estimated using 2019 data. Multivariable logistic regression analysis was used to determine demographic and substance use correlates of current prescription opioid misuse. Current alcohol, lifetime cocaine, methamphetamine, heroin, and injection drug use decreased during 2009-2019. Lifetime use of synthetic marijuana (also called synthetic cannabinoids) decreased during 2015-2019. Lifetime marijuana use increased during 2009-2013 and then decreased during 2013-2019. In 2019, 29.2% reported current alcohol use, 21.7% current marijuana use, 13.7% current binge drinking, and 7.2% current prescription opioid misuse. Substance use varied by sex, race/ethnicity, grade, and sexual minority status (lesbian, gay, or bisexual). Use of other substances, particularly current use of alcohol (59.4%) and marijuana (43.5%), was common among students currently misusing prescription opioids. Findings highlight opportunities for expanding evidence-based prevention policies, programs, and practices that aim to reduce risk factors and strengthen protective factors related to youth substance use, in conjunction with ongoing initiatives for combating the opioid crisis.