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Eslava D, Martínez-Vispo C, Villanueva-Blasco VJ, Errasti JM, Al-Halabí S. Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables. Addict Behav 2023; 146:107798. [PMID: 37406404 DOI: 10.1016/j.addbeh.2023.107798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.
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Affiliation(s)
- Dalila Eslava
- Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza de Feijoo, 33003 Oviedo, Spain
| | - Carmela Martínez-Vispo
- Departament of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Calle Xosé María Suárez Núñez, s/n, 15782 Santiago de Compostela, Spain
| | | | - José Manuel Errasti
- Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza de Feijoo, 33003 Oviedo, Spain
| | - Susana Al-Halabí
- Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza de Feijoo, 33003 Oviedo, Spain
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2
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Fernandez A, Lozano A, Lee TK, Prado G. Screening for Adolescent Risk Behaviors: Preliminary Evidence for a Family Functioning Tool. Int J Behav Med 2023:10.1007/s12529-023-10209-7. [PMID: 37580481 DOI: 10.1007/s12529-023-10209-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Family functioning is associated with adolescent drug use, alcohol use, cigarette use, and sexual risk behaviors. Assessing adolescents for family functioning, commonly associated with multiple risk behaviors, may help identify adolescents at risk for adverse health outcomes. This study examined whether a latent family functioning construct, encompassing multiple dimensions of family functioning, was associated with adolescents' substance use and sexual risk behaviors. METHOD This study used data harmonization with three intervention trials, including data from 1451 adolescents (M = 13.6, SD = 1.0), to perform a full-information item bifactor analysis on 46 family functioning items from five pre-existing family functioning measures. Regression analysis was used to examine the association between the identified subset of items and the following outcomes: cigarette use, alcohol use, drug use, and condom use. RESULTS Bifactor analysis identified a 26-item latent family functioning construct. Regression analysis indicated that a 26-item latent family functioning construct was associated negatively with lifetime and past 90-day cigarette use, alcohol use, and drug use. CONCLUSION In sum, the multi-dimensional latent family functioning construct may target specific barriers to risk screening in adolescent populations, including time constraint, hesitancy in discussing sensitive health topics, and use culturally appropriate and age-appropriate assessments.
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Affiliation(s)
- Alejandra Fernandez
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, TX, USA.
| | - Alyssa Lozano
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Tae Kyoung Lee
- Department of Child Psychology and Education/Social Innovation Convergence Program, Sungkyunkwan University, Seoul, South Korea
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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3
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Flores R, Kerman J, Schneider J, Harawa N. "I feel like marijuana is the only drug that wouldn't kill me": perceptions of cannabis use in previously incarcerated Black men who have sex with other men. Harm Reduct J 2023; 20:13. [PMID: 36737793 PMCID: PMC9896444 DOI: 10.1186/s12954-023-00744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Fragmented state laws have impacted cannabis uptake and perceptions in the USA. Little research has explored the attitudes, beliefs, and social network influences of young Black men who have sex with men (BMSM) who have experienced incarceration and use cannabis. While problematic cannabis use is not well defined and understudied, scholars have found that a person's social network can mediate problematic substance use and reduce recidivism rates by providing both tangible and emotional support. This analysis examines how social networks contribute to cannabis perceptions and use among BMSM with criminal legal system involvement in Chicago, IL, and Houston TX. METHODS Researchers conducted interviews with 25 cis gender Black men informed by life course theory, with a focus on the role of social networks, incarceration, and other life experiences in substance use. All interviews were audio-recorded, de-identified, and transcribed; participants were compensated $50. A deductive-inductive thematic analysis was used to analyze all qualitative data collected. RESULTS Twelve BMSM in Chicago and 13 BMSM in Houston (M = 26.6 years old, SD = 3.7) were interviewed. A majority identified as gay (56%), with 12 participants (48%) reporting having a high school diploma or equivalent; their average age of first substance use was 15.2 (SD = 2.9). Participants perceived cannabis usage to be categorically distinct from other intoxicating substance usage, with many describing it as not harmful and potentially beneficial. Three themes shaped their choices and attitudes regarding cannabis and "hard" drugs-social networks, need fulfillment, and knowledge of risk. CONCLUSION Participant descriptions of cannabis use emphasize their drug-use behavior as being produced by agent decision-making and risk assessment. Future work should expand on how these decisions are made, and how social networks can be leveraged to encourage non-harmful drug consumption behaviors.
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Affiliation(s)
- Rey Flores
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA. .,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA. .,University of Illinois at Chicago, 750 S Halsted St., Chicago, IL, 60607, USA.
| | - Jared Kerman
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA.,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA
| | - John Schneider
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA.,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA
| | - Nina Harawa
- David Geffen School of Medicine at UCLA, 1100 Glendon Ave. Suite 850, Los Angeles, CA, 90024, USA.,Charles Drew University of Medicine and Science, 1731 E. 120th St., Los Angeles, CA, 90059, USA
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4
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Santarato N, Barbosa NG, da Silva ALC, Monteiro JCDS, Gomes-Sponholz FA. Characterization of adolescent sexual practices. Rev Lat Am Enfermagem 2022. [PMID: 36197394 PMCID: PMC9647882 DOI: 10.1590/1518-8345.6289.3711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits. METHOD a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test. RESULTS 21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05). CONCLUSION a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families. UNLABELLED (1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.
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Affiliation(s)
- Nathalia Santarato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Nayara Gonçalves Barbosa
- Universidade Federal de Juiz de Fora, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Minas Gerais, Brasil
| | - Anderson Lima Cordeiro da Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Juliana Cristina dos Santos Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brasil
| | - Flávia Azevedo Gomes-Sponholz
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brasil
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5
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Santarato N, Barbosa NG, da Silva ALC, Monteiro JCDS, Gomes-Sponholz FA. Characterization of adolescent sexual practices. Rev Lat Am Enfermagem 2022; 30:e3712. [PMID: 36197394 PMCID: PMC9647882 DOI: 10.1590/1518-8345.6289.3712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/29/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits. METHOD a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test. RESULTS 21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05). CONCLUSION a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families. UNLABELLED (1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.
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Affiliation(s)
- Nathalia Santarato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Nayara Gonçalves Barbosa
- Universidade Federal de Juiz de Fora, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Minas Gerais, Brasil
| | - Anderson Lima Cordeiro da Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Juliana Cristina dos Santos Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brasil
| | - Flávia Azevedo Gomes-Sponholz
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brasil
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6
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Opara I, Lizarraga A, Lardier DT, Herrera A, Garcia-Reid P, Reid RJ. What happens when we ask? A phenomenological focus group on HIV prevention and sexual health education among emancipated foster care youth. CHILDREN AND YOUTH SERVICES REVIEW 2022; 140:106583. [PMID: 35910532 PMCID: PMC9337728 DOI: 10.1016/j.childyouth.2022.106583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Youth of color who have recently been emancipated from foster care are among the most vulnerable group at risk for having poor sexual health outcomes. It is essential for researchers to understand how emancipated foster care youth receive messages about safe sex and HIV/STI prevention in order to tailor health promotion activities for this group. This study presents a strengths-based view of emancipated foster care youth of color who developed an empowering, arts-based campaign to prevent HIV in their community using Youth Participatory Action Research (Y-PAR) methods. The project was led by 10 emancipated foster care youth who participated in two focus groups that centered on understanding their knowledge of HIV. Five major themes emerged from the focus group. Implications for researchers include incorporating safe spaces for youth to develop ideas that can result in empowering activities relating to prevention.
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Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, USA
| | | | - David T. Lardier
- University of New Mexico, School of Medicine, Department of Psychiatry, USA
| | | | - Pauline Garcia-Reid
- Department of Family Science & Human Development, Montclair State University, USA
| | - Robert J. Reid
- Department of Family Science & Human Development, Montclair State University, USA
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7
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D'Amico EJ, Rodriguez A, Tucker JS, Dunbar MS, Pedersen ER, Seelam R. Disparities in functioning from alcohol and cannabis use among a racially/ethnically diverse sample of emerging adults. Drug Alcohol Depend 2022; 234:109426. [PMID: 35364418 PMCID: PMC9175265 DOI: 10.1016/j.drugalcdep.2022.109426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Trajectory studies have consistently shown that alcohol and cannabis (AC) use during emerging adulthood (EA) affect functioning; however, few studies examine whether racial/ethnic disparities may occur at similar levels of use. METHODS We conducted web-based surveys across five waves from mean age 18.3 through 22.6. The sample (N = 2945) is 55% female, 46% Hispanic, 23% Asian, 23% White, 6% multi-racial (MR)/other, and 2% Black. MEASUREMENTS Past month substance use was defined as number of days used. Outcomes at age 22.6 included negative consequences, delinquency, physical ailments and health, depression and anxiety, peer relationship functioning, life satisfaction, employment, and education. RESULTS Compared to White EAs, Hispanic, Asian, and MR/other EAs reported less initial alcohol use; Hispanic and Asian EAs reported less initial cannabis use, whereas Black EAs reported more cannabis use. Greater initial frequency and increased frequency of AC use were associated with poorer outcomes (e.g., worse mental health). In terms of disparities, compared to White EAs, Hispanic EAs reported poorer physical health at the same levels of AC use; Hispanic, Asian, and MR/other EAs reported greater alcohol consequences and delinquency; Black, Hispanic, Asian and MR/other EAs reported lower life satisfaction; and Hispanic and MR/other EAs were less likely to pursue education beyond high school (although Asian EAs were more likely). CONCLUSIONS Findings emphasize that trajectories of AC use during EA are associated with a range of functional outcomes. Disparities in functioning at similar levels of AC use highlight the importance of reaching racially/ethnically diverse EAs with prevention and intervention programming.
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Affiliation(s)
| | | | - Joan S Tucker
- RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
| | - Michael S Dunbar
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Eric R Pedersen
- University of Southern California, Los Angeles, CA 90089, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
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8
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Daily Marijuana Use Predicts HIV Seroconversion Among Black Men Who Have Sex with Men and Transgender Women in Atlanta, GA. AIDS Behav 2022; 26:2503-2515. [PMID: 35094179 DOI: 10.1007/s10461-022-03598-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/01/2022]
Abstract
We evaluated whether different types of substance use predicted HIV seroconversion among a cohort of 449 Black men who have sex with men (MSM) and transgender women (TGW). A community-based sample was recruited in Atlanta, GA between December 2012 and November 2014. Participants completed a survey and were tested for STIs (Chlamydia and gonorrhoeae using urine samples and rectal swabs) at baseline. HIV testing was conducted at 12-months post enrollment. Multivariable binary logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CI) for associations between substance use and HIV seroconversion. By 12-month follow-up, 5.3% (n = 24) of participants seroconverted. In multivariable analyses, daily marijuana use was positively associated with HIV seroconversion (aOR 3.07, 95% CI 1.11-8.48, P = 0.030). HIV incidence was high and daily marijuana use was associated with a more than threefold increased odds of HIV seroconversion among a community-based cohort of Black MSM and TGW.
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9
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Syndemics of Sexually Transmitted Infections in a Sample of Racially Diverse Pregnant Young Women. Matern Child Health J 2022; 26:299-308. [PMID: 34993752 PMCID: PMC8736293 DOI: 10.1007/s10995-021-03335-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
Introduction Syndemic theory posits that poor health outcomes co-occur and amplify each other in the context of harmful conditions that must be addressed simultaneously to improve health equity. This analysis identifies perinatal syndemic factors and examine how factors are related to STI in a sample of racially diverse young pregnant women. Methods Pregnant participants (n = 61) ages 14–21 from racially diverse backgrounds were recruited from a prenatal clinic for an ongoing longitudinal study between October 2019-February 2020. Participants completed a tablet survey assessing pregnancy intention, psychosocial factors (e.g., depression, stress, partner violence, pregnancy history) and consented to provide access to their medical records for STI and clinical urine samples screened for tobacco and cannabis use. Latent class analysis (LCA) was used to examine probabilities of co-occurring Syndemic indicators. Results Half of the women were Black (52%) and primigravida (54%). Three classes were identified in the LCA, two of them reflecting syndemics related to STI from the medical record. The largest class was half Black (51%), with a high rate of STI (65%), and was characterized by factors including depressive symptoms (93%), stress (64%), and substance use (65% cannabis, 82% tobacco). Additionally, the class with the highest rates of STI (74%) also had higher rates of partner violence (48%), morning sickness (100%), and prenatal cannabis use (63%). Conclusion Findings indicate evidence of a syndemic related to increased STI. A longitudinal evaluation of syndemics in this cohort may inform appropriately tailored intervention strategies to promote perinatal health in racially diverse young pregnant populations.
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10
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Thomas SA, Micalizzi L, Meisel SN, Price D, Spirito A. Adolescent Sibling Associations among Alcohol, Cannabis, and Sexual Risk Behavior: A Test of Interdependence. Subst Use Misuse 2022; 57:1572-1580. [PMID: 35791906 PMCID: PMC9844215 DOI: 10.1080/10826084.2022.2096238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Although siblings are conceptualized as a salient social influence during adolescence, few studies have examined how adolescent siblings influence each other's substance use and risky sexual behavior. Objectives: In this study, we investigated the influence of alcohol use days, cannabis use days, and cannabis and alcohol co-use days on the sexual risk behavior of siblings while accounting for dyadic influence. METHODS At the baseline visit for a randomized controlled trial for adolescents referred due to parents' concerns about their substance use ("referred adolescents"; n = 99; Mage=15.95; 38.38% female), we assessed alcohol and cannabis use days as well as sexual risk behavior of the referred adolescents and their sibling (Mage=15.03; 51.52% female). We computed the number of days in the 30 days prior to the baseline that alcohol and cannabis use occurred on the same day. Using a cross-sectional actor partner interdependence model, we tested two models of how adolescents' substance use is associated with their own ("actor effect") and their siblings' ("partner effect") sexual risk behavior-one model for alcohol and cannabis use, and one model for daily co-use. RESULTS For referred adolescents and their siblings, within an individual, greater alcohol, cannabis, and daily co-use was significantly associated with sexual risk behavior (actor effects). Furthermore, more sibling co-use days was positively associated with referred adolescent sexual risk behavior (partner effect), representing interdependence. CONCLUSION These findings confirm the influence siblings have on one another's risky behavior in adolescence and have implications for prevention and intervention efforts for adolescent substance use.
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Affiliation(s)
- Sarah A Thomas
- Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Lauren Micalizzi
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Samuel N Meisel
- Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA.,Center for Alcohol & Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Dayna Price
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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11
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Wada YH, Khalid GM, Shitu Z, Ibrahim UI. Prevalence and Impacts of Psychoactive Substance Abuse amongst Undergraduate University Students in Katsina State, Nigeria. ADDICTION & HEALTH 2021; 13:221-231. [PMID: 35178194 PMCID: PMC8818309 DOI: 10.22122/ahj.v13i4.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Drug and substance abuse among university students is of public health concern and is becoming a global threat to the education system. This is more devastating to the academic performance of the addicts. The present study aims to assess the prevalence and impacts of psychoactive substance abuse among the university undergraduate students in Katsina State, Nigeria, and to determine the effects of such abuses on the students' academic performance. METHODS A cross-sectional study was conducted using online survey tool (Google Form) validated by content validity and pilot study. The hyperlink to the online survey tool was shared with undergraduate students from three universities located in Katsina State via emails and social media platforms, namely WhatsApp, Facebook, and Twitter. Data collected from eligible participants were analyzed using descriptive statistics. FINDINGS A total of 308 students from the three universities returned the online questionnaire, of which 67.2% were men and 32.8% were women. Among the respondents, 37% admitted practicing drug and/or substance abuse. Majority of them (56.2%) were third-year students in the age range of 20-25 years. CONCLUSION Drug and substance abuse among the undergraduate university students in Katsina State is common, and it cuts across both male and female students. Concerted efforts towards parental support and supervisions, social intervention programs, and campus-based prevention and supported programs against drug and substance abuse should be encouraged.
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Affiliation(s)
- Yusuf Hassan Wada
- Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria AND West African Academy of Public Health, Abuja, Nigeria
| | - Garba M. Khalid
- Department of Pharmaceutics and Pharmaceutical Technology, Bayero University, Kano, Nigeria
| | - Zayyanu Shitu
- Medecins Sans Frontieres Operation Center Barcelona and Athens. Shinkafi Project, Zamfara State, Nigeria
| | - Umar Idris Ibrahim
- Department of Clinical Pharmacy and Pharmacy Practice, Bayero University, Kano, Nigeria
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12
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Baiden P, Jahan N, Mets VE, Adeku Y. An examination of the association between risky sexual behaviors and suicidal behaviors among adolescents: Findings from the 2017 Youth Risk Behavior Survey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Chung T, Hipwell AE, Stepp SD, Miller E, Sartor CE. Profiles of young women's alcohol and cannabis use linked to risk for sexually transmitted infection highlight the importance of multi-level targeted interventions: Findings from the Pittsburgh girls study. Subst Abus 2021; 43:231-239. [PMID: 34143947 DOI: 10.1080/08897077.2021.1931634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18-20. Profile indicators included: women's and partner's alcohol and cannabis use, women's sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors. Results: Two of the five identified profiles had low STI likelihood: "Low Use" of alcohol and cannabis (25.5%; overrepresented by Black women), and "Alcohol Only" (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: "Co-Use: Increasing Alcohol and Occasional Cannabis use" (16.5%; overrepresented by White women), "Co-Use: Occasional Alcohol and Cannabis use" (26.1%; overrepresented by Black women), and "Co-Use: Frequent Cannabis and Occasional Alcohol use" (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with "Low Use" and "Co-Use: Frequent Cannabis and Occasional Alcohol use" profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the "Co-Use: Frequent Cannabis and Occasional Alcohol use" profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural- and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.
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Affiliation(s)
- Tammy Chung
- Department of Psychiatry, Institute for Health, Healthcare Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carolyn E Sartor
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors. PHARMACY 2021; 9:pharmacy9020106. [PMID: 34071670 PMCID: PMC8167772 DOI: 10.3390/pharmacy9020106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
Nonmedical use of prescription opioid medication (NMPO) in the United States is a public health crisis, resulting in high rates of emergency room visits, morbidity, and mortality. The purpose of this study was to explore prevalence estimates and correlates of NMPO among a convenience sample of college students in the northeast and southeast regions of the US to help generate directions for future research. Motivations for misuse, age of onset, access, concomitant substance use, and individual factors were investigated among a sample of undergraduate students from two universities. Participants (N = 847) completed a battery of various self-report measures. Findings revealed that 7.7% (Southeastern University) and 12.8% of students (Northeastern University) reported lifetime NMPO, whereas past-month NMPO was reported by 0.8% and 0.9% of participants, respectively. Lifetime history of regularly using alcohol, nonmedical use of benzodiazepine medication, nonmedical use of prescription stimulants, symptoms of depression and anxiety, and executive functioning (i.e., metacognition and behavioral regulation) were significantly related to lifetime history of NMPO in this college sample. These findings offer several potential subsequent lines of investigation regarding the associations between various demographic and psychological factors and NMPO. Future research is needed to help identify college students who are at risk of NMPO.
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Boyd DT, Opara I, Quinn CR, Waller B, Ramos SR, Duncan DT. Associations between Parent-Child Communication on Sexual Health and Drug Use and Use of Drugs during Sex among Urban Black Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5170. [PMID: 34068128 PMCID: PMC8152761 DOI: 10.3390/ijerph18105170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/28/2022]
Abstract
Black youth and their families living in urban settings may experience unique stressors that contribute to underlying issues due to the environmental context. Such factors may exacerbate and promote drug use and engagement in risky sexual behaviors, unknowingly. Little is known about how family factors, peer pressure, condom use, and other related factors are associated with substance use and engaging in sexual behaviors while on drugs among urban African American youth aged 12-22 (N = 638). We used regression models to examine associations between parental bonding, parent-adolescent sexual health communication, condom use, peer pressure on substance use, and having sex while on drugs. Multivariate results indicated that parental bonding was statistically significant and associated with drug use (OR: 1.36, 95%CI: 1.36). Our study highlights that parental bonding plays a critical role in youth using drugs while living in urban environments.
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Affiliation(s)
- Donte T. Boyd
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
- Center for Interdisciplinary Research on AIDS (CIRA) at Yale University, New Haven, CT 06510, USA;
| | - Ijeoma Opara
- Center for Interdisciplinary Research on AIDS (CIRA) at Yale University, New Haven, CT 06510, USA;
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT 06510, USA
| | - Camille R. Quinn
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Bernadine Waller
- School of Social Work, Adelphi University, Garden City, NY 11530, USA;
| | - S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
| | - Dustin T. Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
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D'Anna LH, Chang K, Wood J, Washington TA. Marijuana Use and Sexual Risk Behavior Among Young Black Men Who Have Sex with Men in California. J Racial Ethn Health Disparities 2020; 8:1522-1532. [PMID: 33197039 DOI: 10.1007/s40615-020-00915-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/21/2020] [Accepted: 10/27/2020] [Indexed: 12/01/2022]
Abstract
Young black men who have sex with men (YBMSM) are disproportionately affected by HIV and continue to experience higher rates of new HIV infections when compared to other population groups. As part of the Peer Promotion of Wellness and Enhanced Linkage to Resources Project, we examined problem marijuana use and the overall sexual risk profile of 250 YBMSM. Eighty percent reported prior use of marijuana in their lifetime (n = 200). Among those, problem marijuana use was correlated with problem use of alcohol (r = 0.51, p < 0.001) and other drugs (r = 0.29, p < 0.001); lower household income (r = - .22, p < .01); homelessness (r = 0.15, p < 0.05); incarceration (r = 0.16, p < 0.05); exchanging sex for money, drugs, or shelter (r = 0.18, p < 0.05); having sex with someone known or suspected of having HIV and/or an STI (r = 0.20, p < 0.01); having sex with someone known or suspected of being an injector (r = 0.24, p < 0.01); and having unprotected sex while under the influence of alcohol or drugs (r = 0.32, p < 0.001). The complex relationship between marijuana and sexual risk behavior was examined while accounting for the possible moderating effects of alcohol or other drugs. Problem marijuana, alcohol, and other drug use each made unique contributions to predicting risky sex behavior. A significant marijuana and other drug interaction was found to predict sexual risk behaviors. Future efforts should include holistic intervention approaches for YBMSM that consider factors facilitating high-risk sexual behaviors.
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Affiliation(s)
- Laura Hoyt D'Anna
- Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., FO5-120, Long Beach, CA, 90840, USA.
| | - Kyle Chang
- Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., FO5-120, Long Beach, CA, 90840, USA
| | - Jefferson Wood
- Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., FO5-120, Long Beach, CA, 90840, USA
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Baru A, Adeoye IA, Adekunle AO. "I was raped by the broker on the first day of my arrival in the town." Exploring reasons for risky sexual behavior among sexually-active unmarried young female internal migrants in Ethiopia: A qualitative study. PLoS One 2020; 15:e0242176. [PMID: 33186376 PMCID: PMC7665896 DOI: 10.1371/journal.pone.0242176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies revealed that internal migrants are one of the most vulnerable groups for poor sexual and reproductive health (SRH) information and services. Risky sexual behavior (RSB) is a threat to public health and might lead to serious health problems such as unintended pregnancy, abortion, and sexually transmitted infections (STIs) including HIV/AIDS. The reported prevalence of RSB among young female internal migrants in Ethiopia was as high as 70.3%. This requires in-depth understanding of the underlying cause. So, this study aimed at exploring reasons for RSB among sexually-active unmarried young female migrants in Ethiopia. METHODS A descriptive qualitative study was conducted using focus group discussions among sexually-active young female migrants working Burayu town. The focus group discussions were done in the local languages of participants (Afaan Oromo and Amharic). The recorded data were transcribed verbatim and translated into English for analysis and presentation in the study. The data were coded and Atlas.ti 7.5 software packages were used for data analyses. Then, the findings were thematically organized and analyzed using content analysis. RESULTS This study revealed that poor socio-economic status, social media indulgence, rape, substance use, poor knowledge of condom use, unfavorable attitude toward condom use, misconceptions about emergency pills, and the nature of the new environment and work place were responsible for RSB among internal migrants. The participants described that the migrants' economic conditions and workplace sexual violence are pushing them toward engaging in unprotected sex, being sexually abused, commercial sex, and transactional sex. CONCLUSIONS Internal migrants' sexual behavior is a complex process influenced by multiple interrelating systems. We have explored a set of factors namely poverty, pressure and sexual abuse from brokers, sexual exploitation and abuses against domestic workers by their bosses, indulgence in social media, sexting, inadequate knowledge, and unfavorable attitude toward condom use that led young female internal migrants to risky sexual practices. An intervention to promote safe sex targeted to this population is urgently needed with a focus on an intervention to eliminate misconceptions about condoms, increase proper condom use, and end sexual violence. Moreover, a relevant policy is needed to safeguard internal migrants from sexual exploitation and abuses at their work place.
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Affiliation(s)
- Ararso Baru
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
- Research and Collaboration Department, Slum and Rural Health Initiative (SRHIN), Country Director to Ethiopia, Addis Ababa, Ethiopia
| | - Ikeola A. Adeoye
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeyemi O. Adekunle
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Department of Obstetrics and Gynecology, Faculty of Clinical Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Baru A, Adeoye IA, Adekunle AO. Risky sexual behavior and associated factors among sexually-active unmarried young female internal migrants working in Burayu Town, Ethiopia. PLoS One 2020; 15:e0240695. [PMID: 33085687 PMCID: PMC7577498 DOI: 10.1371/journal.pone.0240695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/01/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young female internal migrants are highly vulnerable to risky sexual behaviors (RSB) which may result in serious health problems such as unintended pregnancy, abortion and sexually transmitted infections including HIV. RSB includes early sexual debut (before 18 years), having multiple sexual partners, sex without a condom or inconsistent use of condom and sex under the influence of substance use. This study aimed to assess the magnitude and the factors associated with RSB among sexually-active unmarried young female internal migrants in Burayu Town, Ethiopia. METHODS A cross sectional study design was used for the study. A total of 267 respondents was recruited into the study using a simple random sampling technique. A semi-structured interviews-administered questionnaire was used to obtain information from the study participants. The collected data were cleaned, coded and entered into Epi data version 3.1 and then exported to SPSS Ver.21 for analysis. Multiple logistic regression models were used to indicate the association between dependent and independent variables. THE RESULTS About 35% of the young female internal migrants had sexual debut before the age of 18 years; 64.4% had sex without condom or inconsistently used condom; nearly one quarter of the participants had multiple sexual partners, and 29.6% had sex under the influence of substance uses. The magnitude of RSB among the study participants was (79.1%). Sexting [AOR 3.47(95%; CI;1.10-11.94)], frequent engagement in social media [AOR 10.9(95%;CI;2.31-51.89)], feeling of embarrassment to buy condom [AOR 8.28(95%; CI; 2.10-32.62)], unfavorable attitude toward using condom for steady and loving relationship [AOR 5.72(95%; CI; 1.47-22.24)] were related with RSB while self-efficacy [AOR 0.15(95%: CI; 0.04-0.57)] to use condom and perceived risks of getting pregnant [AOR 0.05(95%; CI; 0.01-0.23)] were found to be protective factors. CONCLUSION The study found high levels of RSB among sexually-active unmarried young female internal migrants. This finding suggests an urgent need of intervention to promote safe sex among this group. Special attention and prompt interventions are needed to promote the use of condoms.
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Affiliation(s)
- Ararso Baru
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
- Institute of Life and Earth Science (Including Health and Agriculture), Pan African University, Ibadan, Nigeria
- Slum and Rural Health Initiative Network/Ethiopia, Ethiopia
- * E-mail:
| | - Ikeola A. Adeoye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeyemi O. Adekunle
- Department of Obstetrics and Gynecology, Faculty of Clinical Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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The Healthy Young Men's Cohort: Health, Stress, and Risk Profile of Black and Latino Young Men Who Have Sex with Men (YMSM). J Urban Health 2020; 97:653-667. [PMID: 32864727 PMCID: PMC7560671 DOI: 10.1007/s11524-019-00398-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Young men who have sex with men (YMSM), especially YMSM of color, are at increased risk for a wide range of threats to their health and well-being. In this study, we recruited and surveyed an urban sample of 448 young African American/Black (Black), Hispanic/Latino (Latino), and multi-racial/ethnic YMSM, ages 16-24 years (mean = 22.3 years), about stressful life events, their health and mental health, their access to and utilization of care, and their involvement in risk-related behaviors. We found that the majority reported experiences of racism (87%) and homophobia (76%). A high percentage reported food insecurity/hunger (36%), residential instability (15%), financial hardship (63%), and conflict with family/friends (62%). The prevalence of risk behaviors was also high, including recent use of tobacco (46%), alcohol (88%), and marijuana (72%), and 41% tested positive for 1+ drugs. Furthermore, 26% tested positive for 1+ sexually transmitted infections (STIs). Over half (56%) reported being worried about their health, 33% reported having a chronic health condition and 31% a mental health condition, and 45% had wanted/needed mental health services during the past year. Further, 17% reported suicidal ideation/had planned a suicide attempt and 26% had ever engaged in self-injurious behaviors. Significant differences by race/ethnicity and HIV status included residential status/food insecurity, type of racism/homophobia, drug use, and STIs. These findings demonstrate how vulnerable this population is with respect to a wide range of structural and social determinants of health that may be important drivers of behavioral, health, mental health outcomes, and potentially long-term health disparities.
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Noll M, Noll PRES, Gomes JM, Soares Júnior JM, Silveira EA, Sorpreso ICE. Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE). Reprod Health 2020; 17:139. [PMID: 32894142 PMCID: PMC7487653 DOI: 10.1186/s12978-020-00987-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. Aim Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. Methods The study participants were 100,962 adolescents 13–18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. Results Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. Conclusion High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.
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Affiliation(s)
- Matias Noll
- Instituto Federal Goiano (IF Goiano), Goiás, Brazil. .,Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiás, Brazil.
| | - Priscilla Rayanne E Silva Noll
- Instituto Federal Goiano (IF Goiano), Goiás, Brazil.,Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jéssica Menezes Gomes
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - José Maria Soares Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Erika Aparecida Silveira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiás, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Banks DE, Bello MS, Crichlow Q, Leventhal AM, Barnes-Najor JV, Zapolski TCB. Differential typologies of current substance use among Black and White high-school adolescents: A latent class analysis. Addict Behav 2020; 106:106356. [PMID: 32087473 DOI: 10.1016/j.addbeh.2020.106356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/03/2020] [Accepted: 02/12/2020] [Indexed: 11/27/2022]
Abstract
Black and White adolescents demonstrate different prototypical profiles (i.e., typologies) of substance use, with Blacks demonstrating lower risk for concurrent use of two or more substances. Despite knowledge of these differences, typologies of adolescent substance use identified by person-centered methods, such as latent class analysis, have not characterized profiles by racial group. The current study examined typologies of substance use among Black and White youth separately using person-centered methods to identify common patterns of substance use among subjects. Data were drawn from a 5-year parent study examining adolescent health outcomes. The current study examined high-school aged White (n = 7271, 45.4% male) and Black youth (n = 1301, 40.1% male) who reported past-30-day frequency of cigarette, alcohol, marijuana, inhalant, and other drug use. Latent class analysis was used to examine substance use typologies among each group adjusting for grade and sex. Black and White youth demonstrated different typologies such that four typologies emerged among Blacks: Non-Use (87.8%), Alcohol and Marijuana Use (6.3%), Alcohol, Marijuana, and Cigarette Use (3.8%), and Frequent Polysubstance Use (2.0%). Conversely, five typologies emerged among Whites: Non-Use (73.4%), Predominant Alcohol Use (13.9%), Alcohol, Marijuana, and Cigarette Use (9.4%), Moderate Polysubstance Use (1.6%), and Frequent Polysubstance Use (1.7%). Findings suggest that Black and White youth engage in similar rates of concurrent substance use. Given that Black youth face greater risk for adverse consequences from substance use, prevention efforts are needed to prevent related health disparities related to concurrent substance use.
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Affiliation(s)
- Devin E Banks
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Mariel S Bello
- University of Southern California, Los Angeles, CA, United States
| | - Queenisha Crichlow
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Adam M Leventhal
- University of Southern California, Los Angeles, CA, United States; University of Southern California Keck School of Medicine, Los Angeles, CA, United States
| | | | - Tamika C B Zapolski
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Jones K, Salzman GA. The Vaping Epidemic in Adolescents. MISSOURI MEDICINE 2020; 117:56-58. [PMID: 32158051 PMCID: PMC7023954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Electronic cigarette (e-cigarette) use has recently risen to the forefront of medical discussions across the country. A significant increase in e-cigarette use by adolescents has been observed over the last decade. This article discusses the targeting of adolescents by e-cigarette companies. It looks at how teenagers are uniquely affected by nicotine and at risk for progressing to using combustible cigarettes and marijuana. Lastly, it discusses the role of physicians in combating the spread of e-cigarettes.
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Affiliation(s)
- Kristen Jones
- Kristen Jones, DO, is a Pediatrics Resident in Internal Medicine; Gary A. Salzman, MD, (right), MSMA member since 2007, is Professor of Medicine; University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Gary A Salzman
- Kristen Jones, DO, is a Pediatrics Resident in Internal Medicine; Gary A. Salzman, MD, (right), MSMA member since 2007, is Professor of Medicine; University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
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Age-related associations between substance use and sexual risk behavior among high-risk young African American women in the South. Addict Behav 2019; 96:110-118. [PMID: 31075728 DOI: 10.1016/j.addbeh.2019.04.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/27/2019] [Accepted: 04/28/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND We assessed age-related associations between substance use and sexual risk behavior using data from three HIV prevention trials that enrolled young African American women. METHODS We used integrative data analysis to pool data from 1862 individuals aged 16-25 years. We used time-varying effect models to examine associations between substance use (alcoholic drinks per month, recent marijuana use, cigarettes smoked per day) and sexual risk behaviors (monthly frequency of vaginal sex, multiple sex partners, condomless sex), adjusting for the fixed effect of trial. RESULTS In models that included all three substances, cigarette smoking was not associated with any outcome. Alcohol quantity was associated with greater frequency of sex at all ages, an increased likelihood of having multiple sex partners from about age 17-24 years, and an increased likelihood of condomless sex after about age 18.5 years. Associations between alcohol quantity and sex frequency were relatively stable; associations with having multiple sex partners and condomless sex increased beginning at about age 22 years. Marijuana use was associated with greater sex frequency at approximate ages 16.5-24 years and an increased likelihood of having multiple sex partners at ages 18-24 years. Associations with sex frequency were relatively stable; associations with having multiple sex partners increased from about age 18 and peaked at about age 23 years. CONCLUSIONS We observed developmentally-dependent relationships between both alcohol and marijuana and sexual risk behavior. The findings underscore the need to address substance-related sexual risk among young African American women and may inform optimal timing of intervention.
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Reboussin BA, Ialongo NS, Green KM, Furr-Holden DM, Johnson RM, Milam AJ. The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:270-279. [PMID: 29845401 PMCID: PMC6265122 DOI: 10.1007/s11121-018-0915-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.
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Affiliation(s)
- Beth A Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, 20742, USA
| | - Debra M Furr-Holden
- Public Health Division and Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, Flint, MI, 48502, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Adam J Milam
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Espinoza L, Richardson JL, Ferguson K, Chou CP, Baezconde-Garbanati L, Stacy AW. Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools. Subst Use Misuse 2019; 54:373-383. [PMID: 30654684 PMCID: PMC6438727 DOI: 10.1080/10826084.2018.1496453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. OBJECTIVE To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. METHODS Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. RESULTS Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.
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Affiliation(s)
- Lilia Espinoza
- a Department of Public Health , California State University Fullerton , Fullerton , California , USA
| | - Jean L Richardson
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Kristin Ferguson
- c School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Chih-Ping Chou
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Lourdes Baezconde-Garbanati
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Alan W Stacy
- d School of Community & Global Health , Claremont Graduate University , Claremont , California , USA
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Dir AL, Hulvershorn LA, Aalsma MC. The Role of Pregnancy Concerns in the Relationship between Substance Use and Unprotected Sex among Adolescents. Subst Use Misuse 2019; 54:1060-1066. [PMID: 30957674 PMCID: PMC6498425 DOI: 10.1080/10826084.2018.1524912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Substance use and unprotected sex are prevalent among adolescents. The link between substance use and unprotected sex is well-established. Research has also highlighted how adolescents' attitudes and risk perceptions regarding unprotected sex, including concerns about pregnancy ("Getting pregnant would force me to grow up too fast"), are associated with unprotected sex and unplanned pregnancy. However, less research has examined the potential relationship between pregnancy concerns and substance use among adolescents. OBJECTIVES The study prospectively examined (1) differences in pregnancy concerns across patterns of substance use and (2) whether pregnancy concerns mediate the relationship between substance use and later unprotected sex among a sample of middle and high school students. METHOD 98 adolescents [M(SD) age = 14.28(1.68), 59.4% female, 59.4% black/African American] completed self-report measures of marijuana and alcohol use, pregnancy concerns, and unprotected sex across three time points over 6 months (T1-T3). RESULTS Substance users (alcohol/marijuana) reported fewer pregnancy concerns compared to non-substance users (t = 2.99, p = .04). Pregnancy concerns at T2 mediated the relationship between T1 lifetime substance use and later unprotected sex (T3) (indirect effect: b = 0.10, CI[.01-.41]; direct effect: b = 0.15, p = .32), controlling for gender, age, and race. More frequent substance use (T1) was related to fewer pregnancy concerns at T2 (b = -0.10, p = .04); fewer pregnancy concerns were related to increased likelihood of later unprotected sex (b = -1.02, p = .02). CONCLUSIONS Findings offer new insight into associations between substance use and unprotected sex and suggest that substance use and sexual health interventions should target pregnancy concerns.
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Affiliation(s)
- Allyson L Dir
- a Department of Pediatrics, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.,b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Leslie A Hulvershorn
- b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA.,c Department of Psychiatry, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Matthew C Aalsma
- a Department of Pediatrics, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.,b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA
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De Genna NM, Goldschmidt L, Richardson GA, Cornelius MD, Day NL. Trajectories of pre- and postnatal co-use of cannabis and tobacco predict co-use and drug use disorders in adult offspring. Neurotoxicol Teratol 2018; 70:10-17. [PMID: 30227199 PMCID: PMC6239951 DOI: 10.1016/j.ntt.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 11/21/2022]
Abstract
Co-use of cannabis and tobacco is increasingly common among women and is associated with tobacco and cannabis dependence and poorer cessation outcomes. However, no study has examined maternal patterns of co-use over time, or the impact of maternal co-use on co-use and drug problems in adult offspring. Pregnant women (M age = 23, range = 18-42; 52% African American, 48% White) were asked about substance use during each trimester of pregnancy, and at 8 and 18 months, 3, 6, 10, 14, 16, and 22 years postpartum. We examined patterns of any maternal cigarette and cannabis use during pregnancy and the postpartum years. As young adults (M age = 22.8 years, range = 21-26), 603 offspring completed the Diagnostic Interview Schedule (DIS). Growth mixture modeling (GMM) was used to identify four maternal trajectories through 16 years postpartum: (1) no co-use (66%), (2) decreasing co-use (16%), (3) postpartum-only co-use (11%), and (4) chronic co-use (7%). Offspring whose mothers were in the decreasing co-use group (co-users primarily during prenatal and preschool periods) were more likely to be co-users than the offspring of non-co-users. Offspring whose mothers were chronic co-users of cigarettes and cannabis were more than twice as likely to have a drug use disorder than young adults whose mothers were not co-users. The results of this study highlight the heterogeneity in maternal co-use of tobacco and cannabis over time, with some women quitting during pregnancy but resuming co-use in the postpartum, and other women co-using during pregnancy but desisting co-use over time. Maternal trajectories of co-use were associated with inter-generational transfer of risk for substance use and dependence in adult offspring.
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Affiliation(s)
- Natacha M De Genna
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Lidush Goldschmidt
- Western Psychiatric Institute and Clinic (WPIC) at University of Pittsburgh Medical Center (UPMC), 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Gale A Richardson
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Marie D Cornelius
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Nancy L Day
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Pulvers K, Ridenour C, Woodcock A, Savin MJ, Holguin G, Hamill S, Romero DR. Marijuana use among adolescent multiple tobacco product users and unique risks of dual tobacco and marijuana use. Drug Alcohol Depend 2018; 189:80-89. [PMID: 29890454 PMCID: PMC6062467 DOI: 10.1016/j.drugalcdep.2018.04.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescence is a peak time for uptake of both tobacco and marijuana (dual use). This study aimed to identify clusters of lifetime tobacco and marijuana use patterns and associated risk factors, and to determine whether dual tobacco and marijuana use is uniquely associated with greater risk than use of either tobacco or marijuana alone. METHOD High school students participated in a survey during Fall 2014 (N = 976; 68% Hispanic; 57% parental education < high school). Items from national youth surveys were used to measure lifetime and current use of tobacco products, marijuana, alcohol, drug use, and other risk behaviors, and literature-based surveys were used to measure psychological constructs. RESULTS Latent Class Analysis identified three clusters of lifetime tobacco use patterns (no tobacco, one or two products, and more than two products), each with a correspondingly distinct profile of risk behaviors; risk escalated with use of more tobacco products. Multinomial modeling characterized personal, environmental, and behavioral correlates of dual lifetime tobacco and marijuana use, including lower parental monitoring, lower grades, higher guilt, higher lifetime alcohol and drug use, and more substance use by friends, in reference to single lifetime use of either tobacco or marijuana. CONCLUSION Broader use of tobacco (i.e., more products) was associated with numerous risk factors. Dual lifetime use of tobacco and marijuana was associated with numerous risks compared to single use of either tobacco or marijuana. Longitudinal work is needed to understand temporal relationships between risk variables to determine optimal timing for interventions to reduce harmful behaviors.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States.
| | - Cliff Ridenour
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Anna Woodcock
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Micah J Savin
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Gabriel Holguin
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Sharon Hamill
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
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Fairlie AM, Garcia TA, Lee CM, Lewis MA. Alcohol use and alcohol/marijuana use during the most recent sexual experience differentially predict characteristics of the sexual experience among sexually active young adult drinkers. Addict Behav 2018; 82:105-108. [PMID: 29510295 DOI: 10.1016/j.addbeh.2018.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Few studies have examined associations between using alcohol only and using both alcohol and marijuana with sexual behavior on specific occasions. The current study examined alcohol and marijuana use during the most recent sexual experience in association with relationship characteristics, psychological issues, and condom use. METHODS Young adult drinkers aged 18-25 who reported not using a condom during sex in the past month were recruited nationally. An analytic subsample (N = 378) was identified based on substance use during the most recent sexual experience [53% female, 70% Caucasian; mean age = 22.42 years (SD = 1.90)]. Using logistic regression, two dummy codes compared the alcohol use only group (n = 197) and the both alcohol and marijuana group (n = 95) to the group who used neither substance (n = 86). Participant sex, drinking frequency, and number of sexual partners were included as covariates. RESULTS The alcohol only group and the both alcohol and marijuana group had greater odds of being with a casual acquaintance and loss of respect compared to the group who used neither substance. The alcohol only group had greater odds of being with someone they just met and embarrassment compared to the group who used neither substance. No associations were found for condom use or emotional difficulties. CONCLUSIONS Preventative interventions may need to address both alcohol and marijuana to more effectively reduce risky behaviors.
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Dir AL, Gilmore AK, Moreland AD, Davidson TM, Borkman AL, Rheingold AA, Danielson CK. What's the harm? Alcohol and marijuana use and perceived risks of unprotected sex among adolescents and young adults. Addict Behav 2018; 76:281-284. [PMID: 28886577 DOI: 10.1016/j.addbeh.2017.08.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/18/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022]
Abstract
The link between substance use and risky sexual behavior, particularly unprotected sex, among adolescents and young adults has been well established in the literature; however, less is known regarding how different patterns and types of substance use differentially relate to unprotected sex and perceived risks of unprotected sex. The current study examined perceived risks and unprotected sex among adolescents and young adults, and examined whether marijuana use, alcohol use, and dual marijuana and alcohol use were differentially linked to unprotected sex and perceived risks of unprotected sex. METHOD A sample of N=144 adolescents and young adults (Mage=18.77, SDage=3.4, range: 12-25) completed self-report questionnaires regarding past month substance use, unprotected sex, and perceived risks of having unprotected sex. RESULTS In a hierarchical logistic regression, only alcohol use was related to having unprotected sex at last intercourse (b=0.25, p<0.001). The second multinomial logistic regression showed that the interaction of alcohol and marijuana use was significantly related to lower levels of perceived risk of unprotected sex (moderate risk: b=0.06, p=0.04, OR=1.07; no/slight risk: b=0.07, p=0.03). CONCLUSION While dual marijuana and alcohol use was related to lower perceived risk of unprotected sex, only alcohol use only was associated with a higher likelihood of unprotected sex.
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