High-risk cocktails and high-risk sex: examining the relation between alcohol mixed with energy drink consumption, sexual behavior, and drug use in college students

Escalating caffeine dose-dependently increases alcohol consumption in adult male, but not female, C57BL/6J mice

Although previous research has illustrated the effects of the consumption of alcohol and caffeine individually, less research has focused on the popular combination of the two drugs. The increase in alcohol consumption when combined with caffeine has led to the idea that the stimulant effects of caffeine may mask the depressant effects of alcohol, and this may contribute to increased binge drinking as the individual feels more awake and stimulated. Preclinical research has shown various effects of combined alcohol and caffeine where several studies show decreased alcohol consumption and others show increased alcohol consumption and even binge-like drinking. Results from a previous study in our lab indicate that intermittent access (IA) to steady levels of low (0.015 %) but not moderate (0.03 %) caffeine increased alcohol consumption in male C57BL/6J mice. The current studies further investigated the sex and dose differences in adult mice receiving varying concentrations of caffeine on combined alcohol intake. In Experiment 1, adult mice (n = 50, 25 males and 25 females) had IA to one of the following experimental bottles throughout the 4 week period: water, alcohol (10 % v/v), caffeine (0.015 % w/v), or 10 % alcohol +0.015 % caffeine. In Experiment 2, adult mice (n = 70, 35 males and 35 females) were given IA to one of the following experimental bottles: water, alcohol (10 % v/v; steady, maintained throughout the 4 weeks), caffeine (increasing 0.01 % to 0.015 % to 0.02 % to 0.03 % weekly), or 10 % alcohol+increasing caffeine (at the previously mentioned concentrations). When both caffeine and alcohol concentrations remained steady throughout the 4 weeks, there was no change in alcohol consumption. Chronic exposure to IA caffeine led to increased locomotor activity and decreased freezing episodes when tested in the open field test approximately 6 h after removal of the bottles. In Experiment 2, caffeine dose-dependently increased alcohol co-consumption in male mice whereas female mice consumed less alcohol when it was presented in conjunction with caffeine. The results in males are in line with clinical literature suggesting that the combination of alcohol and caffeine may lead to increased stimulation and alcohol drinking. Additionally, these studies provide evidence that the escalation of caffeine is crucial when investigating alcohol and caffeine co-consumption using the IA paradigm.

Simultaneous Alcohol and Cannabis Use and High-Risk Sexual Behaviors

Background

Alcohol and cannabis use rates are highest in college-aged young adults, and both alcohol and cannabis use are independently related to high-risk sexual behaviors (HRSBs). HRSBs (e.g., sex without protection against sexually transmitted infections) are a prevalent public health problem in college students, with little research examining simultaneous alcohol and cannabis use (i.e., using both alcohol and cannabis at the same time so the effects overlap) and HRSBs.

Method

We examined simultaneous alcohol and cannabis-related HRSB frequency, gender differences in simultaneous alcohol and cannabis-related HRSBs, and differences in HRSBs between simultaneous and non-simultaneous users. Alcohol and cannabis using college students (N = 534; Average Age = 19; 66.9% reported identifying as female) were recruited through a psychology department's human subjects research pool and completed a one-time, online, self-report survey.

Results

One-third of participants engaged in simultaneous alcohol and cannabis use prior to sexual intercourse in the past 3 months. Additionally, over one-third of participants reported heavy drinking (4/5 or more drinks for women/men) simultaneously with cannabis use prior to sexual intercourse in the past 3 months. Simultaneous alcohol and cannabis use was significantly and positively related to sexual intercourse after simultaneous use and after heavy drinking simultaneously with cannabis use. Past year simultaneous alcohol and cannabis users, relative to non-simultaneous users, reported increased incidents of sex without protection against sexually transmitted infections. No gender differences in simultaneous alcohol and cannabis-related HRSBs were found.

Conclusions

Future research should continue examining simultaneous alcohol and cannabis use and HRSBs.

Binge-like administration of alcohol mixed to energy drinks to male adolescent rats severely impacts on mesocortical dopaminergic function in adulthood: A behavioral, neurochemical and electrophysiological study

A growing body of evidence indicates that the practice of consuming alcohol mixed with energy drinks (ED) (AMED) in a binge drinking pattern is significantly diffusing among the adolescent population. This behavior, aimed at increasing the intake of alcohol, raises serious concerns about its long-term effects. Epidemiological studies suggest that AMED consumption might increase vulnerability to alcohol abuse and have a gating effect on the use of illicit drugs. The medial prefrontal cortex (mPFC) is involved in the modulation of the reinforcing effects of alcohol and of impulsive behavior and plays a key role in the development of addiction. In our study, we used a binge-like protocol of administration of alcohol, ED, or AMED in male adolescent rats, to mimic the binge-like intake behavior observed in humans, in order to evaluate whether these treatments could differentially affect the function of mesocortical dopaminergic neurons in adulthood. We did so by measuring: i) physiological sensorimotor gating; ii) voluntary alcohol consumption and dopamine transmission before, during, and after presentation of alcohol; iii) electrophysiological activity of VTA dopaminergic neurons and their sensitivity to a challenge with alcohol. Our results indicate that exposure to alcohol, ED, or AMED during adolescence induces differential adaptive changes in the function of mesocortical dopaminergic neurons and, in particular, that AMED exposure decreases their sensitivity to external stimuli, possibly laying the foundation for the altered behaviors observed in adulthood.

Comparison of Sorority and non-Sorority Women: Risks for Different Sexual Assault Types

Though rates of sexual assault are high among college women, some studies find even greater prevalence rates among women who are sorority members. This study examined the association between familial risk factors (e.g., child physical abuse), PTSD symptoms, and proximal risk factors (e.g., sexual risk behavior) with three sexual assault types (i.e., coercive, incapacitated by alcohol or drugs, and physically forced) among sorority and non-sorority women at a large Midwestern university. Participants completed a paper-and-pencil survey that included measures of different sexual assault types, childhood maltreatment, parental rejection, PTSD symptoms, and sexual and substance use behaviors. A fully recursive path model was estimated to examine the pathways to three different sexual assault types. Results revealed that sorority women experienced coercive and incapacitated sexual assault more so than non-sorority women though there was no significant difference for physically forced sexual assault. Sorority women also reported engaging in more sexual risk behaviors, which was in turn, associated with all three sexual assault types. Sorority women also reported heavier alcohol use, which in turn, was positively associated with coercive and incapacitated sexual assault. These findings have implications for prevention among college undergraduate women.

Alcohol Versus Combined Alcohol and Energy Drinks Consumption: risk behaviours and consumption patterns among European students

INTRODUCTION

Recent research found that mixing energy drinks with alcohol (AmED) could be more risky than drinking alcohol alone. Our aim was to compare rates of risk behaviours in consumers AmED versus exclusive alcohol drinkers, matching them based on their drinking frequency.

METHODS

Data about sixteen-year-old students who reported the number occasions on which they had drunk AmED or alcohol only in the preceding 12 months (n = 32,848) were drawn from the 2019 ESPAD study. After matching for consumption frequency, the sample consisted of 22,370 students (11,185 AmED consumers and 11,185 exclusive alcohol drinkers). Key predictors comprised substance use, other individual risk behaviours and family characteristics (parental regulation, monitoring and caring).

RESULTS

The multivariate analysis showed significantly higher odds of being AmED consumers compared to exclusive alcohol drinkers in the majority of the investigated risk behaviours, including: daily tobacco smoking, illicit drug use, heavy episodic drinking, truancy at school, engaging in physical fights and serious arguments, having troubles with the police and having unprotected sexual intercourse. Instead, lower odds were found for reporting high parents' educational level, medium and low family economic status, perceived possibility to freely talk about problems to family members, spending free time reading books or other hobbies.

CONCLUSIONS

Our study shows that, given the same consumption frequency in the past year, AmED consumers typically reported higher associations with risk-taking behaviours compared to exclusive alcohol drinkers. These findings advance past research that failed to control for the frequency of AmED use versus exclusive alcohol consumption.

Social media use and alcohol consumption among students in Uganda: a cross sectional study

Background

Globally, alcohol use significantly contributes to the disease burden. Alcohol consumption in Uganda is related to several health consequences among young people, including university students. Social media is commonly used by students to share academic information and create social networks. Among young people in high-income countries, previous studies have also shown that social media use can have negative health outcomes related to alcohol use, and associated problems. To date, similar studies conducted in low- and middle-income countries are largely missing.

Objective

To assess the prevalence of and associations between social media use and alcohol consumption among university students in Uganda.

Method

This was a cross-sectional study among 996 undergraduate students at Makerere University. Data were collected using a questionnaire. Alcohol use in the previous 12 months was the dependent variable. The independent variable was social media use categorised as general use, alcohol-related use, and social media lurking/passive participation. Multinomial logistic regression was used to assess associations. Crude and adjusted odds ratios were reported.

Results

Nearly all students (97%) used social media and 39% reported alcohol use. Regular alcohol use was significantly associated with moderate (OR = 2.22, CI: 1.35–3.66) and high level general social media use (OR = 2.45, CI: 1.43–4.20). Regular alcohol use was also associated with alcohol-related social media (OR = 6.46, CI: 4.04–10.30), and alcohol-related lurking (OR = 4.59, CI: 2.84–7.39). Similar, although weaker associations were identified for occasional alcohol use.

Conclusions

Approximately four in ten students reported alcohol use in the past year, and almost all students used social media. Alcohol-related social media use was associated with occasional and regular alcohol use, with stronger associations for regular use. These findings may guide further research and present an opportunity for potential alcohol control interventions to improve health among young populations in low- and middle-income countries.

Alcohol Mixed with Energy Drinks (AmED) Use among University Students: A Systematic Review and Meta-Analysis

In the last decades, there has been a huge increase in the consumption of both Energy Drinks (EDs) and alcohol and, concurrently, these two trends generated the additional practice of mixing ED with alcohol, known as Alcohol mixed with Energy Drink (AmED). One of the most important group of AmED consumers is represented by young. Indeed, the study population of the researches in this field are mainly represented by college students and the results evidence a great range of negative consequences for health. The purpose of the systematic review was to explore the prevalence of AmED consumption among undergraduate students, together with motivations to their use, adverse effects and health-related behaviors associated to AmEDs use. The review was conducted according to the PRISMA Statement and PubMed, Scopus and Web of Science were interrogated. 42 articles, published from 2008 to 2021, were included in the review. An overall prevalence rate of 37% was estimated for AmEDs use in undergraduates, with geographical differences. Although a decrease in consumption was observed throughout the studied period, a continuous monitoring on this phenomenon is needed for identifying those risk groups that could develop risky behaviors related to AmEDs consumption and provide them targeted educational interventions.

The implications of alcohol mixed with energy drinks from medical and socio-legal standpoints

Co-ingestion of energy drinks and alcohol has long been in practice and has been poorly regulated despite a growing body of literature of their potential negative health impacts. Co-ingestion of energy drinks with alcohol has multiple counter-active effects such as reduction of body sway, fatigue and sedative effects induced by alcohol, along with increased subjective feeling of alertness, which may lead to increased binge-drinking, intoxication, decreased perception of intoxication, dehydration, and alcohol poisoning. Adding energy drinks to alcohol may also have synergistic effects in causing alcohol dependency and addiction. The association between caffeine, a common active ingredient in energy drinks, and alcohol is relatively well defined, however association with other active ingredients such as taurine, niacin, and pyridoxine, is less understood, pointing to a gap in our knowledge regarding this practice. Nonetheless, the current associations between AMED (Alcohol Mixed with Energy Drinks) and risky behavior secondary to intoxication and cases of alcohol poisoning have led various national governing bodies to regulate this practice. This review highlights the potential effects of AMED on human physiology based on what is known from human and animal models, and sheds light on specific biochemical interactions between alcohol and active ingredients found in energy drinks; Caffeine, Taurine, and Glucuronolactone. The review also touches on the regulation of this practice around the world, and the impact it has on its users, and points researchers to gaps in our knowledge on the interactions between alcohol and EDs and the full extent of their effects.

Alcohol mixed energy drink usage and risk-taking among college students in Western New York State

Alcohol mixed energy drinks (AmED) may promote excessive alcohol intake and risk-taking among college students. Objective: To understand the relationship between AmED use and risky behavior as well as attitudes and motivations for AmED use. Participants: Undergraduate college students N = 422 (Study 1), N = 37 (Study 2). Methods: Using a mixed-methods approach, we first surveyed undergraduate students about their AmED and alcohol consumption and a series of risk behaviors, self-efficacy, and beliefs (Study 1). We then conducted focus groups within the same population to better understand attitudes, knowledge, and motivations for using AmED (Study 2). Results: Recent AmED use was significantly associated with an increased number of reported binge drinking occasions and self-reported driving while intoxicated events. Our qualitative data analyses revealed two major themes associated with AmED consumption: factors encouraging AmED use and decisions about driving while under the influence of alcohol. Conclusions: These findings add to the literature of beliefs and motivations for AmED use among college students.

Narcissistic grandiosity and risky health behaviors in college students

Objective This study explored associations between narcissistic grandiosity (including its component traits) and reported risky health behaviors in college students. Participants: College men and women (N = 122) participated between December 2015 and January 2016. Methods: Participants completed self-report measures of grandiosity, alcohol consumption, number of sex partners, and condom use. Results: Grandiosity was positively associated with alcohol consumption. Gender interacted with grandiose traits, driving associations with reported sexual behaviors. College men high in entitlement/exploitativeness reported more sex partners. Grandiose exhibitionism was associated with condom use among women but not men, such that college women higher in grandiose exhibitionism were more likely to report not using a condom with their most recent partner. Conclusions: Grandiosity (and grandiose traits) may influence health behavior and/or the reporting of health behavior in college students, but associations may differ for men and women.

Interaction of Energy Drinks with Prescription Medication and Drugs of Abuse

In recent years, the consumption of energy drinks (EDs) has become increasingly popular, especially among adolescents. Caffeine, a psychostimulant, is the main compound of EDs which also contain other substances with pharmacological effects. This review aims to compile current evidence concerning the potential interactions between EDs, medicines, and drugs of abuse as they are frequently consumed in combination. The substances involved are mainly substrates, inductors or inhibitors of CYP1A2, psychostimulants, alcohol and other depressant drugs. Furthermore, intoxications reported with EDs and other substances have also been screened to describe acute toxicity. The results of our review show that the consumption of both EDs alone and in combination is not as safe as previously thought. Health professionals and consumers need to be aware of the potential interactions of these drinks as well as the absence of long-term safety data.

Alcohol Mixed With Energy Drinks and Sexually Related Causes of Conflict in the Barroom

The popularity of alcohol mixed with energy drinks (AmED) among young adults has spurred studies that focus on its links to aggression and risk-taking behaviors, including risky sex and sexual victimization. However, no studies to date have looked at the relationship between AmED and causes of interpersonal conflict in bars at the event level. The present study evaluated whether AmED use at the time of the bar conflict was associated with greater odds that a bar conflict would be precipitated by sexually related causes. Online survey data, including a description of a recent bar conflict, were collected from a community sample of 175 young adult (97 female) AmED users age 18 to 30 in western New York state. Qualitative findings included the natural categorization of sexually related causes of conflict, consisting of unwanted sexual advances and jealousy, and the prominence of sexual competition in these conflicts. Proportion of AmED use (out of the total quantity of alcoholic drinks) predicted the odds that the bar conflict would have a sexually related cause, above and beyond control variables. How AmED use might be associated with sexual competition and conflict in the bar is discussed.

Determinants of energy drink consumption in adolescents: identification of sex-specific patterns

OBJECTIVES

To investigate sex differences in sociodemographic and lifestyle correlates of frequent energy drink (ED) consumption in adolescents.

STUDY DESIGN

This study was based on data collected among French-speaking Belgian adolescents aged 11-20 years (n = 8137) within the 2018 Health Behaviour in School-aged Children study.

METHODS

Multiple logistic analyses stratified by sex were performed to estimate the associations between consuming EDs more than once a week, and various sociodemographic and lifestyle characteristics.

RESULTS

Overall, 14.0% of boys and 7.6% of girls consumed ED more than once a week. For both genders, the likelihood of consuming ED more than once a week was higher among adolescents consuming soft drinks daily (vs. < daily), alcohol weekly (vs. < weekly), spending at least 5 h/day in front of screens (vs. < 5 h/day), and going to bed later than 11:30 PM (vs. ≤ 10:00 PM). Among boys, adolescents reporting at least 1 h of moderate-to-vigorous physical activity (MVPA) daily (vs. < 1 h/day MVPA) were more likely to consume ED more than once a week (adjusted odd ratio (aOR) = 1.49 (95% confidence interval [CI] 1.11-2.01)). Among girls, adolescents from low affluence families (vs. high affluence) (aOR = 2.03 (95% CI 1.19-3.48)) and immigrants (vs. natives) (2nd generation: aOR = 1.75 (95% CI 1.31-2.32); 1st generation: aOR = 1.90 (95% CI 1.20-3.03)) were more likely to consume ED more than once a week.

CONCLUSIONS

We identified different patterns of ED consumption in boys and girls. These results suggest that sex-tailored interventions could be relevant to reduce ED consumption in adolescents.

Case report on energy drink consumption among Health Sciences University students in Gauteng Province, South Africa

Background

There are claims that energy drink (ED) consumption can bring about an improvement in mental functioning in the form of increased alertness and enhanced mental and physical energy. These claims address the lifestyle of a student of sleep deprivation and academic pressure with ED consumption becoming a popular practice amongst students. The study’s objectives were to determine the prevalence, reasons for, and patterns of ED and alcohol mixed with ED (AmED) consumption amongst university students.

Case presentation

Registered students of the Health Sciences University, Gauteng Province, South Africa, formed the study population where this quantitative cross-sectional survey conveniently collected data by means of previous validated self-administered questionnaires from 490 students representing the diverse demographics of the university. Questions on the socio-demographic profile of the participants; pattern of alcohol use; reasons, pattern, and preferred types of EDs use; and the pattern, reason, and experience of AmED use during the past 12 months were asked. Frequency and percentages of distributions were determined, and the possible factors contributing to ED consumption were computed using the chi-square test. Results indicated that a total of 58% of students were consuming EDs mainly to stay awake (31%), to be more alert (14%), and to help with concentration (15%), 69% were consuming alcohol, and 16% were consuming AmEDs.

Conclusion

There is an urgent need for an appropriate public health prevention intervention so that ED consumers can make informed choices when indulging in these health behaviors before the seemingly harmless consumption of ED amongst students becomes a public health issue.

Risky sexual behavior and associated factors in undergraduate students in a city in Southern Brazil

OBJECTIVE

To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors.

METHODS

A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse.

RESULTS

The prevalence of risky sexual behavior was 9% (95%CI 7.6–10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes.

CONCLUSION

Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.

Consumption Patterns of Alcohol and Alcohol mixed with Energy Drinks in Australian Students and Non-Students

Studies assessing alcohol mixed with energy drink (AMED) use and drinking behaviors have been largely restricted to student-only cohorts. Thus, it is not known whether evidence from these studies is applicable to non-student populations. This study examined alcohol consumption and involvement in negative alcohol-related consequences among AMED and alcohol-only (AO) users, with the aim of determining whether drinking behaviors differ according to student status. An online survey was conducted in Australia to assess alcohol consumption and alcohol-related consequences following AMED and AO consumption, according to student status. The final sample consisted of 1369 participants. Between-subjects analyses comparing AMED and AO users, confirmed previous findings in that, compared with AO users, AMED users consumed significantly more alcohol, consumed alcohol more frequently and were involved in a greater number of alcohol-related consequences. Within-subjects analyses of AMED users comparing AMED and AO drinking occasions revealed that significantly less alcohol was consumed and involvement in negative alcohol-related consequences was lower during AMED compared with AO drinking occasions. Regardless of drink type, compared with students, non-students consumed more alcohol, consumed alcohol more frequently and were involved in a greater number of negative alcohol-related consequences. These findings provide further evidence that AMED use is one manifestation of a risk-taking personality and suggest that non-students drink more alcohol, drink more frequently and are involved in a greater number of negative alcohol-related consequences than students.

Concomitant taurine exposure counteracts ethanol-induced changes in locomotor and anxiety-like responses in zebrafish

Taurine (TAU) is a β-amino sulfonic acid with pleiotropic roles in the brain, including the neuromodulatory activity via GABAergic and glycinergic agonism. This molecule is found at high concentrations in energy drinks and is often mixed with alcohol in beverages. Although TAU has a neuroprotective role in the brain, the putative risks of mixing TAU and EtOH are not fully understood. Here, we investigated whether TAU modulates locomotor and anxiety-like behavior in adult zebrafish by using the novel tank and light-dark tests following acute EtOH exposure at anxiogenic and anxiolytic concentrations. Zebrafish were individually exposed to water (control), TAU (42, 150, and 400 mg/L), and EtOH (0.25% (v/v) and 1% (v/v)) both independently and cotreated for 1 h. EtOH 0.25% and TAU produced U-shape anxiolytic-like behavior in the light-dark test, TAU 42 and 400 positively modulated EtOH effects, and TAU 150 exerted a protective effect. All TAU concentrations counteracted EtOH 1%-induced locomotion impairment, as well as the anxiogenic-like behavior. Finally, all TAU concentrations when given independently or cotreated with EtOH 0.25% and 1% decreased the risk assessment of the lit compartment. Principal component analyses revealed that exploration and anxiety-like responses were the main behaviors that contribute to the effects of TAU and EtOH. Overall, we demonstrate that TAU differently modulates EtOH-induced anxiolytic- and anxiogenic-like behaviors depending on the concentration, suggesting a complex mechanism underlying TAU and EtOH interactions.

Protective sexual behaviours among young adults in Nigeria: influence of family support and living with both parents

Background

Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours.

Methods

A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval.

Results

Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults.

Conclusion

This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.

Differences in hope, core self-evaluations, emotional well-being, and health risk behaviors in freshman university students

The purpose of this cross-sectional anonymous survey study was to explore differences in hope, core self-evaluations (CSE), emotional well-being, health risk behaviors, and academic performance by gender, race, and social desirability in a sample of freshman university students. Four hundred and ninety-five freshmen ages 18 to 21 (M age 18.4), 67% female attending a large public university in the Northeast participated in the study. A Health Risk Behavior Score, with scores ranging from 3 to 9, was calculated by creating risk categories for drug use, alcohol use, and sexual risk-taking. Hope and health risk behaviors did not differ by gender, however, men reported higher CSE and emotional well-being. There were racial differences in hope, CSE, emotional well-being, and health risk behaviors. Nurses and researchers should consider gender and racial differences when designing or implementing hope interventions. Future researchers should compare their findings with ours for patterns or convergence and divergence and aim for larger representative samples of nonwhite groups. These are necessary next steps to advance the understanding of the role hope may play in promoting mental health among diverse college students.

The association between caffeinated alcoholic beverages and the perpetration of intimate partner violence

Background: Problematic alcohol use is a recognized risk factor for intimate partner violence (IPV) perpetration.Objective: The use of caffeinated alcoholic beverages (CAB) appears to be associated with high-risk drinking behavior but the relationship between CAB use and IPV has yet to be explored.Methods: Sixty male and 40 female married or dating participants responded to an online survey including measures of past-year alcohol use and partner violence.Results: Logistic regression analyses revealed that CAB users were significantly more likely to perpetrate physical assault and partner injury after controlling for age, sex, ethnicity, income, and heavy alcohol use. The relationship between CAB use and perpetration of sexual coercion was better accounted for by heavy alcohol use.Conclusion: Results from the current study suggest that there exists an independent link between CAB use and partner violence perpetration.

The role of chronotype, circadian misalignment, and tiredness in the substance use behaviors of gay and bisexual men

Although the potential of alcohol and drugs to detrimentally affect sleep has been established, the potential of tiredness to in turn influence substance use has received less attention. We contend that tiredness increases risk for substance use because tiredness impairs self-regulation and heightens the utility of substances to combat tiredness, albeit temporarily-and that these links are especially important because decision-making regarding use often occurs late at night when people are tired. Accordingly, we investigated chronotype, circadian misalignment, and perceived tiredness as risk factors in substance use among gay and bisexual men (GBM). We analyzed two online survey datasets-one of 3,696 GBM and one of 1,113 GBM-asking participants about their time for most frequently using alcohol or club/party drugs, their chronotype, whether they use substances to stay awake, and use severity. Alcohol use and club/party drug use most often occurred from 9pm onwards (for 51.3% and 75.1% of men, respectively), especially among younger men and evening types. Further, many men with a morning chronotype reported most often using alcohol (33.2%) and drugs (64.7%) from 9pm onwards, implicating circadian misalignment. Additionally, feeling tired was a motivator of alcohol use and drug use (for 53.1% and 26.9% of men, respectively), especially among younger men. Finally, those endorsing this motivation had greater use severity. These findings highlight the importance of chronotype, circadian misalignment, and tiredness in substance use, especially among younger men. We therefore recommend including substance use among the behaviors adversely affected by tiredness from circadian misalignment and inadequate/overdue sleep.

Intensity of Energy Drink Use Plus Alcohol Predict Risky Health Behaviours among University Students in the Caribbean

The relationship between energy drink (ED) use and risky behaviours has not been explored in the Caribbean, where youth risky behaviours are prevalent. This paper examines the relationship between ED use and risky behaviours and the moderating effect of gender among 1994 undergraduate students in Trinidad and Tobago. Analyses examined the association between ED use and risky behaviours, and the significant predictors of risky behaviours. Analysis of variance determined whether there were differences in risky behaviours between those who used only alcohol or EDs, both alcohol and EDs, alcohol mixed with EDs and neither alcohol nor EDs; and the difference between those with high and low intensity of ED use. In both males and females current use of energy drinks was positively associated with harmful substance use, risky sexual behaviours, and risky non-sexual behaviours, more strongly for males. The strongest predictor of risky behaviours was gender. Males consuming both alcohol and EDs, independently or mixed, were most likely to have risky behaviours. Consistent with previous reports, harmful alcohol use and other risk taking health behaviours appear to be predicted by a combination of high intensity use of EDs and alcohol. In countries like Trinidad and Tobago where violence, alcohol use disorders, STI/HIV infection and teenaged pregnancy are prevalent, the assessment of consumption of EDs and alcohol may be an important potential predictor of health compromising behaviours.

Alcohol mixed with energy drink use during young adulthood

AIMS

Alcohol mixed with energy drink (AmED) use is associated with negative consequences including hazardous alcohol use and driving under the influence. While many studies have focused on correlates of AmED use among college samples, very few have examined patterns of AmED use during adolescence and young adulthood within the general population. Accordingly, the purpose of this study is to assess age differences in AmED use among a national sample of respondents aged 18 to 30.

METHODS

The data for this study come from the Monitoring the Future panel study from 2012 to 2015. The sample consists of 2222 respondents between the ages of 18 and 30. Multiple logistic regression using generalized estimating equations (GEE) was used to model past-year AmED prevalence across age and other covariates.

RESULTS

Nearly half (45.0%) of respondents indicated past-year AmED use at some point during the study period. The lowest prevalence rates were found at age 18 (25.9%) and the highest prevalence rates at age 21/22 (43.5%). GEE analyses indicated a statistically significant positive linear and negative quadratic trend with respect to the association between age of respondent and past-year AmED use. Namely, peak use occurred in early young adulthood (age 21/22 and 23/24) and then declined, reaching 32.0% by age 29/30. College attendance and several substance use behaviors at age 18 moderated these linear and quadratic age trends.

CONCLUSIONS

AmED use peaked rapidly in early young adulthood and declined into later young adulthood. Substance use during adolescence was associated with a higher incidence of AmED use across all young adult ages and a slower decline of AmED use after age 21/22. Several sociodemographic factors were associated with AmED use, particularly college attendance at the age of 21/22.

Substance abuse behaviors among university freshmen in Iran: a latent class analysis

OBJECTIVES

Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.

METHODS

Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students' socio-demographic characteristics on membership in each specific subgroup.

RESULTS

The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.

CONCLUSIONS

Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.

Prevalence of nonmedical use of prescription-type opioids, methylphenidate, and sedative-hypnotics among university students in the south of Iran: a regression analysis

Background and aim

Nonmedical use of prescription drugs needs particular attention. The aim of this study was to determine the prevalence of prescription-type opioids, methylphenidate and sedative-hypnotics use, and related factors in university students.

Methods

In this cross-sectional study, 524 students of Hormozgan University of Medical Sciences were selected by multi-stage sampling in 2016. A self-report questionnaire had been used examining substance use, religious beliefs and parental support. The questions about substance use were prepared based on the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (WHO ASSIST). Religious beliefs were measured by Kendler's general religiosity questionnaire. Parental support was measured by the Persian version of Aneshensel and Sucoff's scale. All of the analysis was performed using Chi-square test, Fisher exact test, independent-samples t-test and binary logistic regression in SPSS 16 software. The level of significance was 0.05.

Results

The last year prevalence of prescription-type opioids, methylphenidate and sedative-hypnotics use was 16.1%, 3.3%, and 10.3%, respectively. The final model of logistic regression indicated hookah use (OR=2.5), methylphenidate use (OR=4.5), sedative-hypnotics use (OR=2.7), and were associated with students' prescription-type opioids use. The protective factor was familial support (OR=0.97) for prescription-type opioids use. Moreover, sedative-hypnotics use (OR=5.7) and illicit drug use (OR=27.6) were associated with methylphenidate use among students.

Conclusions

The results of this study showed that the prevalence of nonmedical use of prescription drugs is considerably high among students and is in need of interventions to reduce the prevalence of these drugs in universities.

Energy drinks and escalation in drug use severity: An emergent hazard to adolescent health

The aim of the current study is to determine whether energy drink consumption contributes to drug use and, more specifically, an escalation in the severity of drug use. We first examine the association between energy drink use and hard drug use, and subsequently investigate whether soft drug use mediates this relationship. Potential moderating influences are also investigated by testing whether the degree of mediation varies by age, gender, and race. The current study uses a nationally representative sample of 8th (ages 13-14), 10th (ages 15-16), and 12th (ages 17-18) grade adolescents from the 2015 Monitoring the Future survey. Negative binomial regression is employed to examine associations between energy drink consumption and soft and hard drug use. Mediation results indicate that energy drink consumption is significantly associated with increased soft drug use, which is, in turn, associated with significant increases in hard drug use. This cascading effect of energy drink consumption on drug use appears to be stronger among younger females and older males. Results for the moderating effect of race are mixed. Energy drinks appear to pose an important threat to adolescent health in the form of soft and hard drug use. The United States may want to consider adopting energy drink policies similar to European countries and Canada, which require warning labels on beverages with high caffeine content.

Alcohol mixed with energy drink (AMED): A critical review and meta-analysis

The purpose of this systematic review and meta-analysis was to critically review the (1) prevalence of alcohol mixed with energy drink (AMED) consumption, (2) motives for AMED consumption, (3) correlates of AMED consumption, and (4) whether AMED consumption has an impact on (a) alcohol consumption, (b) subjective intoxication, and (c) risk-taking behavior. Overall a minority of the population consumes AMED, typically infrequently. Motives for AMED consumption are predominantly hedonistic and social. Meta-analyses revealed that AMED consumers drink significantly more alcohol than alcohol-only (AO) consumers. Within-subject comparisons restricted to AMED consumers revealed that alcohol consumption does not significantly differ between typical AMED and AO occasions. On past month heaviest drinking occasions, AMED users consume significantly less alcohol on AMED occasions when compared to AO occasions. AMED consumers experience significantly fewer negative consequences and risk-taking behavior on AMED occasions compared with AO occasions. Meta-analyses of subjective intoxication studies suggest that AMED consumption does not differentially affect subjective intoxication when compared to AO consumption. In conclusion, when compared to AO consumption, mixing alcohol with energy drink does not affect subjective intoxication and seems unlikely to increase total alcohol consumption, associated risk-taking behavior, nor other negative alcohol-related consequences. Further research may be necessary to fully reveal the effects of AMED.

Energy Drink Use Among Ohio Appalachian Smokers

Caffeine-containing energy drinks have emerged as a public health concern due to their association with caffeine toxicity and alcohol use. Despite the fact that previous research has linked caffeine use in the form of coffee drinking to smoking, there is little research examining the association between energy drinks and smoking. The present study examines demographic and behavioral factors associated with energy drink use among a sample of rural Ohio Appalachian smokers. It was hypothesized that male gender, young age (21-30 years.) and alcohol use would be associated with energy drink use. A sample of adult smokers (n = 298) from Ohio Appalachian counties were interviewed regarding demographic and behavioral factors. Logistic regression analysis was used to assess the association between these factors and energy drink use. Seventy percent of Ohio Appalachian smokers studied had ever used an energy drink and 40 % had used an energy drink in the past month. Young age, male gender, and single marital status were associated with higher odds of ever having used an energy drink. Young age, and binge drinking were associated with higher odds of past 30-day use while abstinence from drinking was associated with lower odds of past 30-day use. Ohio Appalachian adult smokers had higher rates of energy drink use compared to previous estimates of ever or past month use found in other studies. The combined use of caffeine, nicotine, and alcohol warrants attention due to potential for health risk.

Are energy drinks unique mixers in terms of their effects on alcohol consumption and negative alcohol-related consequences?

Introduction

Previous research has suggested that consuming alcohol mixed with energy drinks (AMED) increases overall alcohol consumption. However, there is limited research examining whether energy drinks are unique in their effects when mixed with alcohol, when compared with alcohol mixed with other caffeinated mixers (AOCM). Therefore, the aim of this survey was to investigate alcohol consumption on AMED occasions, to that on other occasions when the same individuals consumed AOCM or alcohol only (AO).

Methods

A UK-wide online student survey collected data on the frequency of alcohol consumption and quantity consumed, as well as the number of negative alcohol-related consequences reported on AO, AMED and AOCM occasions (N=250).

Results

Within-subjects analysis revealed that there were no significant differences in the number of alcoholic drinks consumed on a standard and a heavy drinking session between AMED and AOCM drinking occasions. However, the number of standard mixers typically consumed was significantly lower on AMED occasions compared with AOCM occasions. In addition, when consuming AMED, students reported significantly fewer days consuming 5 or more alcohol drinks, fewer days mixing drinks, and fewer days being drunk, compared with when consuming AOCM. There were no significant differences in the number of reported negative alcohol-related consequences on AMED occasions to AOCM occasions. Of importance, alcohol consumption and negative alcohol-related consequences were significantly less on both AMED and AOCM occasions compared with AO occasions.

Conclusion

The findings that heavy alcohol consumption occurs significantly less often on AMED occasions compared with AOCM occasions is in opposition to some earlier claims implying that greatest alcohol consumption occurs with AMED. The overall greatest alcohol consumption and associated negative consequences were clearly associated with AO occasions. Negative consequences for AMED and AOCM drinking occasions were similar, suggesting that energy drink was comparable with AOCM in this regard.

Modeling The Underlying Tobacco Smoking Predictors Among 1st Year University Students In Iran

Background:

There are scant studies on the prevalence and determinants of tobacco smoking among 1^st year university students in Iran. We aim to determine the prevalence of substance abuse and identify factors related with tobacco smoking in 1^st year students of Qazvin University of Medical Sciences (QUMS).

Methods:

A self-administered questionnaire was used to collect information on sociodemographic, cigarette smoking, hookah smoking, and related risk factors among 521 1^st year students in QUMS between January and February 2014. We used logistic regression to determine factors associated with substance abuse among students.

Results:

The descriptive statistics indicated that the prevalence of lifetime cigarette and hookah smoking was 8.6% (confidence interval [CI] 95%: 6.5–11.4) and 35.5% (CI 95%: 31.5–39.7), respectively. After adjustment for other factors, being male, the presence of any smoker in the family and having smoker friends were factors associated with cigarette and hookah smoking among students. Our findings also revealed the co-occurrence of risk-taking behaviors among students.

Conclusions:

Our study showed considerably low prevalence of tobacco smoking among 1^st year students. Longitudinal studies are necessary to approve the observed results of this study and thus allow for a certain generalization of the observations.

Behavioural correlates of energy drink consumption among adolescents: A review of the literature

Despite regulatory measures on the labelling of energy drinks (EDs), their consumption among adolescents continues to grow in popularity, but teachers increasingly report significant behavioural concerns among students who disclose habitual ED consumption. A review of papers published between January 2010 and October 2016 was undertaken to determine whether an association between adverse behaviour and consumption of ED exists. Findings indicate that ED consumption among adolescents is associated with alcohol and substance use, risky behaviours and psychological states including sensation seeking, depression and anxiety symptoms. ED consumption impacts negatively on executive functions and increases hyperactivity/inattention symptoms among adolescents. An inverse association between ED consumption and sleep duration exists. The findings highlight the need for greater awareness of the potential risk of ED consumption among adolescents.

Energy Drink and Alcohol mixed Energy Drink use among high school adolescents: Association with risk taking behavior, social characteristics

PURPOSE

The aims of the study were to: a) examine the prevalence of energy drink (ED) and alcohol mixed with energy drink (AmED) consumption; b) investigate the relationships between ED and AmED with alcohol, binge drinking and drugs accounting for at risk behaviors among a representative sample of Italian adolescents.

METHODS

A representative sample of 30,588 Italian high school students, aged 15-19years, was studied. Binary and multivariate logistic regression analyses were performed to determine the independent association of the potential predictors' characteristics with the ED and AmED drinking during the last year.

RESULTS

Respectively 41.4% and 23.2% of respondents reported drinking EDs and AmEDs in the last year. Multivariate analysis revealed that consumption of EDs and AmEDs during the last year were significantly associated with daily smoking, binge drinking, use of cannabis and other psychotropic drugs. Among life habits and risky behaviors the following were positively associated: going out with friends for fun, participating in sports, experiencing physical fights/accidents or injury, engaging in sexual intercourse without protection and being involved in accidents while driving.

CONCLUSIONS

This study demonstrates the popularity of ED and AmED consumption among the Italian school population aged 15-19years old: 4 out of 10 students consumed EDs in the last year and 2 out of 10 AmED. Multivariate analysis highlighted the association with illicit drug consumption and harming behaviors, confirming that consumption of EDs and AmEDs is a compelling issue especially during adolescence, as it can effect health as well as risk taking behaviors.

Sources of Misspecification Bias in Assessments of Risks Related to Alcohol Use

OBJECTIVE

Many different measures of alcohol use are applied in survey-based epidemiological studies of alcohol-related risks. Differences in the selection of drinking measures and alternative specifications of quantitative relationships of these measures to problem outcomes limit researchers' abilities to compare and assess alcohol effects across studies. We used a quantitative definition of drinking patterns to identify relationships among drinking measures and uncover sources of bias in assessments of drinking risks.

METHOD

A census of drinking measures from studies published in four leading journals in the first half of 2013 were mapped onto a "drinking patterns table," quantitatively relating each measure to every other. Relationships among these measures and in relation to two problem outcomes, physiological problems and sexual risks, were examined using data from 41,352 undergraduate college student drinkers in California.

RESULTS

Twenty-nine sets of drinking measures appeared across 74 published studies; no common statistical procedure was used to assess drinking risks. Empirically observed distributions of heavy drinking (R(2) = .887, p < .001) and variances in drinking quantities (R(2) = .645, p < .001) were predicted from the drinking patterns table. Heteroscedasticity in drinking measures also biased estimates of physiological risks related to drinking quantities (z = -5.159, p < .001), volume (z = 4.592, p < .001), and heavy drinking (z = -5.431, p < .001).

CONCLUSIONS

Relationships between drinking measures can be formally identified and related to one another using drinking patterns tables. Biases related to selections of different drinking measures and unobserved heteroscedasticity can be identified and controlled through formal quantitative assessments of relationships between drinking measures and observed outcomes.

Acute impact of caffeinated alcoholic beverages on cognition: A systematic review

INTRODUCTION

Energy drinks are popular beverages that are supposed to counteract sleepiness, increase energy, maintain alertness and reduce symptoms of hangover. Cognitive enhancing seems to be related to many compounds such as caffeine, taurine and vitamins. Currently, users mostly combine psychostimulant effects of energy drinks to counteract sedative effects of alcohol. However, recent literature suggests that this combination conducts to feel less intoxicated but still impaired. The goal of the present article is to review cognitive impact and subjective awareness in case of caffeinated alcoholic beverage (CAB) intoxication.

METHOD

PubMed (January 1960 to March 2016) database was searched using the following terms: cognitive impairments, alcohol, energy drinks; cognition, alcohol, caffeine.

RESULTS

99 papers were found but only 12 randomized controlled studies which explored cognitive disorders and subjective awareness associated with acute CAB or AED (alcohol associated with energy drinks) intoxication were included.

DISCUSSION

The present literature review confirmed that energy drinks might counteract some cognitive deficits and adverse effects of alcohol i.e. dry mouth, fatigue, headache, weakness, and perception of intoxication due to alcohol alone. This effect depends on alcohol limb but disappears when the complexity of the task increases, when driving for example. Moreover, studies clearly showed that CAB/AEDs increase impulsivity which conducts to an overconsumption of alcohol and enhanced motivation to drink compared to alcohol alone, potentiating the risk of developing addictive behaviors. This is a huge problem in adolescents with high impulsivity and immature decision making processes.

CONCLUSION

Although energy drinks counteract some cognitive deficits due to alcohol alone, their association promotes the risk of developing alcohol addiction. As a consequence, it is necessary to better understand the neurobiological mechanisms underlying these interactions in order to better prevent the development of alcohol dependence.

A daily diary examination of caffeine mixed with alcohol among college students

OBJECTIVE

Caffeinated alcoholic beverage (CAB) use is associated with a range of substance-related problems. The majority of prior research on CABs is based on cross-sectional and retrospective reports, which do not account for intraindividual differences in use and may be subject to recall biases. The current research used a daily diary, within-subjects design to compare days where individuals simultaneously mixed alcohol with caffeine (CAB days) and days where individuals drank other types of alcohol (non-CAB days) on alcohol use outcomes. These relationships were tested further by examining the impact of the type of mixer (i.e., energy drink or cola-caffeinated).

METHOD

Participants were 122 (73.8% women) heavy drinking, college student CAB users. Mean age was 20.39 (SD = 2.08) years. Students completed a baseline questionnaire and up to 14 consecutive daily surveys about the previous night's drinking behavior.

RESULTS

Multilevel modeling results indicated that CAB days were associated with heavier alcohol use, regardless of mixer type. In addition, beyond amount of alcohol consumed the previous night and trait impulsivity, CAB days were linked with more alcohol-related problems, but only when the mixer was an energy drink. CAB days did not differ from non-CAB days on driving or sex after drinking.

CONCLUSIONS

This study was the first to demonstrate the unique risks posed by simultaneously consuming caffeine and alcohol in a within-subjects, daily diary design. Future research investigating use patterns may benefit from the use of fine-grained approaches in order to provide information relevant for CAB prevention and intervention efforts. (PsycINFO Database Record

Characteristics of university students who mix alcohol and energy drinks

OBJECTIVE

Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep).

PARTICIPANTS

Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester.

METHODS

The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use.

RESULTS

Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04-1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01-1.12), and smoking (AOR = 2.12; 95% CI = 1.22-3.68) were independently associated with AMED use; sleep problems were non-significant.

CONCLUSIONS

Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.

Intoxication-Related Alcohol Mixed with Energy Drink Expectancies Scale: Initial Development and Validation

BACKGROUND

Young adult use of alcohol mixed with energy drinks (AmEDs) has been linked with elevated risks of a constellation of problem behaviors. These risks may be conditioned by expectancies regarding the effects of caffeine in conjunction with alcohol consumption. The aim of this study was to describe the construction and psychometric evaluation of the Intoxication-Related AmED Expectancies Scale (AmED_EXPI), 15 self-report items measuring beliefs about how the experience of AmED intoxication differs from the experience of noncaffeinated alcohol (NCA) intoxication.

METHODS

Scale development and testing were conducted using data from a U.S. national sample of 3,105 adolescents and emerging adults aged 13 to 25. Exploratory and confirmatory factor analyses were conducted to evaluate the factor structure and establish factor invariance across gender, age, and prior experience with AmED use. Cross-sectional and longitudinal analyses examining correlates of AmED use were used to assess construct and predictive validity.

RESULTS

In confirmatory factor analyses, fit indices for the hypothesized 4-factor structure (i.e., Intoxication Management [IM], Alertness [AL], Sociability [SO], and Jitters [JT]) revealed a moderately good fit to the data. Together, these factors accounted for 75.3% of total variance. The factor structure was stable across male/female, teen/young adult, and AmED experience/no experience subgroups. The resultant unit-weighted subscales showed strong internal consistency and satisfactory convergent validity. Baseline scores on the IM, SO, and JT subscales predicted changes in AmED use over a subsequent 3-month period.

CONCLUSIONS

The AmED_EXPI appears to be a reliable and valid tool for measuring expectancies about the effects of caffeine during alcohol intoxication.

University Students' Sexual Health Knowledge: A Scoping Literature Review

Sexual health plays an important role in the well-being of university students. The literature shows that the majority of university undergraduates are sexually active and at high risk of contracting sexually transmitted infections (STIs); however, the breadth and degree of the literature on their sexual health knowledge is unclear. The purpose of this scoping review was to gain a deeper understanding of the state of research on the sexual health knowledge of university/college students globally. A 5-stage framework was used to guide the review and to characterize the literature on sexual health knowledge. Articles published in English between 2000 and 2014 were reviewed if they included university students as a population of interest and described the methods used to measure sexual health knowledge. Of the 2,386 articles retrieved, 91 met the criteria. The majority of the articles (n = 79) used a cross-sectional design to investigate students' knowledge about HIV/AIDS (n = 45), STIs (n = 23), HPV (n = 9), and contraception (n = 24). The review highlights gaps in the literature and in findings relating to the research dominance of various geographic locations, common research designs, the wide range of measurement tools used, and the variety of sexual health knowledge outcomes of interest. The review provides a useful description of the literature on sexual health knowledge among university/college students and some recommendations for moving the field forward.

Consumption of energy drinks among Québec college students

OBJECTIVES

Consumption of energy drinks (ED) raises concerns because of adverse health effects possibly linked with high levels of caffeine and sugar intake. The study looks at the scope of ED consumption as well as some of the associated characteristics.

METHODS

Thirty-six public colleges in the Canadian province of Québec agreed to participate in a descriptive cross-sectional study (n = 36). In February 2013, participating colleges invited their students to answer an online questionnaire on consumption of ED, alcoholic ED (AED), and ED in combination with other psychotropic drugs. A descriptive and correlational analysis was carried out. Logistic regressions explored associations between ED consumption and associated characteristics.

RESULTS

Of the students who successfully completed the questionnaire and participated in the study (n = 10,283), a low proportion consumed ED (9.1%; n = 935) and/or AED (1.1%; n = 109) at least once a week in the previous month. Although low in proportion, a number of participants reported having used ED with other stimulant psychoactive substances (n = 247) and ≥3 ED/day (n = 193) or ≥3 AED/occasion (n = 167), which can pose a risk for serious adverse effects. Weekly ED consumption was associated with consumption of ≥20 cups of coffee/week, smoking, excessive use of alcohol and past use of cannabis, glues or solvents and amphetamines.

CONCLUSION

A majority of respondents are not heavy users of ED, AED, or ED with drugs. Yet, the profiles of ED consumption potentially harmful to health that characterize some participants indicate that the potential health consequences of such behaviour are of concern.

Nonmedical use of prescription drugs and related negative sexual events: Prevalence estimates and correlates in college students

The present study of college students investigated (a) the prevalence of nonmedical use of three classes of prescription drugs (stimulants, anxiolytics/sedatives, analgesics), (b) the prevalence of negative sexual events (NSE) associated with any nonmedical use of prescription drugs (NMUPD), and (c) a set of correlates of NSE. The specific NSE were sexual aggression victimization and perpetration, and regretted sex. The correlates of the NSE were sex, race/ethnicity, year in school, psychological symptoms, alcohol use, illegal drug use, and NMUPD. Participants were 509 (254 females, 255 males) randomly-selected college students who reported any NMUPD. The majority (76.2%) of the sample reported ever using stimulants, 38.9% reported ever using anxiolytics/sedatives, and 40.9% reported using analgesics. During NMUPD, 14.3% of the students reported regretted sex, 7.1% of female students reported sexual victimization, and 6.3% of male students reported perpetrating sexual aggression. Multiple logistic regression analyses indicated that anxiolytic/sedative use (Adj. OR=1.99; 95% CI=1.51-2.62) was positively associated with regretted sex, whereas anxiolytic/sedative use (Adj. OR=1.79; 95% CI=1.01-3.16) and psychological symptoms (Adj. OR=1.06; 95% CI=1.02-1.10) were positively associated with sexual victimization. Illegal drug use was positively associated with perpetrating sexual aggression (Adj. OR=4.10; 95% CI=1.21-13.86). These findings suggest that among these college students, NMUPD-associated NSE were not uncommon, and primarily associated with anxiolytic/sedative use. Given the academic, physical, and psychological implications associated with NSE, research needs to further explore the causal nature of these relations.

Dangerous Beliefs: College Alcohol Beliefs Are Associated With Increased Risk of Regretted Sexual Encounters

This study explored the relative impact of college alcohol beliefs (CABs; i.e., the extent to which the student views alcohol as part of the fabric of college life), descriptive norms, injunctive norms, positive alcohol expectancies, and sensation seeking on college students' (N = 415) risk for engaging in regretted sexual encounters (RSE). Overall, 12% of our sample reported having experienced RSE within the past 30 days. When pitted against the other traditional predictors of college student drinking and its consequences, such as positive alcohol expectancies, descriptive and injunctive norms, and sensation seeking, CABs emerged as the strongest correlate of RSE other than drinking itself, and explained significant additional variance in RSE beyond these other predictors. Mediation analyses revealed that CABs had a significant indirect effect on RSE through typical weekly drinking. This pattern of findings indicates that college alcohol beliefs are, from a public health perspective, dangerous beliefs, that warrant serious consideration in the development of new approaches to college student drinking and its consequences.

The Association between Alcohol and Sexual Risk Behaviors among College Students: A Review

PURPOSE OF REVIEW

Alcohol use is prevalent among college students and may contribute to sexual risk behavior engagement. A narrative review of the recent empirical literature examining the association between alcohol use and sexual risk behaviors among college student samples was conducted. The purpose of this review was to: (a) review studies examining the association between alcohol use and risky sexual behaviors; and (b) overview research investigating alcohol expectancies and partner characteristics as factors that may influence the alcohol-risky sex relation among college students.

RECENT FINDINGS

Findings regarding the direct link between alcohol use and sexual risk behaviors were mixed. Results suggest a more nuanced association between alcohol and risky sexual behaviors that is influenced by alcohol expectancies and partner characteristics.

SUMMARY

Results highlight the importance of considering additional factors that may influence the alcohol-risky sex relation. Future interventions targeting alcohol-related sexual risk behavior engagement among college students are needed.

Alcohol mixed with energy drinks: Associations with risky drinking and functioning in high school

BACKGROUND

Mixing alcohol with energy drinks is associated with heavier drinking and related problems among college students. However, little is known about how high school drinkers who mix alcohol with energy drinks (AmED) compare to those who do not (AwoED). This study compares high school AmED and AwoED users on their alcohol use during middle and high school, as well as key domains of functioning in high school.

METHODS

Two surveys were conducted three years apart in adolescents initially recruited from 16 middle schools in Southern California. The analytic sample consists of 696 past month drinkers. Multivariable models compared AmED and AwoED users on alcohol use, mental health, social functioning, academic orientation, delinquency and other substance use at age 17, and on their alcohol use and related cognitions at age 14.

RESULTS

AmED was reported by 13% of past month drinkers. AmED and AwoED users did not differ on alcohol use or cognitions in middle school, but AmED users drank more often, more heavily, and reported more negative consequences in high school. AmED users were also more likely to report poor grades, delinquent behavior, substance use-related unsafe driving, public intoxication, and drug use than AwoED users in high school. Group differences were not found on mental health, social functioning, or academic aspirations.

CONCLUSIONS

AmED use is common among high school drinkers. The higher risk behavioral profile of these young AmED users, which includes drug use and substance use-related unsafe driving, is a significant cause for concern and warrants further attention.

Investigating Sociodemographic Factors and HIV Risk Behaviors Associated With Social Networking Among Adolescents in Soweto, South Africa: A Cross-Sectional Survey

Background

Internet access via mobile phones and computers facilitates interaction and potential health communication among individuals through social networking. Many South African adolescents own mobile phones and can access social networks via apps.

Objective

We investigated sociodemographic factors and HIV risk behaviors of adolescent social networking users in Soweto, South Africa.

Methods

We conducted an interviewer-administered, cross-sectional survey of adolescents aged 14-19 years. Independent covariates of social networking were assessed by multivariate logistic regression analysis.

Results

Of 830 adolescents, 57% (475/830) were females and the median age was found to be 18 years (interquartile range 17-18). Social networking was used by 60% of adolescents (494/830); more than half, that is, 87% (396/494) accessed social networks through mobile phones and 56% (275/494) spent more than 4 hours per day using their mobile phones. Social networking was independently associated with mobile usage 2-4 hours (adjusted odds ratio [AOR]: 3.06, CI: 1.69-5.51) and more than 4 hours per day (AOR: 6.16, CI: 3.46-10.9) and one (AOR: 3.35, CI: 1.79-6.27) or more sexual partner(s) (AOR: 2.58, CI: 1.05-6.36).

Conclusions

Mobile phone–based social networking is prevalent among sexually active adolescents living in Soweto and may be used as an entry point for health promotion and initiation of low-cost adolescent health interventions.

A UK student survey investigating the effects of consuming alcohol mixed with energy drinks on overall alcohol consumption and alcohol-related negative consequences

Previous research reported positive associations between alcohol mixed with energy drink (AMED) consumption and overall alcohol consumption. However, results were largely based on between-subjects comparisons comparing AMED consumers with alcohol-only (AO) consumers, and therefore cannot sufficiently control for differences in personal characteristics between these groups. In order to determine whether AMED consumers drink more alcohol on occasions they consume AMED compared to those when they drink AO additional within-subjects comparisons are required. Therefore, this UK student survey assessed both alcohol consumption and alcohol-related negative consequences when consumed alone and when mixed with energy drinks, using a within-subject design. A total of 1873 students completed the survey, including 732 who consumed AMED. It was found that AMED consumers drank significantly less alcohol when they consumed AMED compared to when they drank AO (p < 0.001). In line with reduced alcohol consumption significantly fewer negative alcohol-related consequences were reported on AMED occasions compared to AO occasions (p < 0.001). These findings suggest that mixing alcohol with energy drinks does not increase total alcohol consumption or alcohol-related negative consequences.

HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People

The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.