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Lewis MA, Zhou Z, Fairlie AM, Litt DM, Geusens F, Parks KA, McCabe SE. Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States. Addict Behav 2024; 155:108040. [PMID: 38657402 DOI: 10.1016/j.addbeh.2024.108040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse). METHOD We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up. RESULTS Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up. CONCLUSIONS Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.
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Affiliation(s)
- Melissa A Lewis
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States.
| | - Zhengyang Zhou
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Anne M Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, United States
| | - Dana M Litt
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Femke Geusens
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 752 37 Uppsala, Sweden; Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, Park Hall, Buffalo, NY 14226, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building Ann Arbor, MI 48109, United States
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2
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Kritikos AF, Johnson JK, Hodgkin D. Simultaneous Cannabis and Alcohol Use among Medical Cannabis Patients. Subst Use Misuse 2024; 59:847-857. [PMID: 38343069 DOI: 10.1080/10826084.2024.2305795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Background: During the past two decades of cannabis legalization, the prevalence of medical cannabis (MC) use has increased and there has also been an upward trend in alcohol consumption. As less restricted cannabis laws generate more adult cannabis users, there is concern that more individuals may be simultaneously using medical cannabis with alcohol. A few studies have examined simultaneous use of medical cannabis with alcohol, but none of those studies also assessed patients' current or previous non-medical cannabis use. This paper explores simultaneous alcohol and medical cannabis use among medical cannabis patients with a specific focus on previous history of cannabis use and current non-medical cannabis use. Methods: A retrospective cohort study of MC patients (N = 319) from four dispensaries located in New York. Bivariate chi-square tests and multivariable logistic regression are used to estimate the extent to which sociodemographic and other factors were associated with simultaneous use. Results: Approximately 29% of the sample engaged in simultaneous use and a large share of these users report previous (44%) or current (66%) use of cannabis for non-medical purposes. MC patients who either previously or currently use cannabis non-medicinally, men, and patients using MC to treat a pain-related condition, were significantly more likely to report simultaneous alcohol/MC use. Conclusions: Findings indicate that there may be differential risks related to alcohol/MC use, which should be considered by cannabis regulatory policies and prevention/treatment programs. If patients are using cannabis and/or alcohol to manage pain, clinicians should screen for both alcohol and cannabis use risk factors.
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Affiliation(s)
| | - Julie K Johnson
- Cannabis Control Commission, Commonweath of Massachusetts, Worcester, MA, USA
| | - Dominic Hodgkin
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Lewis MA, Zhou Z, Parks KA, Evans-Polce R, Litt DM, Fairlie AM, Geusens F, LoParco C, McCabe SE. Polysubstance use among young adults and differences in negative alcohol-related sexual experiences. Addict Behav 2023; 138:107571. [PMID: 36502745 PMCID: PMC9780189 DOI: 10.1016/j.addbeh.2022.107571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.
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Affiliation(s)
- Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States.
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States
| | - Femke Geusens
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 box 3603, 3000 Leuven, Belgium; Research Foundation Flanders/FWO Vlaanderen, Leuvenseweg 38, 1000 Brussel, Belgium
| | - Cassidy LoParco
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
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4
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Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020. AIDS Behav 2022; 27:2041-2053. [PMID: 36441411 PMCID: PMC9707195 DOI: 10.1007/s10461-022-03937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/30/2022]
Abstract
Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.
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Giménez-García C, Ballester-Arnal R, Ruiz-Palomino E, Nebot-García JE, Gil-Llario MD. Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999-2020). SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 31:100677. [PMID: 34775354 DOI: 10.1016/j.srhc.2021.100677] [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] [Received: 08/12/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.
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Affiliation(s)
- Cristina Giménez-García
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | - Rafael Ballester-Arnal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain.
| | - Estefanía Ruiz-Palomino
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - María Dolores Gil-Llario
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Valencia, Spain
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Wesche R, Claxton SE, Waterman EA. Emotional Outcomes of Casual Sexual Relationships and Experiences: A Systematic Review. JOURNAL OF SEX RESEARCH 2021; 58:1069-1084. [PMID: 32991206 PMCID: PMC8579856 DOI: 10.1080/00224499.2020.1821163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Casual sexual relationships and experiences (CSREs) are common and emotionally significant occurrences. Given the uncommitted, often emotionally complicated nature of CSREs, researchers have asked whether these experiences may have positive and/or negative emotional consequences. We reviewed 71 quantitative articles examining emotional outcomes of CSREs, including subjective emotional reactions (e.g., excitement, regret) and emotional health (e.g., depression, self-esteem). Overall, people evaluated their CSREs more positively than negatively. In contrast, CSREs were associated with short-term declines in emotional health in most studies examining changes in emotional health within a year of CSRE involvement. Emotional outcomes of CSREs differed across people and situations. Women and individuals with less permissive attitudes toward CSREs experienced worse emotional outcomes of CSREs. Alcohol use prior to CSREs, not being sexually satisfied, and not knowing a partner well were also associated with worse emotional outcomes. These findings suggest directions for prevention/intervention related to CSREs. For example, skill-building related to sexual decision-making may help individuals decide whether, and under what circumstances, CSREs are likely to result in positive or negative emotional outcomes. In addition, the limitations of extant research suggest directions for future inquiry (e.g., examining whether verbal and nonverbal consent practices predict emotional outcomes of CSREs).
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Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | | | - Emily A. Waterman
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE
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Wesche R, Lefkowitz ES, Maggs JL. Short-Term Consequences of Sex: Contextual Predictors and Change Across College. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1613-1626. [PMID: 33907943 PMCID: PMC8629131 DOI: 10.1007/s10508-020-01874-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 06/12/2023]
Abstract
Although sexual experiences are normative by young adulthood, individuals continue to explore and develop their sexual behaviors and cognitions across the college years. Thus, perceived consequences of sexual experiences may change. Similarly, characteristics of sexual experiences such as partner type, alcohol use, and sexual behavior type predict perceived consequences, and these associations may change over time. In this study, we addressed links between characteristics of sexual experiences (casual vs. committed partner, heavy alcohol use on sex days, and kissing/touching only vs. oral/penetrative sex) and short-term perceived consequences of sexual experiences (physical satisfaction, emotional intimacy, not satisfied, guilt, not ready), using daily data collected longitudinally across seven college semesters. We also examined whether perceived consequences of sex change across college and whether within-person daily associations between sexual experience characteristics and perceived consequences of sex change across college. An ethnically and racially diverse sample of traditionally aged first year university students (N = 566; 54% female; 98% heterosexual) completed online surveys, yielding 8,838 daily reports about sexual behaviors. Multilevel models indicated that partner type, heavy alcohol use, and sexual behavior type predicted within-person differences in perceived consequences of sex. Interactions between characteristics of sexual experiences and college semester indicated that differences in perceived consequences of sexual experiences with casual versus committed partners lessened over time. The likelihood of reporting physical satisfaction and guilt after only kissing/touching (but not oral/penetrative sex) decreased across college semesters. Findings inform understanding of normative sexual development by demonstrating that perceived consequences and their predictors change across time.
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Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, 313 Wallace Hall (0416), 295 West Campus Drive, Blacksburg, VA, 24061, USA.
| | - Eva S Lefkowitz
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, The Pennsylvania State University, State College, PA, USA
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Willis M, Marcantonio TL, Jozkowski KN. Internal and external sexual consent during events that involved alcohol, cannabis, or both. Sex Health 2021; 18:260-268. [PMID: 34134817 DOI: 10.1071/sh21015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/16/2021] [Indexed: 11/23/2022]
Abstract
Background Substance-involved sexual activity is common. Even though people recognise that substance-related impairment can be a barrier to people's ability to consent to sexual activity, most do not believe that substance use automatically negates sexual consent. We extended previous work on substance-related effects on internal and external consent by investigating sexual events that involved alcohol, cannabis, or both. METHODS For 28 days, 113 participants (MAge = 29.2 years, 57.5% women, 70.8% White) responded to three surveys per day on their personal devices. At time points when participants reported having engaged in partnered sexual activity, they were asked to report their alcohol use, cannabis use, internal consent feelings, and external consent communication. RESULTS Across 1189 partnered sexual events, 31.5% involved alcohol, cannabis, or both. Sexual events that involved combined use were associated with diminished feelings of safety/comfort and feelings that the sexual act was consensual, compared with events that involved neither substance. Greater levels of alcohol consumption were descriptively associated with lower ratings of internal sexual consent. CONCLUSIONS We found that combined use of alcohol and cannabis may lead to lower internal sexual consent than using either substance alone - potentially due to greater levels of impairment associated with polysubstance use. Sexual health education programs should consider more nuanced approaches to teaching people how to navigate substance use and sexual consent.
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Affiliation(s)
- Malachi Willis
- University of Glasgow, Institute of Health and Wellbeing, MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK; and Corresponding author.
| | - Tiffany L Marcantonio
- University of Arkansas, Department of Health, Human Performance, and Recreation, Fayetteville, AR, USA; and Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA
| | - Kristen N Jozkowski
- Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA; and Indiana University, Department of Applied Health Sciences, Bloomington, IN, USA
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Conway FN, Sokolovsky A, White HR, Jackson KM. Simultaneous Alcohol and Marijuana Use: A Brief Measure of Motives. J Stud Alcohol Drugs 2020; 81:203-211. [PMID: 32359050 PMCID: PMC7201206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/18/2019] [Indexed: 03/29/2024] Open
Abstract
OBJECTIVE Increasing numbers of substance users report simultaneous alcohol and marijuana (SAM) use such that their effects overlap. More research is needed to understand what motivates this behavior, especially to inform interventions that address SAM use. A 26-item measure of SAM motives was designed and tested in previous research. The purpose of the current study was to validate that measure and create a briefer version of it. METHOD Using two waves of data from a multi-site sample of college students (n = 1,014), exploratory and confirmatory factor analyses were conducted to develop a brief 11-item SAM Motives Measure (B-SMM). Negative binomial regression analyses were conducted to assess the reliability and validity of both the original and brief measures. RESULTS The brief measure contains four subscales (conformity, positive effects, calm/coping, and social) that match the empirically supported motivational model of substance use. Internal consistency of the subscales ranged from .77 to .87. Most subscales significantly predicted frequency and consequences of SAM use both concurrently and prospectively. CONCLUSIONS The psychometrically sound measure developed in this study facilitates the examination of SAM motives in clinical settings with time-constrained patient contact and can be valuable for research involving frequent and repeated measures of substance use behaviors.
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Affiliation(s)
- Fiona N. Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Alexander Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Department of Sociology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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Conway FN, Sokolovsky A, White HR, Jackson KM. Simultaneous Alcohol and Marijuana Use: A Brief Measure of Motives. J Stud Alcohol Drugs 2020; 81:203-211. [PMID: 32359050 PMCID: PMC7201206 DOI: 10.15288/jsad.2020.81.203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/18/2019] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE Increasing numbers of substance users report simultaneous alcohol and marijuana (SAM) use such that their effects overlap. More research is needed to understand what motivates this behavior, especially to inform interventions that address SAM use. A 26-item measure of SAM motives was designed and tested in previous research. The purpose of the current study was to validate that measure and create a briefer version of it. METHOD Using two waves of data from a multi-site sample of college students (n = 1,014), exploratory and confirmatory factor analyses were conducted to develop a brief 11-item SAM Motives Measure (B-SMM). Negative binomial regression analyses were conducted to assess the reliability and validity of both the original and brief measures. RESULTS The brief measure contains four subscales (conformity, positive effects, calm/coping, and social) that match the empirically supported motivational model of substance use. Internal consistency of the subscales ranged from .77 to .87. Most subscales significantly predicted frequency and consequences of SAM use both concurrently and prospectively. CONCLUSIONS The psychometrically sound measure developed in this study facilitates the examination of SAM motives in clinical settings with time-constrained patient contact and can be valuable for research involving frequent and repeated measures of substance use behaviors.
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Affiliation(s)
- Fiona N. Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Alexander Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Department of Sociology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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