Alcohol and marijuana use in pathways of risk for sexually transmitted infection in white and black adolescent females

Cumulative Health Vulnerabilities Among Adolescents by Age and Neighborhood Opportunity

BACKGROUND AND OBJECTIVES

Early detection of health vulnerabilities in adolescents is integral to promoting healthy behaviors into adulthood. Our objective was to quantify the prevalence of health vulnerabilities among adolescents and examine differences by age and neighborhood opportunity.

METHODS

In a cross-sectional analysis of electronic health record data for adolescents aged 13 to 18 years with preventive visits in a large pediatric primary care network between September 2021 and September 2022, we examined 5 health vulnerabilities: Tobacco use, substance use, firearm access, condomless intercourse, and depressive symptoms. Health vulnerabilities were assessed via self-reported adolescent health questionnaire and the validated Patient Health Questionnaire-Modified. Prevalence of health vulnerabilities were calculated alone and in combination, and compared by age and by quintile of neighborhood Child Opportunity Index (COI) score. Multivariable logistic regression estimated associations of neighborhood COI with reporting ≥2 health vulnerabilities.

RESULTS

Among 40 197 adolescents (57.7% aged 13-15 years, 66.3% living in "high"/"very high" COI neighborhoods), 29.7% reported at least 1 health vulnerability and 7.9% reported ≥2 vulnerabilities. Cumulative health vulnerabilities were more prevalent among older adolescents and adolescents from lower opportunity neighborhoods. In adjusted models, lower COI was associated with 65% higher odds of having ≥2 vulnerabilities (odds ratio 1.65, 95% confidence interval 1.43-1.91) compared with adolescents from the highest COI quintile.

CONCLUSIONS

Understanding the relationship between health vulnerabilities and neighborhood opportunities among adolescents may allow pediatric primary care providers and health systems to offer more tailored community support services and transdiagnostic specialized care navigation to address the health needs of teens with multiple vulnerabilities.

Sexual Networks and STI Infection Among Young Black Men Who Have Sex With Women in a Southern U.S. City

PURPOSE

The configuration of one's sexual network has been shown to influence sexually transmitted infection (STI) acquisition in some populations. Young Black men who have sex with women (MSW) have high rates of STIs, yet little is known about their sexual networks. The purpose of this study is to describe the characteristics of sexual networks and their association with selected STI infections among young Black MSW.

METHODS

Black MSW aged 15-26 years who were enrolled in the New Orleans community-based screening program named Check It from March 2018 to March 2020 were tested for C. trachomatis and N. gonorrhoeae infection and asked about the nature of their sexual partnerships. Sexual partnerships with women were defined as dyadic, somewhat dense (either themselves or their partner had multiple partners), and dense (both they and their partner(s) had multiple partners).

RESULTS

Men (n = 1,350) reported 2,291 sex partners. The percentage of men who reported their networks were dyadic, somewhat dense, and dense was 48.7%, 27.7%, and 23.3%, respectively; 11.2% were STI-positive and 39.2% thought their partner(s) had other partners. Compared to men in dyadic relationships, those in somewhat dense network did not have increased risk of STI infection, but those in dense networks were more likely to have an STI (adjusted odds ratio = 2.06, 95% confidence interval [1.35-3.13]).

DISCUSSION

Young Black MSW, who had multiple partners and who thought their partner(s) had other sex partners were at highest risk for STIs. Providers should probe not only about the youth's personal risk but should probe about perceived sexual partners' risk for more targeted counseling/STI testing.

Ethnic Identity, Empowerment, Social Support and Sexual Risk Behaviors Among Black Adolescent Girls: Examining Drug Use as a Mediator

Substance abuse and sexual health research tends to overlook the resiliency skills that Black adolescent girls possess. Using a strengths-based lens, this study examines the role of protective factors: (e.g. ethnic identity, social support, and psychological empowerment) on sexual risk behaviors testing drug use as a mediator among a sample of Black adolescent girls. The study uses a sample (N = 340) female adolescents (13-17 years old) who identified as being Black only and reside in a northeastern urban community in New Jersey. Structural equation modeling was employed to test the hypothesized model of the mediating role of drug use on sexual risk behaviors among this sample. Findings revealed that drug use significantly mediated the relationship between social support, ethnic identity, and psychological empowerment on sexual risk behaviors, with high ethnic identity scores having the strongest relationship on low sexual risk behaviors and low levels of drug use. Given the rise of sexually transmitted infections (STIs) in the United States among Black adolescent girls, findings from this study can contribute to development of culturally appropriate and innovative strategies to reduce risky behaviors by promoting social and cultural strengths among Black girls living in urban communities.

Alcohol drinking patterns and occurrence of genital warts among Danish adolescents

BACKGROUND

Under the influence of alcohol adolescents are more prone to engage in unprotected sex, which increases the risk of acquiring genital warts. The study aim was to examine whether alcohol consumption among adolescents is associated with acquiring genital warts.

METHODS

Health behavior data were extracted from the Danish National Youth Study 2014. Complete data were available for 63,648 students. Number of binge drinking episodes in the past 30 days, frequency of drinking on weekends and total number of drinks consumed during 7-day week were collected by a questionnaire. Information on genital warts for the period between filling the questionnaire in 2014 and December 31, 2018 was retrieved from the Danish National Prescription Register and Danish National Patient Register.

RESULTS

Adjusted analysis showed that, compared to students who did not drink alcohol, increasing frequency of binge drinking in the past 30 days was independently associated with greater hazard of acquiring genital warts (1-3 times hazard ratio [HR]: 1.36, 95 % confidence interval [CI]: 1.09-1.69; 4-6 times HR: 1.55, 95 % CI: 1.22-1.96; >6 times HR: 1.84, 95 % CI 1.39-2.45). Compared to students who did not drink alcohol, consistent alcohol drinking every weekend was associated with greater risk of developing genital warts (HR: 1.62, 95 % CI: 1.20-2.17). Total weekly number of alcohol drinks consumed was not associated with occurrence of genital warts.

CONCLUSION

Increased alcohol intake was associated with occurrence of genital warts over 4 year of follow-up. There is an urgent need for change of excessive alcohol intake tendencies among adolescents.

Time-varying associations of alcohol and cannabis use with intimate partner violence for black and white young women

BACKGROUND

Substance use is linked to increases in young women's risk for intimate partner violence (IPV). Increased understanding of the magnitude of and changes in the associations between substance use and risk for IPV in the transition to emerging adulthood, and differences between Black and White women, could inform efforts to protect women from substance use-related harm.

METHODS

Young women (N = 1,852; 59% Black, 41% White) in the Pittsburgh Girls Study completed yearly assessments at ages 17-21 on frequency of alcohol and cannabis use, and experiences of IPV (minor physical assault). Time-varying effect models (TVEMs) were used to examine changes in the strength of the association between frequency of alcohol and cannabis use with IPV across ages 17-21, controlling for time-invariant covariates (socioeconomic status, conduct problems, and depression).

RESULTS

Across ages 17 to 21, White, relative to Black, women reported more frequent alcohol use and less frequent cannabis use, and lower rates of IPV. Alcohol use was not significantly associated with IPV at ages 17-21 among White women, but among Black women, alcohol use was associated with increased likelihood of IPV at ages 17-20. Cannabis use was associated with increased likelihood of IPV at ages 19-21 among Black women, and at ages 20-21 among White women.

CONCLUSIONS

Associations between IPV (specifically minor assault) in the context of a romantic relationship differed for alcohol and cannabis across ages 17-21, and by race, among White and Black women. Results highlight the importance of substance-specific prevention efforts that are timed and tailored to subgroups.

Profiles of young women's alcohol and cannabis use linked to risk for sexually transmitted infection highlight the importance of multi-level targeted interventions: Findings from the Pittsburgh girls study

Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18-20. Profile indicators included: women's and partner's alcohol and cannabis use, women's sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors. Results: Two of the five identified profiles had low STI likelihood: "Low Use" of alcohol and cannabis (25.5%; overrepresented by Black women), and "Alcohol Only" (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: "Co-Use: Increasing Alcohol and Occasional Cannabis use" (16.5%; overrepresented by White women), "Co-Use: Occasional Alcohol and Cannabis use" (26.1%; overrepresented by Black women), and "Co-Use: Frequent Cannabis and Occasional Alcohol use" (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with "Low Use" and "Co-Use: Frequent Cannabis and Occasional Alcohol use" profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the "Co-Use: Frequent Cannabis and Occasional Alcohol use" profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural- and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.

Two- and three-year follow-up from a gender-specific, web-based drug abuse prevention program for adolescent girls

INTRODUCTION

Rates of drug use among early adolescent girls meet or exceed rates of their male counterparts. Girls are also vulnerable to differential risk factors for drug use. Yet, expressly designed prevention programs targeting this population are absent. The present study reports 2- and 3-year findings on a web-based drug abuse prevention program for adolescent girls.

METHODS

A sample of adolescent girls (N = 788) were recruited via Facebook. Online, all girls completed pretests; girls were randomly assigned to a 9-session intervention arm or to a measurement-only control arm and all girls completed posttests. All girls also completed 1-, 2-, and 3-year follow-up measurements.

RESULTS

At 2-year follow-up and compared to girls in the control arm, intervention-arm girls reported less past-month cigarette, marijuana, and "other" drug use (club drugs, cocaine, ecstasy, hallucinogens, heroin, inhalants, methamphetamines, steroids, prescription drugs), lower rates of peer drug use, and increased scores on drug refusal skills, coping skills, self-esteem, media literacy, and self-efficacy. At 3-year follow-up, and compared to girls in the control arm, intervention-arm girls reported less past-month cigarette and e-cigarette use, lower rates of peer drug use, lower reported anxiety and stress, and increased scores on drug refusal skills, self-esteem, media literacy, self-efficacy, and body image.

CONCLUSIONS

Longitudinal outcome data lend support to the efficacy of a gender-specific, web-based drug abuse prevention program to reduce adolescent girls' drug use rates and associated risk factors.

An Online Drug Abuse Prevention Program for Adolescent Girls: Posttest and 1-Year Outcomes

Early adolescent girls' rates of drug use have matched, and in some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session, gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early adolescent girls.