Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students

Comprehensive HIV knowledge, stigma and associated sexual risk behaviors among sexually active adolescent girls and young women in the Philippines

This study aims to investigate how comprehensive HIV knowledge, stigma and sociodemographic factors relate to sexual risk behaviors among sexually active young women in the Philippines. Using the 2022 Philippine National Demographic and Health Survey data, a cross-sectional quantitative approach analyzed 2494 sexually active young women aged 15-24 years. Logistic regression models examined associations, controlling for sociodemographic factors. Sexual risk behaviors included STI symptoms, multiple sexual partners and non-condom use. Findings revealed 26.6% reported sexual risk behaviors. Significant associations were found with secondary or lower educational attainment (AOR = 0.56, 95% CI 0.42-0.76) reducing the odds and daily internet access (AOR = 1.63, 95% CI 1.18-2.23) and recent alcohol consumption (AOR = 1.82, 95% CI 1.30-2.54) increasing the odds of sexual risk behavior. Knowing one's HIV test result was protective (AOR = 0.33, 95% CI 0.21-0.51), while comprehensive HIV/AIDS knowledge and stigma showed no significant associations. Overall, one in four sexually active young women in the Philippines is at risk of HIV infection. Thus, targeted interventions are crucial to address risk factors identified among young women. This study informs public health strategies, emphasizing proactive HIV testing to empower informed decision-making and reduce risky sexual behaviors.

The magnitude of casual sex and associated factors among students at Debre Berhan University

Background

Today's youth are adopting a new trend: casual sex. College students are expected to engage in a range of potentially harmful sexual activities, such as casual sex. Numerous factors can lead students to engage in casual sexual encounters. However, there has been limited research on the prevalence of casual sex and related issues in higher education institutions in Ethiopia.

Objective

To assess the prevalence of casual sex and its associated factors among regular undergraduate students at Debre Berhan University in 2023.

Methods

From 15 May 2023, to 30 May 2023, regular undergraduate students from Debre Berhan University participated in a cross-sectional study. A total of 512 samples were collected using a multistage sampling technique. Subsequently, a simple random sampling technique was employed to select the students, with a proportionate allocation of samples distributed to randomly selected colleges, departments, and academic years. The data were collected using a structured, pretested, and self-administered questionnaire. Once the data were imported into Epi-data version 4.6 and exported to SPSS version 20 for analysis, frequencies, percentages, and tables were generated. Bivariate and multivariate logistic regression models were used to identify characteristics associated with casual sex.

Results

The prevalence of casual sex among regular undergraduate students at Debre Berhan University was 31.0% 95% CI (27.2-34.6). Several factors were significantly associated with casual sex. These included students from urban areas [AOR: 2.95; 95% CI (1.66-5.24)], students with poor academic performance [AOR: 2.81; 95% CI (1.51-5.22)], alcohol consumption [AOR: 4.59; 95% CI (2.60-8.12)], attending nightclubs [AOR: 2.75; 95% CI (1.47-5.16)], watching pornography [AOR: 2.59; 95% CI (1.47-5.16)], and peer pressure [AOR: 2.24; 95% CI (1.38-3.65)].

Conclusion

The prevalence of casual sex was high among Debre Berhan University students. In order to lessen the negative effects of casual sex practices, this study found predictors that can be avoided through various interventions. Key preventative measures include improving student academic performance, providing engaging and free entertainment, restricting access to pornographic websites on university Wi-Fi, and employing peer educators.

Risky sexual behavior and associated factors among reproductive age women in eastern African countries: a multilevel analysis of the recent demographic and health survey

INTRODUCTION

Risky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention.

METHOD

The appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.

RESULT

The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior.

CONCLUSION

The overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior.

Which parents provide zero-alcohol beverages to adolescents? A survey of Australian parents' practices and intentions

OBJECTIVE

Zero-alcohol beverages (<0.5% alcohol by volume) appear and taste similar to alcoholic beverages but are regulated similarly to soft drinks in many countries, blurring the distinction between alcoholic and non-alcoholic beverages. How parents view provision of zero-alcohol beverages to adolescents is likely a key determinant of adolescent consumption. We investigated factors associated with parents' provision of zero-alcohol beverages to adolescents, including attitudes toward zero-alcohol beverages and demographic, knowledge, and behavioural factors known to be associated with provision of alcoholic beverages.

METHODS

We conducted an online cross-sectional survey of N = 1197 Australian parents of adolescents aged 12-17 years in April-May 2022. We examined associations with zero-alcohol beverage provision using binomial logistic regression, and with future provision intentions using multinomial logistic regression analyses.

RESULTS

Factors significantly associated (p < .001) with parents' provision and future intentions to provide zero-alcohol beverages to their adolescent included beliefs that zero-alcohol beverages had benefits for adolescents (Adjusted Odds Ratio [AOR] 2.69 (provision); 3.72 (intentions)), provision of alcoholic beverages (AOR 2.67 (provision); 3.72 (intentions)), and an incorrect understanding of alcohol guidelines for adolescents (AOR 2.38 (provision); 1.95 (intentions)).

CONCLUSIONS

Parents' provision and intentions to provide zero-alcohol beverages were associated with beliefs about zero-alcohol beverages as well as some factors associated with provision of alcoholic beverages. Precautionary advice to parents that the provision of zero-alcohol beverages may serve to normalise alcohol consumption may be warranted.

Relationship Between Alcohol Consumption and Risky Sexual Behaviors Among Adolescents and Young Adults: A Meta-Analysis

Objectives: Adolescents exposed to alcohol have increased risky sexual behaviors (RSBs); however, the association between alcohol consumption and RSBs has to be systematically and quantitatively reviewed. We conducted a meta-analysis of the literature to systematically and quantitatively review the association between alcohol consumption and RSBs in adolescents and young adults. Methods: We searched for qualified articles published from 2000 to 2020 and calculated pooled odds ratios (ORs) using the random-effect model. We also conducted meta-regression and sensitivity analyses to identify potential heterogeneity moderators. Results: The meta-analysis of 50 studies involving 465,595 adolescents and young adults indicated that alcohol consumption was significantly associated with early sexual initiation (OR = 1.958, 95% confidence interval (CI) = 1.635-2.346), inconsistent condom use (OR = 1.228, 95% CI = 1.114-1.354), and having multiple sexual partners (OR = 1.722, 95% CI = 1.525-1.945). Conclusion: Alcohol consumption is strongly associated with RSBs, including early sexual initiation, inconsistent condom use, and multiple sexual partners among adolescents and young adults. To prevent the adverse consequences of alcohol consumption, drinking prevention programs should be initiated at an early age and supported by homes, schools, and communities.

Alcohol, age at first sexual intercourse and number of sexual partners in young Mexican women

AIM

To identify the relationship between use of alcohol, number of sexual partners and age of sexual initiation.

METHOD

Descriptive-correlational study. A random sample of 319 young women (age 18-25) from Nuevo Laredo, Mexico was recruited. A sociodemographic data sheet and the AUDIT questionnaire were used. Non-parametric Spearman's rank correlation coefficient and Kruskal-Wallis H test were selected.

RESULTS

On average the participants were 20.70 years old (±2.1), had 1.86 sexual partners (±1.27), started drinking alcohol at the age of 16.82 (±1.79), and their first sexual intercourse was at the age of 17.38 (±1.65). There was a decrease in the age of onset of alcohol use (H=16.646, p<.001) and the age at first sexual intercourse (H=26.749, p<.001) on the lower their current age. The overall AUDIT score negatively correlated with the age of the participants on their first sexual intercourse (r_s=-.168, p<.001) and positively correlated with the number of sexual partners (r_s=.243, p<.001). The aforementioned correlations were more intense among the younger participants (18- and 19-year olds; p<.01).

CONCLUSIONS

There was an association between higher use of alcohol, early age of sexual initiation and number of sexual partners. Nursing professionals may address such variables simultaneously through preventive strategies directed specifically at young women.

Alcohol-Related Behaviour in Freshmen University Students in Sardinia, Italy

This study aims to provide a picture of University of Cagliari students’ alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three questions from the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C short form). Three subgroups of alcohol-related behaviour were distinguished (risky drinkers, social drinkers and abstainers). In order to explore factors associated with patterns of alcohol consumption, a multivariate logistic regression was performed. The prevalence of risky drinkers was 35%. A binge-drinking behaviour at least once in the last twelve months was declared by 65% (more widespread in men and in students living away from their parents). Risky consumption is significantly associated with age of onset of alcohol use, living away from parents’ home, drinking outside meals and attending health courses. Regarding the levels of daily alcohol consumption perceived as a health risk, 66% of men and 88% of women indicate values higher than those recommended. The results underline the need for tailored prevention measures. University could be a promising setting to implement actions according to a health promotion perspective, to empower students to control their alcohol consumption.

Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

BACKGROUND

Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents' Health (2016-2030) aimed at improving adolescent health and responding more effectively to adolescents' needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15-19 years in 14 sub-Saharan countries.

METHODS

Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression.

RESULTS

In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence.

CONCLUSION

Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.

Alcohol, age at first sexual intercourse and number of sexual partners in young Mexican women

AIM

To identify the relationship between use of alcohol, number of sexual partners and age of sexual initiation.

METHOD

Descriptive-correlational study. A random sample of 319 young women (age 18-25) from Nuevo Laredo, Mexico was recruited. A sociodemographic data sheet and the AUDIT questionnaire were used. Non-parametric Spearman's rank correlation coefficient and Kruskal-Wallis H test were selected.

RESULTS

On average the participants were 20.70 years old (±2.1), had had 1.86 sexual partners (±1.27), started drinking alcohol at the age of 16.82 (±1.79), and their first sexual intercourse was at the age of 17.38 (±1.65). There was a decrease in the age of onset of alcohol use (H=16.646, p <.001) and the age at first sexual intercourse (H=26.749, P<.001) on the lower their current age. The overall AUDIT score negatively correlated with the age of the participants on their first sexual intercourse (rs=-.168, P<.001) and positively correlated with the number of sexual partners (rs=.243, P<.001). The aforementioned correlations were more intense among the younger participants (18- and 19-year olds; P<.01).

CONCLUSIONS

There was an association between higher use of alcohol, early age of sexual initiation and number of sexual partners. Nursing professionals may address such variables simultaneously through preventive strategies directed specifically at young women.

Harmful drinking is associated with mental health conditions and other risk behaviours in Australian young people

OBJECTIVE

To investigate factors associated with alcohol use in adolescents, with the focus on analysing the comorbidities between single-occasion harmful-drinking episodes with mental health issues and risk behaviours.

METHODS

This study used data from the Young Minds Matter survey, designed to inform on the prevalence of the seven most common mental health disorders of children and adolescents. Logistic regression modelling was used to assess the odds of harmful drinking behaviour in young people aged 13-17 years in Australia.

RESULTS

We found a strong association between single-occasion harmful drinking and mental health issues, which hold after controlling for sociodemographic characteristics. Young people with severe mental health issues within the past year were four times more likely to have been drinking at harmful levels in the past 30 days.

CONCLUSIONS

Alcohol use can have adverse health effects among children and adolescents. Research has found a bidirectional association between alcohol use and mental health conditions where the presence of one issue almost doubles the risk of having the other issue. Implications for public health: The comorbidity between these issues suggests the need for strategies to integrate policies addressing mental health and alcohol use disorders in young people.

Sexual health practices of 16 to 19 year olds in New Zealand: an exploratory study

INTRODUCTION New Zealand sexual health surveillance data suggest that young people aged 15-19 years are at considerable risk of contracting sexually transmitted infections. Although there is an established body of international research around sexual behaviours and sexual health practices among teenagers, there is a dearth of local research focusing on this age group. AIM The aim of this study was to explore the sexual repertoires and sexual health practices among teenagers in New Zealand with a view to better understanding levels of risk in this age group. METHODS This study comprised a cross-sectional online survey designed to ask questions about sexual behaviours. A convenience sample of young people (n=52) aged 16-19 years living in New Zealand completed the survey. RESULTS Most participants (71.2%) were sexually active, reporting engagement in a range of sexual practices. The most commonly reported sexual behaviours were penis-in-vagina sex (86.5%) and oral sex with a person-with-a-penis (81.1%). Infrequent and inconsistent use of barrier protection across all types of sexual behaviour was also reported. DISCUSSION The findings of this study highlight the importance of ensuring that young people have access to sexual health education that routinely includes health information and advice addressing the full range of sexual practices, regardless of the identity classifications they may use, or that may be attributed to them.

How Alcohol, Space, and Time Influence Young People's Sexual Encounters in Tanzania: A Qualitative Analysis

A significant under-addressed issue in the global adolescent health agenda is the interaction between alcohol use and sexual encounters among adolescent boys and girls in sub-Saharan Africa. The aim of this study was to explore the structural and environmental factors influencing young people's access to and use of alcohol, and subsequent engagement in safe or unsafe sexual behaviors in such contexts, from the perspective of young people themselves. We used qualitative and participatory methodologies to explore the experiences and perspectives of 177 adolescent girls and boys in and out of school in four sites across Dar es Salaam, Tanzania. Findings suggest that alcohol use intersects with a spatial dimension in relation to where youths are consuming alcohol and subsequently engaging in sex. This in turn influences young people's likelihood of using condoms and practicing safer sex. The spatial dimension was found to be influenced by time, gender, age, economics, and social norms around the carrying of and use of condoms. Interventions are needed that both address the gendered and social sanctioning of youth carrying condoms in Tanzania and that increase the availability of condoms where alcohol is sold and consumed.

Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia

BACKGROUND

The association between sedentary behavior and sexual behavior has not been investigated among adolescents.

AIM

The aim of this study was to: (i) investigate the association between leisure-time sedentary behavior and sexual intercourse, and (ii) test for mediation by alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms in a large global sample of young adolescents.

METHODS

Data were analyzed from 34,674 adolescents aged 12-15 years participating in the Global School-based Student Health Survey. Participants reported the number of hours spent in leisure-time sedentary behavior on a typical day (<1, 1-2, 3-4, 5-8, and >8 hours). Data on alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms were considered as potential mediators.

OUTCOME

Participants reported whether or not they had sexual intercourse in the past 12 months (yes/no).

RESULTS

The prevalence of past 12-month sexual intercourse was 11.9%, whereas the prevalence of <1, 1-2, 3-4, 5-8, and >8 hours per day of leisure-time sedentary behavior were 26.7%, 35.6%, 21.4%, 11.5%, and 4.9%, respectively. There was a dose-dependent relationship between sedentary behavior and odds of reporting sexual intercourse: compared with <1 hour/day of sedentary behavior, the odds ratio (95% CI) of sexual intercourse associated with 1-2, 3-4, 5-8, and >8 hours/day of sedentary behavior were 1.12 (0.94-1.33), 1.22 (1.01-1.48), 1.34 (1.08-1.66), and 1.76 (1.37-2.27), respectively. There was no significant interaction by sex. The largest proportion of the association between sedentary behavior and sexual intercourse was explained by alcohol use (% mediated 21.2%), with other factors explaining an additional 11.2%.

CLINICAL TRANSLATION

Interventions to reduce leisure-time sedentary and/or alcohol consumption may contribute to a reduction in the proportion of adolescents engaging in sexual intercourse at a young age. The strengths and limitations of this study are the large, representative sample of adolescents from 19 countries. However, the cross-sectional design means causality or temporal associations could not be established.

CONCLUSIONS

In young adolescents, leisure-time sedentary behavior is positively associated with odds of having sexual intercourse in both boys and girls, in a dose-dependent manner. Alcohol consumption seems to be a key mediator of this relationship. Smith L, Jackson SE, Jacob L, et al. Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia. J Sex Med 2019;16:1355-1363.

A retrospective examination of antisocial and risk-taking behaviours

Engagement in antisocial and risk-taking behaviours is a recurring issue that has been associated with a range of negative outcomes for the individual, community, and society. This research explored factors that influenced engagement and co-occurring behaviours. Responses (n = 393) from an Australian sample who completed the Antisocial Engagement Questionnaire showed that the majority of the behaviours of interest were associated, indicating that engagement in one behaviour was associated with engagement in additional antisocial and risk-taking behaviours. Engagement in antisocial behaviours was also associated with increased substance consumption. An investigation into the associations between 15 substance-related behaviours found that use of one substance was associated with the use of additional substances. The findings have implications for understanding the development of an antisocial lifestyle, the associations between behaviours, the findings build on research relating to behaviour prediction and will assist clinicians working with at-risk individuals and intervention design.

Alcohol use among Nigerian university students: prevalence, correlates and frequency of use

BACKGROUND

Globally, alcohol use is responsible for 320 deaths every hour, and the impact is more among those in the younger age group. Despite the adverse health and social challenges associated with alcohol use, alcohol remains the most used and abused psychoactive substance among young adults. Our study aimed at determining the prevalence, correlates and frequency of alcohol use among young adults in two Nigerian universities. We further explored the role of family structure, family support and religion/religiosity on alcohol use in this study setting. Such findings could help to inform public health policy formulation in the country.

METHODS

This was a cross-sectional study conducted in two selected universities in the North Central region of Nigeria. The study was conducted among a final sample of 784 students selected using stratified random sampling. An interviewer-administered questionnaire was used to collect data on ever and current alcohol use and frequency of alcohol use between February and April 2018. The data were analysed using descriptive and inferential statistics.

RESULTS

The level of ever and current use of alcohol was 43.5 and 31.1%, respectively. The mean frequency of alcohol use among the study participants was three days, but ten days among current alcohol users. In the adjusted model, male sex, age above 19 years, infrequent attendance of religious rituals, and belonging to rich/middle-class family were significantly associated with a higher likelihood of ever use and current use of alcohol, while living in the same household as one's father was associated with lower odds of current and ever use of alcohol.

CONCLUSION

There is a high rate of lifetime and current use of alcohol among university students in the study setting. Alcohol use was significantly associated with living with parents, religion and religiosity. Both high and low socioeconomic status were associated with alcohol use. There is a need to implement measures in controlling alcohol manufacturing and marketing as well as policies regulating alcohol outlets establishment around educational institutions as well as the working hours in such outlets. Finally, there is a need to organise interventions aimed at reducing this unhealthy social norm among students in this setting.

Outcomes of Early Adolescent Sexual Behavior in Australia: Longitudinal Findings in Young Adulthood

PURPOSE

Limited longitudinal research has examined the adult health and behavioral outcomes associated with early adolescent sexual behavior. This paper examined whether adolescent sexual behavior predicted young adult health and social outcomes within longitudinal cohorts in Victoria, Australia.

METHODS

Adolescents were recruited in 2002 to be state-representative of school students in Victoria, Australia, and resurveyed in 2003 and 2004. The sample responded to a web-based survey as young adults in 2010/2011. Multivariate negative binomial regression models examined the predictive effect of sex by age 15 on young adult outcomes (average age 21) of sexual risk taking, substance use, antisocial behavior, and psychological distress (N = 2,147).

RESULTS

After adjustment for other factors, sex at age 15 or younger (early sex) predicted higher rates of young adult sexual risk taking such as pregnancy, lifetime partners, and sex without using a condom. Early sex also predicted higher rates of young adult substance use (alcohol, tobacco, and/or illicit substance use) and antisocial behavior, but rates of adult psychological distress were not affected.

CONCLUSIONS

This study found that early adolescent sex had unique predictive effects on a range of adverse young adulthood outcomes. Public health policies should synthesize longitudinal data on the risks of early sexual behavior, while advocating evidence-based adolescent sexual health promotion interventions.

Researching the decline in adolescent drinking: The need for a global and generational approach

Adolescent alcohol consumption has been in decline across many high-income countries since the early to mid-2000s. This is a significant public health trend, with few documented examples from history where such a global downward shift in alcohol consumption has occurred primarily among the adolescent segment of the population. In this commentary we describe the nature and breadth of the trend; reflect on the environmental, social and policy factors that have been proffered; and argue that to adequately understand and support the maintenance of these trends, three important methodological considerations are needed for future research. Firstly, longitudinal panel and qualitative studies are needed to complement and inform continuing cross-sectional research. Secondly, a collaborative cross-cultural approach is needed to contextualise the international scale of the trend and thirdly, future research must be situated within a historical and generational perspective to understand declines in adolescent drinking in the context of a broader shift in adolescent behaviours.

Beyond Basic Feedback in Mobile Brief Interventions: Designing SMS Message Content for Delivery to Young Adults During Risky Drinking Events

BACKGROUND

Brief interventions can reduce alcohol consumption in young people through screening and delivery of personally relevant feedback. Recently, Web and mobile platforms have been harnessed to increase the reach of brief interventions. Existing literature on mobile-based alcohol brief interventions indicates mixed use of theory in developing interventions. There is no research available to guide the development of SMS text messaging (short message service, SMS) interventions delivered during risky drinking events.

OBJECTIVE

The aim of this study was to develop and pilot an alcohol-related risk-reduction brief intervention delivered by SMS to Australian young adults during drinking events. This paper describes the development of intervention message content, with specific focus on the context of delivery during drinking events.

METHODS

A sample of 42 young adults attended 4 workshops; these comprised focus-group style discussion on drinking habits and motivations, discussion of intervention design, analysis of existing alcohol media campaigns, and participant development of message content. Data were analyzed thematically.

RESULTS

Participants described a focus on having fun and blocking out any incongruent negative influences during drinking episodes. For content to be acceptable, nonjudgmental and non-authoritative language was deemed essential. A preference for short, actionable messages was observed, including suggestions for reminders around drinking water, organizing transport home, checking on friends, and plans the next day. Participants were excited about the potential for messages to be tailored to individuals, as previous alcohol-related campaigns were deemed too generic and often irrelevant. Normative-based messages were also perceived as largely irrelevant as participants felt that they understood the drinking-related norms of their immediate peers already.

CONCLUSIONS

Findings from this study offer insights into young adults' drinking events and practical advice for designing alcohol-related brief interventions. During our formative development process, we demonstrated a neat correspondence between young people's preferences for alcohol harm reduction interventions and the theoretical principles of brief interventions, including acceptable topics and message style.

An Ecological Momentary Intervention to Reduce Alcohol Consumption in Young Adults Delivered During Drinking Events: Protocol for a Pilot Randomized Controlled Trial

Background

Risky drinking is a significant public health issue in young Australian adults. Brief interventions are one of few effective methods of reducing risky drinking but are time and cost intensive; innovative methods of delivery are therefore of interest. Mobile phones offer new opportunities to collect data and intervene during risky drinking events. Mobile phones have successfully been used for delivery of alcohol-related brief interventions and data collection but not in combination with or during drinking events.

Objective

This pilot study will investigate the efficacy of an ecological momentary intervention (EMI), with combined ecological momentary assessment (EMA) and brief intervention delivered by mobile phones to young adults during risky drinking events.

Methods

We will use a 3-armed randomized controlled trial to investigate the efficacy of the intervention for reducing peak single occasion drinking. Our sample is recruited from an observational cohort study of young, risky drinkers. Participants will be randomized into 1 of 3 intervention arms. On 6 nights across a 12-week study period, EMI and EMA groups will complete hourly EMA surveys on their mobile phone. EMI participants will receive tailored feedback short message service (SMS) texts corresponding to their EMA survey responses. The EMI participants will not receive feedback SMS. A third group will have no contact (no-contact control). All groups will then be contacted for a follow-up interview within 4 weeks of the 12-week study period ending.

Results

The primary outcome is mean reduction in standard drinks consumed during their most recent heavy drinking occasion as measured at follow-up. Secondary outcomes include alcohol consumption over the previous 6 months, experiences of alcohol-related harms, attitudes toward drinking and drunkenness, hazardous drinking and use of tobacco and illicit drugs. A random effects mixed modelling approach using maximum likelihood estimation will be used to provide estimates of differences in mean drinking levels between those receiving the intervention and control participants.

Conclusions

This study is novel in that, unlike previous work, it will intervene repeatedly during single occasion drinking events. Further, it extends previous research in this area, which has applied limited tailoring of message content for SMS-based brief interventions. The findings of this study will contribute to the growing body of evidence to inform the use of mobile health interventions for reducing alcohol consumption and harms.

Trial Registration

Australian New Zealand Clinical Trials ACTRN12616001323415; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/ 6qDqBZV9b)

Condom use and alcohol consumption in adolescents and youth

OBJECTIVE

To determine the association between not using the male condom and alcohol consumption in adolescents and schoolchildren.

METHODS

An epidemiological study, with a cross-sectional, descriptive, and correlation design carried out from March to July 2014. The sample consisted of students in public primary and secondary education, aged between 12 and 24 years. The social and demographic survey and the Youth Risk Behavior Survey questionnaire were used.

RESULTS

The study included 1,275 students, of these; 37.0% reported having had sexual relations. The prevalent age of sexual initiation was 14-16 years 55.7% and 65.6% used condom in the last sexual intercourse. Regarding the lack of condom use at the last intercourse, girls showed an association with drunkenness in the previous 30 days (2.19; 95%CI: 1.06-4.54).

CONCLUSION

In females, the non-use of condoms was associated with drunkenness in the previous 30 days.

OBJETIVO

Identificar os fatores associados ao não uso de preservativo masculino e ao consumo de bebida alcoólica em adolescentes e jovens escolares.

MÉTODOS

Estudo epidemiológico, com delineamento transversal, descritivo e correlacional, desenvolvido de março a julho de 2014. A amostra foi composta por estudantes dos Ensinos Fundamental e Médio da rede pública estadual, com idades entre 12 e 24 anos. Empregaram-se o inquérito sociodemográfico e o questionário Youth Risk Behavior Survey.

RESULTADOS

Foram incluídos 1.275 estudantes; 37,0% deles relataram terem tido relação sexual. A idade prevalente de iniciação sexual foi de 14 a 16 anos, com 55,7%; 65,6% usaram preservativo na última relação. Com relação ao não uso de preservativo na última relação, as meninas apresentaram associação com bebedeira nos últimos 30 dias (2,19; IC95%: 1,06-4,54).

CONCLUSÃO

O não uso de preservativos esteve associado com bebedeira nos últimos 30 dias nas meninas.

Association between the number of sexual partners and alcohol consumption among schoolchildren

OBJECTIVE

To determine the association between the number of sexual partners and alcohol consumption in adolescents and young schoolchildren.

METHODS

The sample consisted of students from public schools aged 12-24 years who answered the Brazilian version of the Youth Risk Behavior Survey questionnaire. The analysis was performed by multinomial logistic regression model.

RESULTS

1275 students were analyzed. For females, having two to five partners was associated with age ≥15 years (OR 14.58) and maternal education up to incomplete high school or lower educational level (OR 3.37). No consumption of alcohol decreased the chances of having more partners by 96%. For males, the associated variables were: age ≥15 years (OR 18.15); having no religion (OR 3.55); age at first dose ≤14 years (OR 3.48). Binge drinking increases the chances of having a higher number of sexual partners.

CONCLUSION

Regardless of the number of partners, binge drinking and age of alcohol consumption onset are risk factors for vulnerable sexual behavior.

Alcohol consumption among university students: a typology of consumption to aid the tailoring of effective public health policy

OBJECTIVE

Elevated levels of alcohol consumption among university students are well documented. Policymakers have attempted to combat this issue at a university, national and international level. Tailoring public health policy to effectively tackle alcohol use is crucial. Using Q-methodology, the current study aims to develop a typology of alcohol consumption in the Irish university student population.

SETTING

A large Irish university.

PARTICIPANTS

Hundreds of possible statements on types of consumption were generated from a systematic review and a set of one-on-one interviews. These were reduced to 36 statements, 6 statements which define each of the 6 previously defined consumption types. Participants were advised to scan through the 36 statements and fill the statements into a 'forced choice, standardised distribution'. Following this, a 45-90 min interview was conducted with students to illuminate subjectivity surrounding alcohol consumption. Analysis was conducted using PQ Method and NVivo software. Principal component analysis, followed by varimax rotation, was conducted to uncover the final factor information.

RESULTS

In total, 43 students completed the Q-study: 19 men and 24 women. A typology describing 4 distinct groupings of alcohol consumer was uncovered: the guarded drinker, the calculated hedonist, the peer-influenced drinker and the inevitable binger. Factor loadings of each of the consumer groupings were noted for type description.

CONCLUSIONS

This is the first study to propose ideal types of alcohol consumption among a university student population. Further research is required to investigate the degree to which each of these ideal types is subscribed. However, this typology, in addition to informing public policy and strategies, will be a valuable analytic tool in future research.

Is higher risk sex common among male or female youths?

There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries' Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel-Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15-19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.

Sexual behaviour in early adolescence: a cross-national comparison of Australian and United States youth

OBJECTIVE

This study used matched samples from schools in the states of Victoria, Australia and Washington, United States (US), to compare sexual behaviour in early adolescence. It was hypothesised that the contrasting dominant policy objectives of harm minimisation in Australia and abstinence in the US would result in state differences for markers of sexual risk, mirroring prior cross-national findings in substance use.

METHOD

A two-stage cluster sampling approach was used to recruit students from the two states. Self-reported sexual behaviour was examined for 1,596 students in annual surveys from Grade 7 in 2002 to Grade 9 in 2004. Prevalence estimates were derived for each measure of sexual behaviour, and comparisons were made between gender groups in each state.

RESULTS

State differences were found for girls' first sex, with significantly more girls in Washington than Victoria having had sex by Grade 7. By Grade 9, significantly more girls in Victoria reported sex in the last year and more sexual partners than girls in Washington. A large proportion of Grade 9 students across both states reported inconsistent contraception use.

CONCLUSIONS

Contradicting the abstinence policy objective, first sex by Grade 7 was more prevalent in Washington than Victoria. Whilst sexual behaviour was more prevalent in Grade 9 in Victoria, the sexually active showed no clear cross-national differences in markers of risk such as contraception use and pregnancy outcomes. Findings demonstrate few cross-national differences in adolescent sexual behaviour despite the different policy contexts of Victoria, Australia and Washington, US.

Participatory development of MIDY (Mobile Intervention for Drinking in Young people)

Background

There are few effective strategies that respond to the widespread practice of risky single-occasion drinking in young people. Brief interventions, which involve screening of alcohol consumption and personalised feedback, have shown some efficacy in reducing alcohol consumption, but are typically delivered in clinical settings. Mobile phones can be used to reach large populations instantaneously, both for data collection and intervention, but this has not been studied in combination during risky drinking events

Methods

Our study investigated the feasibility and acceptability of a mobile-phone delivered Ecological Momentary Assessment (EMA) and brief intervention for young people during drinking events. Our participatory design involved development workshops, intervention testing and evaluation with 40 young people in Melbourne, Australia. The final intervention included text message prompts to fill in mobile-based questionnaires, which measured drinks consumed, spending, location and mood, with additional questions in the initial and final questionnaire relating to plans, priorities, and adverse events. Participants received a tailored feedback SMS related to their drinking after each hourly questionnaire. The intervention was tested on a single drinking occasion. Prompts were sent between 6 pm and 2 am during a drinking event, with one follow up at 12 pm the following day.

Results

Participants reported being comfortable with hourly mobile data collection and intervention during social occasions, and found the level of intrusion acceptable; we achieved an 89 % response rate on the single occasion of testing. Participants were proactive in suggesting additional questions that would assist in the tailoring of feedback content, despite the added time burden. While we did not test the effectiveness of the intervention, participants reported value in the tracking and feedback process, with many stating that they would normally not be aware of how much alcohol they consumed in a night.

Conclusions

Findings suggest that the intervention was considered acceptable, feasible and novel to our participants; it now requires comprehensive testing and evaluation.

Hazardous alcohol consumption among university students in Ireland: a cross-sectional study

OBJECTIVE

There is considerable evidence of a cultural shift towards heavier alcohol consumption among university students, especially women. The aim of this study is to investigate the prevalence and correlates of hazardous alcohol consumption (HAC) among university students with particular reference to gender and to compare different modes of data collection in this population.

SETTING

A large Irish university.

DESIGN

A cross-sectional study using a classroom distributed paper questionnaire.

PARTICIPANTS

A total of 2275 undergraduates completed the classroom survey, 84% of those in class and 51% of those registered for the relevant module.

MAIN OUTCOME MEASURES

Prevalence of HAC measured using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) and the proportion of university students reporting 1 or more of 13 adverse consequences linked to HAC. HAC was defined as an AUDIT-C score of 6 or more among males and 5 or more among females.

RESULTS

In the classroom sample, 66.4% (95% CI 64.4 to 68.3) reported HAC (65.2% men and 67.3% women). In women, 57.4% met HAC thresholds for men. Similar patterns of adverse consequences were observed among men and women. Students with a hazardous consumption pattern were more likely to report smoking, illicit drug use and being sexually active.

CONCLUSIONS

The findings highlight the high prevalence of HAC among university students relative to the general population. Public policy measures require review to tackle the short-term and long-term risks to physical, mental and social health and well-being.

The big night out: what happens on the most recent heavy drinking occasion among young Victorian risky drinkers?

INTRODUCTION AND AIMS

In spite of the major focus on risky, single-occasion drinking by young people in Australia, little is known about the specific circumstances of risky drinking occasions. This study examines drinking behaviours and drinking contexts for the most recent risky, single-occasion drinking episode in a representative sample of young risky drinkers in Victoria, Australia.

DESIGN AND METHODS

A representative sample of 802 young risky drinkers was recruited across metropolitan Melbourne and surveyed about their drinking and related behaviours. Specific questions focused on participants' most recent high-risk (>10 Australian standard drinks for males, >7 Australian standard drinks for females) drinking occasion in terms of self-reported amount drunk, alcohol expenditure (including buying rounds) and drinking partners for up to 10 different drinking settings.

RESULTS

Participants reported drinking a mean of 13 Australian standard drinks on their last episode of risky, single-occasion drinking; for half of the participants, this occurred less than 20 days prior to being surveyed. The majority (62%) of risky single occasion drinking sessions commenced at private homes in the company of close friends (81%). Around 40% of the sample reported going to one (42%) or two (37%) drinking locations, and only 5% reported going to more than three drinking locations.

DISCUSSION AND CONCLUSIONS

Contrary to public portrayals, a significant amount of risky drinking by young people occurs in private settings. These contexts are rarely mentioned except in relation to underage drinking. Further work is needed to understand how these drinking behaviours and contexts link to harm.