title: Prescription drug misuse and sexual risk behaviors among adolescents and emerging adults.
abstract: OBJECTIVE
  The purpose of this study was to evaluate associations between prescription drug misuse (PDM) and sexual risk behaviors (SRBs) among adolescents and emerging adults.
  
  
  METHODS
  In a hospital emergency department, 2,127 sexually active 14- to 20-year-olds (61% female) reported on past-year alcohol use severity (using the Alcohol Use Disorders Identification Test-consumption [AUDIT-C]), cannabis use, PDM (n = 422), and SRBs (inconsistent condom use, multiple partners, intercourse following alcohol/other drug use).
  
  
  RESULTS
  Bivariately, AUDIT-C score, cannabis use, and PDM of stimulants, opioids, and sedatives were positively associated with each SRB. Because many participants reported PDM for multiple drug classes (i.e., sedatives, stimulants, opioids), participants were categorized as (a) no PDM (n = 1,705), (b) PDM of one class (n = 251), (c) PDM of two classes (n = 90), or (d) PDM of three classes (n = 81). Three hierarchical logistic regression models evaluated the associations of number of classes of PDM with SRBs separately, after accounting for demographics (age, gender, race), AUDIT-C score, and cannabis use. Adding PDM statistically improved each model beyond what was accounted for by demographics, alcohol, and cannabis use. For inconsistent condom use and substance use before sex, PDM of one, two, or three classes was significantly associated with increased odds of these SRBs. PDM of two or three classes was associated with increased odds of reporting multiple partners.
  
  
  CONCLUSIONS
  Findings suggest that PDM, especially poly-PDM, may be a pertinent risk factor for SRBs among youth. Event-based research could further evaluate how PDM, as well as other substance use, is related to SRBs at the event level in order to inform interventions.
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Bonar
authors.affiliation: Injury Center, University of Michigan, Ann Arbor, Michigan, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Cunningham
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, Department of Veterans Affairs, National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chermack
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, Department of Veterans Affairs, National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan.
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Barry
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, Injury Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Walton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D063487:Prescription Drug Misuse / Q000009:adverse effects / Q000523:psychology* / Q000639:trends; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult