Comparison of Substance Use Typologies as Predictors of Sexual Risk Outcomes in African American Adolescent Females.
African American female adolescents have a disproportionate risk of sexually transmitted infections (STIs) and other adverse sexual health outcomes. Both alcohol and marijuana use have been shown to predict sexual risk among young African American women. However, no studies have attempted to differentiate alcohol and marijuana typologies use as predictors of sexual risk outcomes exclusively among adolescents who use these substances. This study compared recent alcohol and/or marijuana use as predictors of sexual risk outcomes over 18 months among 182 African American female adolescents. African American females (14-20 years) completed interviews at baseline, 6-, 12-, and 18-months. At each assessment, pregnancy testing was conducted and self-collected vaginal swab specimens were assayed for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae using DNA amplification. Logistic subject-specific random-intercept models compared sexual risk outcomes during follow-up among adolescents who reported recent use of alcohol only (AO), marijuana only (MO) or both substances (A + M) at the baseline assessment. Relative to baseline AO use, baseline MO use predicted condom non-use at last sex. Relative to AO use, A + M use predicted pregnancy. Relative to MO use, A + M use predicted pregnancy and acquisition of T. vaginalis and any STI. The results suggest that African American female adolescents who use A + M may represent a priority population for STI, HIV, and pregnancy prevention efforts.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA. alswart@emory.edu.|Centers for AIDS Research, Emory University, Atlanta, GA, USA. alswart@emory.edu.
Andrea
A
Swartzendruber
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.|Centers for AIDS Research, Emory University, Atlanta, GA, USA.
Jessica M
JM
Sales
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.|Centers for AIDS Research, Emory University, Atlanta, GA, USA.
Jennifer L
JL
Brown
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.|Centers for AIDS Research, Emory University, Atlanta, GA, USA.|Division of Infectious Diseases, Epidemiology, and Immunology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Ralph J
RJ
DiClemente
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
Eve S
ES
Rose
D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000208:ethnology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D002189:Marijuana Abuse / Q000208:ethnology* / Q000523:psychology; D012306:Risk; D012309:Risk-Taking; D021841:Safe Sex; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D055815:Young Adult
Adolescents; Alcohol; Marijuana; Sexual risk; Substance use