title: Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey.
abstract: Health risk behaviours are prominent in late adolescence and young adulthood, yet UK population-level research examining the relationship between drug or alcohol use and sexual health and behaviour among young people is scarce, despite public health calls for an integrated approach to health improvement. Our objective was to further our understanding of the scale of and nature of any such relationship, using contemporary data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).
  
  
  
  Analyses of data from Natsal-3, a stratified probability survey of 15 162 men and women (3869 aged 16-24 years), undertaken in 2010-2012, using computer-assisted personal interviewing, were carried out. Logistic regression was used to explore associations between reporting (1) frequent binge drinking (≥weekly), (2) recent drug use (within past 4 weeks) or (3) multiple (both types of) substance use, and key sexual risk behaviours and adverse sexual health outcomes. We then examined the sociodemographic profile, health behaviours and attitudes reported by 'risky' young people, defined as those reporting ≥1 type of substance use plus non-condom use at first sex with ≥1 new partner(s), last year.
  
  
  
  Men and women reporting frequent binge drinking or recent drug use were more likely to report: unprotected first sex with ≥1 new partner(s), last year; first sex with their last partner after only recently meeting; emergency contraception use (last year) and sexually transmitted infection diagnosis/es (past 5 years). Associations with sexual risk were frequently stronger for those reporting multiple substance use, particularly among men. The profile of 'risky' young people differed from that of other 16-24 years old.
  
  
  
  In this nationally representative study, substance use was strongly associated with sexual risk and adverse sexual health outcomes among young people. Qualitative or event-level research is needed to examine the context and motivations behind these associations to inform joined-up interventions to address these inter-related behaviours.
authors.affiliation: Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK.
authors.forename: S N
authors.initials: SN
authors.lastname: Khadr
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: K G
authors.initials: KG
authors.lastname: Jones
authors.affiliation: Research Department of Reproductive Health, University College London Institute of Women's Health, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mann
authors.affiliation: Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Hale
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Johnson
authors.affiliation: Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Viner
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: C H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Wellings
mesh_terms: D000293:Adolescent; D063425:Binge Drinking / Q000453:epidemiology; D044363:Contraception, Postcoital / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D000073599:Health Risk Behaviors; D006306:Health Surveys; D006801:Humans; D008297:Male; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
keywords: EPIDEMIOLOGY; GENITOURINARY MEDICINE; PUBLIC HEALTH