title: Alcohol and marijuana use in pathways of risk for sexually transmitted infection in white and black adolescent females.
abstract: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females.
  
  
  
  The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16-18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18.
  
  
  
  Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI.
  
  
  
  Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.
authors.affiliation: a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Chung
authors.affiliation: b School of Education, University of Pittsburgh , Pittsburgh , Pennsylvania , USA.
authors.forename: Feifei
authors.initials: F
authors.lastname: Ye
authors.affiliation: a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.|c Department of Psychology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Hipwell
authors.affiliation: a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.|c Department of Psychology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Stepp
authors.affiliation: d Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
authors.affiliation: e Division of General Internal Medicine, University of Pittsburgh , Pittsburgh , Pennsylvania , USA.|f VA Center for Health Equity and Promotion, VA Pittsburgh Healthcare System , Pittsburgh , Pennsylvania , USA.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: g Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Hawk
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American / Q000523:psychology*; D019955:Conduct Disorder / Q000150:complications / Q000523:psychology; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D000074609:Marijuana Use / Q000523:psychology*; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000523:psychology*; D000066608:Underage Drinking / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology; D014505:Urban Population; D044465:White People / Q000523:psychology*
keywords: Adolescent; alcohol; female; marijuana; risky sexual behavior; sexually transmitted infection