title: Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood.
abstract: Urban populations disproportionately experience poor sexual outcomes, including high rates of teenage pregnancy and sexually transmitted infections. However, the contribution of substance use across adolescence to poor sexual outcomes in young adulthood has not been investigated in depth, despite offering opportunities for more targeted prevention. This study aimed to estimate joint trajectories of adolescent alcohol and marijuana use to determine if they relate differently to four sexual outcomes: multiple sexual partners, sex without a condom, teenage pregnancy, and contraction of a sexually transmitted infection in young adulthood (by age 25). Data came from a longitudinal study of urban youth followed from age 6 to age 25, with annual assessments during adolescence and young adulthood (n = 608). The sample showed high levels of sexual risk, with young adults on average having sex without a condom once in the past month, 28.5% having multiple sexual partners in the past month, one quarter having contracted a sexually transmitted infection, and over 60% of the women being pregnant as a teenager and 36% of the men having gotten a partner pregnant. Applying longitudinal latent profile analysis to estimate joint trajectories of alcohol and marijuana use from grades 8-12, we identified four classes representing high dual use, moderate alcohol use, moderate alcohol use with increasing marijuana use, and non-use. Class membership differently predicted all four outcomes investigated with high dual users having the highest level of teenage pregnancy and the increasing marijuana trajectory having the highest risk of engaging with multiple sexual partners in the past month. Results suggest implications for both sexual risk and substance use prevention for urban youth.
authors.affiliation: Department of Behavioral and Community Health, University of Maryland School of Public Health, SPH Building, Valley Drive, College Park, MD, 20742, USA. greenkm@umd.edu.
authors.forename: Kerry M
authors.initials: KM
authors.lastname: Green
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA.
authors.forename: Rashelle J
authors.initials: RJ
authors.lastname: Musci
authors.affiliation: Department of Pediatrics, Johns Hopkins School of Medicine, 200 N. Wolfe St, Rm 2025, Baltimore, MD, 21287, USA.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Matson
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA.
authors.forename: Renee M
authors.initials: RM
authors.lastname: Johnson
authors.affiliation: Department of Biostatistical Sciences and Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Reboussin
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Ialongo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
keywords: African Americans; Blacks; Cannabis; HIV/AIDS; Latent profile analysis; Longitudinal patterns; Substance use effects