Substance Use and Sexual Risk Taking in Adolescence

"Sexual exploration is a normal and typically healthy part of adolescent development. However, certain behaviors increase the likelihood of unwanted outcomes such as pregnancy or sexually transmitted disease (STD)....This article outlines what research has to say about connections between substance use and sexual risk taking among adolescents (primarily middle and high school aged youth), and describes how adults can promote healthier environments for growing up"

This research is from the ACT for Youth Center of Excellence, a partnership among Cornell University Bronfenbrenner Center for Translational Research, Cornell University Cooperative Extension of New York City, the New York State Center for School Safety, and the University of Rochester Medical Center Adolescent Medicine Division, both in the United States. It describes risky behaviour in adolescence and the role it plays in personal development; then, it elaborates on risky sexual behaviour including: early initiation of sexual intercourse; vaginal, anal, or oral sex without a condom, or when a condom is used incorrectly; and multiple sexual partners. "Although it is a contextual factor that cannot necessarily be changed, it is also worth noting that sexual involvement in social networks with higher rates of STD/HIV infection is a potent risk factor."

The research analyses the connection between youth drug use and sex, including citing studies that link early sexual initiation with drug use. "These studies appear to be fairly consistent; however, one study involving African American and Latino students found a link between early drinking and sexual initiation for girls but not for boys." Substance use also seems to be linked with multiple partners, though proof also of inconsistent condom use has not been shown. "Youth are more likely to become involved in many different risk behaviors when they experience a preponderance of risk factors without the counteracting forces of positive opportunities, relationships, and resources." Positive support may include:

• Supportive, connected families - "Conversely, parental/ family neglect, conflict, and substance use are associated with greater sexual risk as well as substance abuse."
• Peers - Peers can encourage risk taking or have a protective effect.
• Neighbourhood may play a role.
• "Substance use can be considered a risk factor for risky sexual behavior. Protective factors that prevent substance use (such as family attachment and involvement in school/community activities) may lead to lower levels of risk behavior."
• Some degree of economic stability - Poverty is associated with many risk behaviors.

Programmatic approaches with communication components include:

• Drug and alcohol interventions in early adolescence and continuing through adolescence that include an HIV intervention.
• Multi-level interventions (individual, school, parents, and community involvement) across many settings including building protective assets (positive relationships with parents and friends, attachment to school, opportunities to get involved, and religiosity, among others).
• Parent education, youth employment, school and faith community programmes helping youth develop a sense of purpose and direction, as well as positive social networks.