Alcohol, risky sexual behavior, and sexually transmitted diseases in an African American adolescent female population

Background: Alcohol use may impair sexual decision-making leading to unprotected sexual intercourse. While adolescent African American females remain a high-risk group for STDs, little research has examined alcohol consumption and sexual behavior in this population. Thus, we explored the relationship between alcohol use and psychosocial correlates of risk, risky sexual behavior, and laboratory-confirmed STD acquisition.

Methods: Data were collected via ACASI from 407 sexually active African American female adolescents (16-20 years) seeking services at an urban health department. Alcohol use, psychosocial correlates of risk, and self-reported sexual behavior were collected. Self-collected vaginal swab specimens were collected to assess the prevalence of three STDs and a nondisease marker of unprotected sex (Yc PCR).

Results: Alcohol use was significantly related to three of four psychosocial correlates and to five self-report measures of risky sexual behavior. Additionally, females consuming more drinks on a drinking occasion were significantly more likely to have Chlamydia and a positive test for the presence of semen in vaginal fluid. When controlling for alcohol consumption, sexual sensation seeking remained a significant predictor of several sexual risk behaviors.

Conclusion: Results suggest greater frequency and volume of alcohol consumption is related to adverse psychosocial correlates, self-report measures, and biological markers of risky sexual behavior. Amount of drinking per drinking occasion appears to be the most important predictor of the two biological markers indicating that binge drinking may be an important factor influencing risk of disease for this population. Implications for HIV interventions with this population are discussed.