Marijuana use, risky sexual behavior, and sexually transmitted diseases in African-American adolescent females

Background: Marijuana use may impair sexual decision-making leading to unprotected sexual intercourse or intercourse with risky partners. While adolescent African-American females remain a high-risk group for STDs, little research has examined their marijuana use and sexual behavior. Thus, we explored the relationship between marijuana use, risky sexual behavior, and laboratory-confirmed STDs.

Methods: Data were collected via ACASI from 439 sexually active African-American female adolescents (15-21 years) seeking services at an urban health department. Marijuana use and self-reported sexual behavior were collected. Self-collected vaginal swab specimens were collected to assess the prevalence of three STDs. Contingency table analyses and t-tests examined differences in sexual risk behaviors and STDs between adolescent marijuana users and non-users.

Results: Adolescents using marijuana in the past 60 days had significantly higher rates of STDs than non-marijuana users (32% vs. 23%; p = .04). No significant group differences were observed for condom use. However, marijuana users had more sex partners (p = .006), riskier sex partners (i.e., just released from jail) (p = .004), and more recent episodes of vaginal sex while their partner was high (p = .001).

Conclusion: Although no differences in condom use were identified between marijuana users and non-users, results suggest that marijuana users are engaging in sexual acts with riskier partners and under riskier circumstances, and had higher rates of STDs. HIV interventions with this population might benefit from addressing the nexus between marijuana use and HIV risk, with an emphasis on social networks and male partner-specific factors.