Substance Use in Adolescence and Subsequent HIV Sexual Risk Behavior in Young Adulthood

Background Research has demonstrated associations between substance use and risky sexual behavior. We examined the relationship between substance use in adolescence and subsequent HIV sexual risk behavior in young adulthood. Methods We assessed the frequency of using alcohol, marijuana and other substances during the previous 12 months among 558 adolescents (ages 15-20) in Colorado. The subjects included a community and clinical (treated for substance abuse) sample. At follow-up (ages 20-27), we assessed sexual risk behavior during the previous 12 months among the same respondents. Sexual behavior questions were used to construct a risky sexual behavior score that was dichotomized to indicate “high-risk” versus “low-risk” study participants. The relationship between substance use patterns and risky sexual behavior was modeled using multiple logistic regression. Results Higher frequency of alcohol use [OR = 1.17; 95% CI = (1.06,1.29)] and ever use of drugs other than marijuana [OR = 2.00; 95% CI = (1.20,3.34)] during the past 12 months in adolescence were independently associated with the “high-risk” sexual behavior group in the follow-up assessment. Frequency of marijuana use was not independently associated with risky sexual behavior. Conclusion Frequent users of alcohol and other substances in adolescence are more likely to engage in risky sexual behavior during young adulthood. Although substance use patterns in adolescence should not be interpreted as a cause of risky sexual behavior in later periods, they may be useful markers that could aid practitioners in identifying adolescents who are at risk for sexually transmitted infections, including HIV.