Examining the relationship between substance use and sexual risk-taking behaviors among high school students in Ghana, West-Africa

Background/Purpose Few studies exist on sexual risk behaviors of Ghanaian adolescents. Using national level data, this study examines the association between substance use and two sexual risk behavior variables when considering gender. Method We utilized data from the 2008 Ghana Global School-based Student Health Survey. The sample size was 7,137 senior high school (SHS) students. Selected substance (alcohol, tobacco, and illicit drugs) and sex related variables (3/+ lifetime sexual partners and condom use last sex) were dichotomized for complex sample tables' analyses. Analysis/Results Overall, 10.2% of the sample used 2/+ substances (male: 12.2%; female: 6.6%). Among current drinkers, females were 3.8 times (95% CI: 2.5-5.9) more likely to have had 3/+ lifetime sexual partners than male drinkers (OR: 1.7; CI: 1.3-2.2). Current smokers (OR: 2.0; 95% CI: 1.5-2.8) and those who had used any illicit drugs (OR: 2.2; 95% CI: 1.6-3.2) were more likely to have 3/+ sexual partners than those who abstained from smoking and drugs, respectively. Overall, males (OR: 2.3; 95% CI: 1.4-3.5) and females (OR: 3.7; 95% CI: 1.7-7.9) using 2/+ substances were more likely to have 3/+ sexual partners than their counterparts, respectively. Odds of not using a condom during last sex was significantly greater among smokers (OR: 1.7; 95% CI: 1.1-2.6) but not significant for other two substances. Condom use and use of any number of substances was not significant. Conclusions Ghanaian students' substance use behaviors are significantly associated with engagement in risky sexual behaviors that can lead to significant negative health outcomes.