Alcohol and other drug (AOD) use proximal to sexual intercourse in adolescent girls: Implications for the prevention of STIs, pregnancy, and sexual assault

Background: Research has found that adolescent girls are more likely to engage in high-risk sexual behavior when using alcohol and other drugs (AODs) proximal to sexual intercourse. Sexual risk behavior in adolescent girls remains a consistent challenge to the field of public health due to the risks of contracting STIs including HIV/AIDS, unintended pregnancy, and sexual assault. Methods: Nationally representative data were used from the 2009 Youth Risk Behavior Survey (YRBS). An ethnically diverse sample of adolescents girls (n=3,497) in grades 9-12, ages 14-18 years, was taken from the YRBS data set and used for final analysis. Using logistic regression analysis, associations were examined between AOD use proximal to last sexual intercourse and other variables including age, condom use at last sexual intercourse, and sexual assault. Results: AOD use proximal to last sexual intercourse was associated with an increased likelihood of not using a condom during last sexual intercourse [OR = 1.21; 95% CI = 1.02, 1.47]. Ethnicity was a significant confounder for condom use during last sexual intercourse. Sexual assault increased the likelihood of AOD use proximal to last sexual intercourse [OR = 1.97; 95% CI = 1.60, 2.43]. A trend also emerged where AOD use proximal to last sexual intercourse increased as age increased. Conclusions: AOD use proximal to sexual intercourse in adolescent girls increases the likelihood of sexual risk behavior. Findings reinforce the importance of health promotion interventions before and throughout high school that specifically address social factors related to AOD use, sexual intercourse, and sexual assault.