Examining the racial differentials in the associations between adolescent substance use and subsequent risk of sexually transmitted infection (STI) in young adulthood

Introduction: Substance use during adolescents is perceived to be correlated with risk of sexually transmitted infection (STI) at later age. Estimation of these associations between adolescent substance use and the risk of STI during adulthood will enable the assessment of whether reductions in adolescent drug use may contribute to reductions in adult risk behavior and infection. Objective: The main objective of the study is to examine the racial differentials in the association between adolescent substance use and subsequent risk of STI in young adulthood. Data and Methods: This study uses National Longitudinal Study of Adolescent Health Wave-I (adolescence data collected in 1995) and Wave-III (young adulthood data collected in 2001-2002) data for sample of about 13,123. Racial (black vs. white) differences in longitudinal associations between marijuana and cocaine use in adolescence (in the year prior to Wave-I data) and the risk of STI in young adulthood at Wave III were examined. STI data were biologically-confirmed for chlamydia, gonorrhea, or trichomoniasis infection in Wave-III. Results: The most commonly-used drug was marijuana followed by cocaine. Among all groups, adolescent marijuana use is significant predictors of multiple partnerships. Cocaine use among white adolescents is associated with increased risk of multiple partnerships and STI (for multiple partnership, RR: 1.35, 95% and CI: 1.03-1.85; for STI, RR: 2.30, and 95% CI: 1.22-5.88). However, among black cocaine use is significantly associated with STI among men (RR: 2.68, 95% CI: 1.12-8.08). Conclusions: Adolescent substance use may represent a modifiable STI risk among both black and white youth.