Dynamics of sexual debut and substance use among university youth from Lebanon

The study used online survey data on sexual behaviors, perceptions and attitudes of private university students from Lebanon (N=2543) reporting their first sexual experience (oral, anal, and/or vaginal sex) while using alcohol/drugs. About 11% (n=104) of sexually active students (n=943) used alcohol/drugs at sexual debut; no differences in mean age (17 years) was observed. Males, non-Arab foreigners, and those living independently were at least twice as likely to have used substances at sex debut. Compared to the very religious, the somewhat to not-at-all religious were 3.3 and 5.6 times as likely to report alcohol/drug use at sex debut [p=<0.0001]. Similarly, students who attended a religious high school, always lived in Lebanon, and were in a relationship had 40-60% lesser odds to use substances at first sex [p= 0.004-0.019]. Sex debut under the influence placed youth at a thrice higher odds of engaging in oral sex with an unfamiliar partner, even after controlling for gender, nationality, relationship status, having lived abroad, and religiosity/spirituality [95%CI=1.7-5.2]. In contrast, association with first-time vaginal sex with an unfamiliar partner faded when adjusted for sex (male). Interestingly, ever experiencing sexual coercion was not linked to substance abuse at debut, nor was the use of condoms or paying for sex. The study describes the population to engage in first sex under the influence, and given the patriarchal and/or conservative society that limits the expression of sexual desires, insinuates that the behavior first and most frequented among all youth is oral sex with unfamiliar partners in contrast to vaginal sex among males only.