Reproductive health characteristics of marijuana and cocaine users: results from the 2002 National Survey of Family Growth

Adding up risks: Sexual debut and substance use among Italian university students

Adolescence and youth are periods of great changes in an individual's life, during which experiencing first events of the transition to adulthood and, sometimes, violating social norms. Literature has identified an association of risk behaviours with timing of first sexual intercourse, but scant information is available about their relationship with the use of protection or the choice of a casual partner. This study focuses on the relation between initiation of risk behaviours (get drunk and drug use) and initiation of intercourse. Using event history analysis - also in their competing risk form - on data on Italian university students collected in 2000-2001 and in 2017, we intend to verify to what extent the initiation and the timing to risk behaviours is associated with the circumstances of first intercourse (timing, use of protection, type of partner), and if and how initiation to risk behaviours interacts differently with age at sexual debut. Our results show that in a country such as Italy, where family and sexual norms are relatively traditional, young people who got drunk, used marijuana or ecstasy at least one time in their life are more likely to experience risky sexual intercourse.

Sex, marijuana and baby booms

We study the behavioral changes caused by marijuana use on sexual activity, contraception, and birth counts by applying a differences-in-differences approach that exploits the variation in timing of the introduction of medical marijuana laws (MMLs) among states. We find that MMLs cause an increase in sexual activity, a reduction in contraceptive use conditional on having sex, and an increase in number of births. There is also suggestive evidence on temporary increases in the state-year gonorrhea rate. These changes may be attributed to behavioral responses including increased attention to the immediate hedonic effects of sexual contact, increased sexual frequency, as well as delayed discounting and ignoring the future costs associated with sex. Our findings on births suggest that behavioral factors can counteract the physiological changes from marijuana use that tend to decrease fertility. Our findings are robust to a broad set of tests.

Cannabis consumption might exert deleterious effects on sperm nuclear quality in infertile men

RESEARCH QUESTION

Can cannabis consumption alter sperm nuclear integrity in infertile men?

DESIGN

A retrospective cross-sectional study conducted between July 2003 and December 2013, which included 54 men who consulted for male-factor infertility. Twenty-seven infertile men who were regular cannabis users were matched to 27 infertile men who were cannabis non-users. To complement the conventional semen parameter and plasma hormone level assessments, sperm nuclear alterations were explored using fluorescence in-situ hybridization to assess numerical chromosomal abnormalities, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling to investigate DNA fragmentation, aniline blue staining to examine chromatin condensation and a motile sperm organelle morphology examination to detect vacuoles in sperm heads.

RESULTS

The rates of sperm aneuploidy (P = 0.0044), diploidy (P = 0.037), total chromosome abnormalities (P = 0.0027) and DNA fragmentation (P = 0.027) were significantly higher in cannabis users than in non-cannabis users.

CONCLUSIONS

Cannabis consumption might have deleterious effects on sperm nuclear quality in infertile men by increasing numerical chromosome abnormalities and DNA fragmentation. Cannabis consumption induces these detrimental effects on the progression of spermatogenesis from meiotic stages to spermiogenesis and potentially on post-testicular sperm maturation in infertile men. Any potential findings, however, need to be validated with larger sample size, and our data are only exploratory findings.

Is Preconception Substance Use Associated With Unplanned or Poorly Timed Pregnancy?

OBJECTIVE

Unplanned and poorly timed pregnancies are associated with adverse maternal and neonatal outcomes. Further understanding of preconception substance use with unplanned and poorly timed pregnancy is warranted.

METHODS

Data were analyzed from a prospective study enrolling women early in pregnancy. Preconception tobacco, alcohol, marijuana, opioid, and cocaine use was ascertained. Participants reported whether their current pregnancy was planned and whether it was a good time to be pregnant. Multivariable logistic regression modeling generated risk estimates for preconception substance use, and pregnancy planning and timing, adjusting for confounders.

RESULTS

Overall, 37.2% reported unplanned pregnancy, 13.0% poorly timed pregnancy, and 39.0% reported either unplanned and/or poorly timed pregnancy. Within 6 months preconception, one-fifth (20.2%) reported nicotine cigarette use. In the month before conception, 71.8% reported alcohol use, 6.5% marijuana, and approximately 1% opioid or cocaine use. Multivariable analysis demonstrated preconception opioid use was associated with increased odds of poorly timed pregnancy (odds ratio [OR] 2.87, 95% confidence interval [CI] 1.03-7.99). Binge drinking the month before conception was associated with increased odds of poorly timed pregnancy and unplanned pregnancy (OR 1.75, 95% CI 1.01-3.05; and OR 1.68, 95% CI 1.01-2.79, respectively). Marijuana use 2 to 3 times in the month preconception was associated with increased risk of unplanned pregnancy, and unplanned and/or poorly timed pregnancy compared with nonuse (OR 1.78, 95% CI 1.03-3.08; and OR 1.79, 95% CI 1.01-3.17, respectively). Preconception tobacco or cocaine use was not associated with unplanned or poorly timed pregnancy following adjustment.

CONCLUSIONS

We demonstrate increased odds of unplanned or poorly timed pregnancy among women with preconception binge drinking, marijuana use, and opioid use; however, no association is observed with other substances after multivariable adjustment, including tobacco. Further research to evaluate high-level preconception substance use and substance disorders with pregnancy planning and timing is warranted. Focused efforts optimizing preconception health behaviors and reducing risk of unplanned or poorly timed pregnancy are needed.

Early age at childhood parental incarceration and STI/HIV-related drug use and sex risk across the young adult lifecourse in the US: Heightened vulnerability of black and Hispanic youth

BACKGROUND

We measured associations between parental incarceration and STI/HIV-related drug use and sex risk, assessing differences by race, age at first parental incarceration, and potential mediators of the relationship.

METHODS

We used Waves I (adolescence), III (young adulthood), and IV (adulthood) of the National Longitudinal Study of Adolescent to Adult Health (n = 11,884) to measure associations between age of parental incarceration (never; <8; 8-17; ≥18 years old) and marijuana and cocaine use, multiple partnerships, and STI in adolescence and adulthood among white, Black, and Hispanic participants and assessed mediation by sexual and physical abuse, mental disorder symptoms, and drug use.

RESULTS

By Wave IV, approximately one in six had experienced a parental incarceration; higher prevalence observed among black (26%) and Hispanic (20%) versus white (15%) respondents (p < 0.0001). Parental incarceration at any age was moderately to strongly associated with STI/HIV risk outcomes. In multivariable models, parental incarceration at age <8 years old (versus never) remained strongly associated with STI/HIV risk in both adolescence and adulthood, with strongest associations among non-whites. Among black participants, parental incarceration at <8 years old was associated with over double the odds of adulthood use of marijuana (adjusted odds ratio (AOR): 2.53, 95% confidence interval: 1.62, 3.95) and cocaine (AOR: 4.41, 95% CI: 2.05, 9.48). Delinquency, drug use, and mood disorders appeared to partially mediate the relationship.

CONCLUSIONS

Children impacted by parental incarceration constitute priority populations for substance use and STI/HIV prevention and treatment. The unintended consequences of incarceration for children should be considered in decarceration discussions.

Psychological Well-Being as a Predictor of Casual Sex Relationships and Experiences among Adolescents: A Short-Term Prospective Study

Psychological characteristics may predispose youths to engage in casual sex relationships and experiences (CSREs). Using a prospective longitudinal design and in a subsample of 2601 high school students in the province of Québec, we explored possible shifts in engaging in one-night stands (ONSs) and friends with benefits (FWB) relationships over a 6-month period among sexually active adolescents. We also examined the relationships among well-being predictors (psychological distress, self-esteem, suicidal ideation, and alcohol and drug consumption) and these shifts while exploring possible gender differences. Multinomial regressions in Mplus were used to explore whether initial psychological well-being was related to entrance type, the transition from having no CSREs to having one, or discontinuation or continuation type. Frequent alcohol consumption (i.e., once or twice a week or more) for boys and frequent consumption of both alcohol and drugs for girls were associated with continuation of CSREs. Suicidal ideation was associated with entrance into FWB relationships as well as continuation of FWB relationships and ONSs for girls. Psychological distress was a predictor of discontinuation of ONSs for boys. These results suggested that interventions should consider the specific and common needs of both genders in regard to ONSs and FWB relationships.

Committee Opinion No 708: Improving Awareness of and Screening for Health Risks Among Sex Workers

The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from the routine sexual history by women and clinicians. Data on the prevalence of sex work in the United States are largely lacking. The American College of Obstetricians and Gynecologists supports increasing awareness about the health risks, preventive care needs, and limited health care services for female sex workers.

"Get drunk. Smoke weed. Have fun.": A Content Analysis of Tweets About Marijuana and Alcohol

PURPOSE

To explore the sentiment and themes of Twitter chatter that mentions both alcohol and marijuana.

DESIGN

Cross-sectional analysis of tweets mentioning both alcohol and marijuana during 1 month was performed.

SETTING

The study setting was Twitter.

PARTICIPANTS

Tweets sent from February 4 to March 5, 2014, were studied.

METHOD

A random sample (n = 5000) of tweets that mentioned alcohol and marijuana were qualitatively coded as normalizing both substances, preferring one substance over the other, or discouraging both substances. Other common themes were identified.

RESULTS

More than half (54%) of the tweets normalized marijuana and alcohol (without preferring one substance over the other), and 24% preferred marijuana over alcohol. Only 2% expressed a preference for alcohol over marijuana, 7% discouraged the use of both substances, and the sentiment was unknown for 13% of the tweets. Common themes among tweets that normalized both substances included using the substances with friends (17%) and mentioning substance use in the context of sex or romance (14%). Common themes among tweets that preferred marijuana over alcohol were the beliefs that marijuana is safer than alcohol (46%) and preferences for effects of marijuana over alcohol (40%).

CONCLUSION

Tweets normalizing polysubstance use or encouraging marijuana use over alcohol use are common. Both online and offline prevention efforts are needed to increase awareness of the risks associated with polysubstance use and marijuana use.

Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey

BACKGROUND

Health risk behaviours are prominent in late adolescence and young adulthood, yet UK population-level research examining the relationship between drug or alcohol use and sexual health and behaviour among young people is scarce, despite public health calls for an integrated approach to health improvement. Our objective was to further our understanding of the scale of and nature of any such relationship, using contemporary data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

METHODS

Analyses of data from Natsal-3, a stratified probability survey of 15 162 men and women (3869 aged 16-24 years), undertaken in 2010-2012, using computer-assisted personal interviewing, were carried out. Logistic regression was used to explore associations between reporting (1) frequent binge drinking (≥weekly), (2) recent drug use (within past 4 weeks) or (3) multiple (both types of) substance use, and key sexual risk behaviours and adverse sexual health outcomes. We then examined the sociodemographic profile, health behaviours and attitudes reported by 'risky' young people, defined as those reporting ≥1 type of substance use plus non-condom use at first sex with ≥1 new partner(s), last year.

RESULTS

Men and women reporting frequent binge drinking or recent drug use were more likely to report: unprotected first sex with ≥1 new partner(s), last year; first sex with their last partner after only recently meeting; emergency contraception use (last year) and sexually transmitted infection diagnosis/es (past 5 years). Associations with sexual risk were frequently stronger for those reporting multiple substance use, particularly among men. The profile of 'risky' young people differed from that of other 16-24 years old.

CONCLUSIONS

In this nationally representative study, substance use was strongly associated with sexual risk and adverse sexual health outcomes among young people. Qualitative or event-level research is needed to examine the context and motivations behind these associations to inform joined-up interventions to address these inter-related behaviours.

Invited Commentary: The Association Between Marijuana Use and Male Reproductive Health

Approximately 15% of all couples are unable to conceive after a year and are labeled infertile. In recent years, increasing attention has been given to lifestyle factors that may impact fertility. In the United States, it is estimated that there are more than 17 million current users of marijuana with 4.6 million using marijuana almost daily. Although common, to date, little data exist on the impact of marijuana use on male fertility. In the current issue of the Journal, Gundersen et al. (Am J Epidemiol. 2015;182(6):473-481) provide data examining the relationship between marijuana use and semen quality from young men recruited out of the general Danish population. Men who reported daily marijuana use displayed significant lower sperm concentration and sperm counts compared with nonusers, while testosterone levels were higher. The current report provides important information for patients and providers regarding the negative association of marijuana use on semen quality. Although the benefit of marijuana cessation on recovery is uncertain, further study on the impact of marijuana use on male reproductive health is warranted as more states explore marijuana legalization.

Cognitive-enhancing substance use at German universities: frequency, reasons and gender differences

BACKGROUND

The purpose of this study was to give an overview whether German students regularly use stimulants for enhancing their academic performance. Reasons associated with the use of these substances were explored. Moreover, gender differences were analyzed.

METHODS

A cross-sectional survey study was performed analyzing a random sample of 1,053 students of different fields of study in Germany. Students were asked to complete an anonymous self-administered web-based survey containing questions on cognitive performance-enhancing substance use. We used statistical analyses, e.g. non-parametric tests to evaluate the data of our questionnaire.

RESULTS

Among 1,053 students, 61 % responded to our questionnaire. The average age was M = 24.58; 635 participants were female and 418 were male students. Total 1-13 % of the participating students have taken prescription stimulants (e.g. modafinil) or illicit drugs (e.g. cannabis) at least once in their lifetime. The most common reasons for taking stimulants were to support concentration, to relax and to increase alertness. We found significant gender differences with regard to frequency and reason for using performance-enhancing substances.

CONCLUSIONS

Our study results give an overview about the actual situation on frequency and reasons for taking performance-enhancing substances. Departments of Public Health should address this issue in national health debates and discussions. Based on our study findings health education programmes should be developed.

Sexual Hookup Culture: A Review

"Hookups," or uncommitted sexual encounters, are becoming progressively more engrained in popular culture, reflecting both evolved sexual predilections and changing social and sexual scripts. Hook-up activities may include a wide range of sexual behaviors, such as kissing, oral sex, and penetrative intercourse. However, these encounters often transpire without any promise of, or desire for, a more traditional romantic relationship. A review of the literature suggests that these encounters are becoming increasingly normative among adolescents and young adults in North America, representing a marked shift in openness and acceptance of uncommitted sex. We reviewed the current literature on sexual hookups and considered the multiple forces influencing hookup culture, using examples from popular culture to place hooking up in context. We argue that contemporary hookup culture is best understood as the convergence of evolutionary and social forces during the developmental period of emerging adulthood. We suggest that researchers must consider both evolutionary mechanisms and social processes, and be considerate of the contemporary popular cultural climate in which hookups occur, in order to provide a comprehensive and synergistic biopsychosocial view of "casual sex" among emerging adults today.