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Murray GE, Palfai TP, Kratzer MPL, Maisto SA, Simons JS. Sexual alcohol expectancies moderate the relation between alcohol use and sexual behavior among men who have sex with men. Alcohol 2023:S0741-8329(23)00345-2. [PMID: 38101524 DOI: 10.1016/j.alcohol.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND HIV transmission remains a significant health concern for men who have sex with men (MSM) in the United States. Heavy episodic drinking (HED) is related to increased rates of condomless anal intercourse (CAI) among MSM, though evidence suggests that this association may vary by individual difference factors. The present secondary analysis tested whether sexual alcohol expectancies (SAEs) moderate the associations between frequency of HED and anal intercourse (AI) with and without a condom among moderate-to-heavy drinking HIV- MSM. METHODS Two hundred and forty-eight moderate-to-heavy drinking MSM completed self-report questionnaires including the Sexual Behavior Questionnaire, the Modified Daily Drinking Questionnaire, and the Sexual Alcohol Expectancies Questionnaire. RESULTS Negative binomial regressions indicated that SAEs moderated the association between frequency of HED and AI with a condom, but not between the frequency of HED and condomless AI (CAI). CONCLUSIONS These results suggest that stronger SAEs play a role in alcohol-related sexual behavior among MSM, but do not provide evidence that SAEs are associated with increased risk for HIV transmission through CAI.
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Affiliation(s)
- Grace E Murray
- Boston University, Department of Psychological and Brain Sciences, Boston, MA.
| | - Tibor P Palfai
- Boston University, Department of Psychological and Brain Sciences, Boston, MA
| | - Maya P L Kratzer
- Boston University, Department of Psychological and Brain Sciences, Boston, MA
| | | | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, SD
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2
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Bogren A, Hunt G, Petersen MA. Rethinking intoxicated sexual encounters. DRUGS: EDUCATION, PREVENTION AND POLICY 2022; 30:31-41. [PMID: 37065682 PMCID: PMC10103807 DOI: 10.1080/09687637.2022.2055446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Social research on alcohol and sexual encounters has tended to be siloed into several different research endeavors, each addressing separate aspects of wanted and unwanted sexual encounters. While sociologists have focused on the patterns of social interaction, status competition, and emotional hierarchies of sexual encounters, they have left the role of alcohol intoxication largely unexamined. Conversely, the two dominant approaches to sexual encounters within alcohol research, the theories of alcohol myopia and alcohol expectancy, while focusing on alcohol have tended to take little account of the socio-relational dynamics and gendered meanings involved in those encounters. Our aim in this theoretical paper is to begin to bring together some of the concepts from these different research strands in examining how the social processes of intoxication potentially impact heteronormative sexual scripts and hence notions of femininity and masculinity among cisgender, heterosexual women and men. Our discussion is focused on the concepts of ritual and scripts; power, status, and hierarchies; and socio-spatial contexts, which are central to an understanding of the gendered and embodied social practices that take place within intoxicated sexual events; the emotional nature of the socio-spatial contexts within which they occur; and the socio-structural conditions that frame these events.
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Affiliation(s)
- Alexandra Bogren
- School of Social Sciences, Södertörn University, Huddinge, Sweden
| | - Geoffrey Hunt
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
- Institute for Scientific Analysis, Alameda, California, USA
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3
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Hunt G, Sanders E, Petersen MA, Bogren A. "BLURRING THE LINE:" INTOXICATION, GENDER, CONSENT AND SEXUAL ENCOUNTERS AMONG YOUNG ADULTS. CONTEMPORARY DRUG PROBLEMS 2022; 49:84-105. [PMID: 36092964 DOI: 10.1177/00914509211058900] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social concern about sexual practices and sexual consent among young adults has increased significantly in recent years, and intoxication has often played a key role in such debates. While many studies have long suggested that alcohol plays a role in facilitating (casual) sexual encounters, intoxication has largely either been conceptualized as a risk factor, or researchers have focused on the pharmacological effects of alcohol on behaviors associated with sexual interaction and consent. To date little work has explored how young adults define and negotiate acceptable and unacceptable levels of intoxication during sexual encounters, nor the ways in which different levels of intoxication influence gendered sexual scripts and meanings of consent. This paper explores the latter two research questions using data from 145 in-depth, qualitative interviews with cisgender, heterosexual young adults ages 18-25 in the San Francisco Bay Area. In examining these interview data, by exploring the relationship between intoxication and sexual consent, and the ways in which gender plays out in notions of acceptable and unacceptable intoxicated sexual encounters, we highlight how different levels of intoxication signal different sexual scripts. Narratives about sexual encounters at low levels of intoxication highlighted the role of intoxication in achieving sexual sociability, but they also relied on the notion that intoxicated consent was dependent on the social relationship between the partners outside drinking contexts. Narratives about sexual encounters in heavy drinking situations were more explicitly gendered, often in keeping with traditionally gendered sexual scripts. In general we found that when men discussed their own levels of intoxication, their narratives were more focused on sexual performance and low status sex partners, while women's and some men's narratives about women's levels of intoxication were focused on women's consent, safety, and respectability. Finally, some participants rely on 'consent as a contract' and 'intoxication parity'- the idea that potential sexual partners should be equally intoxicated - to handle relations of power in interpersonal sexual scripts. Since these notions are sometimes deployed strategically, we suggest that they may serve to "black-box" gendered inequalities in power between the parties involved.
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Affiliation(s)
- Geoffrey Hunt
- Centre for Alcohol and Drug Research, Aarhus University, Denmark.,Institute for Scientific Analysis, Alameda, California
| | - Emile Sanders
- Institute for Scientific Analysis, Alameda, California
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4
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Willoughby JF, Hust SJT, Li J, Couto L. Social Media, Marijuana and Sex: An Exploratory Study of Adolescents' Intentions to Use and College Students' Use of Marijuana. JOURNAL OF SEX RESEARCH 2022; 59:85-97. [PMID: 33034543 DOI: 10.1080/00224499.2020.1827217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recreational marijuana continues to be legalized in U.S. states, with popular media discussing connections between cannabis and the facilitation of sexual activity. We conducted two surveys with adolescents and college students in Washington state to examine the role of viewing social media and pro-marijuana content on sex-related marijuana expectancies and intentions to use. In Study 1, among adolescents (N = 350), we found connections between social media use, exposure to pro-marijuana content, and sex-related marijuana expectancies, with boys' sex-related marijuana expectancies predicting intentions to use marijuana. In Study 2, we expanded this research to college students (N = 966), with the addition of frequency of marijuana use as an outcome. For men, sex-related marijuana expectancies were negatively associated with marijuana use. Sex-related marijuana expectancies were not associated with intentions to use or use of marijuana among adolescent girls and college women. Our findings highlight how social media use is associated with increased exposure to pro-marijuana content for adolescents and college students, and how such content is associated with sex-related marijuana expectancies. The mixed relationships in our data between sex-related marijuana expectancies and intentions and use highlight potential gender and developmental differences.
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Affiliation(s)
| | - Stacey J T Hust
- The Edward R. Murrow College of Communication, Washington State University
| | - Jiayu Li
- The Edward R. Murrow College of Communication, Washington State University
| | - Leticia Couto
- The Edward R. Murrow College of Communication, Washington State University
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5
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Ssekamatte T, Kibira SPS, Tetui M, Isunju JB, Mugambe RK, Wafula ST, Buregyeya E, Nalwadda CK, Bukenya JN, Wanyenze RK. Do sexual expectancies and inhibitions predict high-risk sexual behaviours? Evidence from a cross-sectional survey among young psychoactive substance users in informal settlements in Kampala, Uganda. BMC Public Health 2021; 21:1506. [PMID: 34348701 PMCID: PMC8336356 DOI: 10.1186/s12889-021-11536-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/23/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychoactive substance use is a public health challenge among young people in informal settlements. Though rarely examined, psychoactive substance use is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibitions, and high-risk sexual behaviours among young psychoactive substance users (PSUs) in informal settlements in Kampala, Uganda. METHODS This cross-sectional study recruited 744 young PSUs from informal settlements in Kampala. Respondent driven sampling was used to recruit respondents. A 'modified' Poisson regression model was used for inferential statistics. Data were analysed using the Stata 14 software. RESULTS Of the 744 study participants, 45.6% believed that psychoactive substance use improves sexual performance; 43.3% believed that psychoactive substances make sex more pleasurable, and 53.3% believed that psychoactive substances give courage or confidence to approach a partner for sex. The belief that psychoactive substance use improves sexual performance (PR 1.14, 95% CI: 1.01-1.30), increases the likelihood of engaging in sex (PR 1.20, 95% CI: 1.04-1.40) or gives courage or confidence to approach a sexual partner (PR 1.21, 95% CI: 1.05-1.39) were associated with having sex while under the influence of psychoactive substances. The belief that a psychoactive substance user under the influence of psychoactive substances is more likely to engage in sex (PR 1.48, 95% CI: 1.15-1.90), and likely to find it difficult to refuse sex (PR 1.28, 95% CI: 1.06-1.55) were positively associated with engaging in multiple sexual partnerships. The belief that one easily forgets to use a condom when under the influence of psychoactive substances was positively associated with inconsistent condom use (PR 1.26, 95% CI: 1.09-1.45). CONCLUSION Psychoactive substance use expectancies associated with high-risk sexual behaviours included the belief that psychoactive substances improve sexual performance and improve confidence in approaching a sexual partner. Psychoactive substance use inhibitions associated with high-risk sexual behaviours included an increased likelihood of engaging in sexual intercourse, difficulties in refusing to engage in sexual intercourse, and forgetting to use condoms while intoxicated. Interventions targeting a reduction in high-risk sexual behaviour should integrate the impact of psychoactive substance use on sexual behaviour.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, Waterloo, Canada
- Departement of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Christine Kayemba Nalwadda
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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6
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Proudfoot P, Heubeck B, Ward J, Degenhardt L. Ecstasy Use, Outcome Expectancies, and Sexual Risk Taking. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2010.00016.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Phoebe Proudfoot
- Department of Psychology, The Australian National University, Canberra
| | - Bernd Heubeck
- Department of Psychology, The Australian National University, Canberra
| | - Jeff Ward
- Department of Psychology, The Australian National University, Canberra
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7
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Sharma SK, Vishwakarma D. Transitions in adolescent boys and young Men's high-risk sexual behaviour in India. BMC Public Health 2020; 20:1089. [PMID: 32653036 PMCID: PMC7353811 DOI: 10.1186/s12889-020-09191-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 07/01/2020] [Indexed: 02/05/2023] Open
Abstract
Background The sexual behaviour of adolescents is of importance due to the engagement in risky sexual activity at a too early age, which may be associated with the adverse outcomes. The study aims to understand the transitions in adolescent boys and young men’s high-risk sexual behaviour in India using two rounds of Indian demographic health survey, NFHS-3 (2005–06) and NFHS-4 (2015–16). Methods A total of 25,538 in NFHS-3 (2005–06) and 35,112 in NFHS-4 (2015–16) men were considered for the analysis. Men have been divided into two age groups as 15–19 years (adolescent) and 20–24 (young men) for comparison purposes. Descriptive and multivariate statistics have been used. Results Overall, high-risk sexual behaviour has increased among adolescent boys (64 to 70%) and young men (18 to 27%) from 2005–06 to 2015–16. The trend of live-in relationship has increased among adolescent boys of rural areas (0.6 to 6.0%) as well as in urban areas (3.1 to 10.9%) over the last 10 years. Adolescent boys having 10th and above years of schooling (AOR = 1.98; p < 0.01), residing in urban areas (AOR = 2.23; p < 0.01), and belonging to the affluent class of households (AOR = 1.41; p < 0.05) were more likely to engage in high-risk sexual activity than the young men in India. The odds of high-risk sexual behaviour was higher among alcohol-using adolescent boys (AOR = 1.82; p < 0.01) and young men (AOR = 2.38; p < 0.01) in 2015–16. Conclusions The study concludes that early sexual debut, lower prevalence of condom use at first sexual experience, tendency of live-in-relationship, and alcohol consumption indicate the hazardous interconnection between such behaviours among adolescent boys over the last decade which placed them at higher-risky sexual behaviour as compared to young men. Adolescent’ sexual behaviours have both short-term and long-term consequences, and interventions that focus on multiple domains of risk may be the most effective in helping to promote broad reproductive health among young adults.
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Affiliation(s)
- Santosh Kumar Sharma
- International Institute for Population Sciences, Deonar, Govandi Station Road, Mumbai, Maharashtra, 400088, India.
| | - Deepanjali Vishwakarma
- Deepanjali Vishwakarma, Doctoral Fellow, International Institute for Population Sciences, Deonar, Mumbai, India
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8
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Van Swol LM, Chang CT, Kerr B, Moreno M. Linguistic Predictors of Problematic Drinking in Alcohol-related Facebook Posts. JOURNAL OF HEALTH COMMUNICATION 2020; 25:214-222. [PMID: 32096449 PMCID: PMC7654720 DOI: 10.1080/10810730.2020.1731632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Emerging adults often increase problematic drinking during college. Although they generally do not seek help for problematic drinking, college students discuss their drinking on social media. This study followed college students' Facebook profiles from the inception of their attendance at a university and identified alcohol-related posts. Within 28 days of their first alcohol-related Facebook post, participants were interviewed to assess problematic drinking (binge drinking episodes and number of drinks). Linguistic analysis of alcohol-related Facebook posts found that use of negative emotion language and swear words were related to problematic drinking, in support of proposed hypotheses. Results are situated within alcohol use disorder and health research examining the link between problematic drinking and anxiety, deviant behavior, and negative emotions.
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Affiliation(s)
- Lyn M. Van Swol
- Department of Communication Arts, University of Wisconsin–Madison
| | - Chen-Ting Chang
- Department of Communication Arts, University of Wisconsin–Madison
| | - Bradley Kerr
- Department of Pediatrics, University of Wisconsin–Madison
| | - Megan Moreno
- Department of Pediatrics, University of Wisconsin–Madison
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9
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Knox J, Reddy V, Lane T, Lovasi GS, Hasin D, Sandfort T. Safer sex intentions modify the relationship between substance use and sexual risk behavior among black South African men who have sex with men. Int J STD AIDS 2019; 30:786-794. [PMID: 31142222 DOI: 10.1177/0956462418825333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Due to the global burden of HIV, a better understanding of the relationship between substance use and HIV risk behavior is a public health priority, particularly among populations with high rates of HIV infection. The current study explored the moderating effects of psychosocial factors on the relationship between substance use and sexual risk behavior. Among 480 black South African men who have sex with men recruited using respondent-driven sampling, a cross-sectional survey was conducted that included questions about their last sexual event that involved anal sex. Substance use was not associated with unprotected anal intercourse (UAI) ( P = 0.97). The effect of substance use on UAI was modified by safer sex intentions ( P = 0.001). Among those with higher safer sex intentions, substance use was positively associated with UAI (aOR = 5.8, 95%CI = 1.6–21.3, P < 0.01). This study found that among men who have sex with men with high intentions to engage in safer sex, substance use was associated with increased risky sexual behavior.
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Affiliation(s)
- Justin Knox
- 1 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Vasu Reddy
- 2 Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Tim Lane
- 3 Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
| | - Gina S Lovasi
- 4 Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Deborah Hasin
- 1 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Theo Sandfort
- 5 HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, USA.,6 Department of Psychology, University of Pretoria, Pretoria, South Africa
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Nguyen-Louie TT, Courtney KE, Squeglia LM, Bagot K, Eberson S, Migliorini R, Alcaraz AR, Tapert SF, Pulido C. Prospective changes in neural alcohol cue reactivity in at-risk adolescents. Brain Imaging Behav 2019; 12:931-941. [PMID: 28801730 DOI: 10.1007/s11682-017-9757-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Adolescence represents an ideal time for elucidating the etiology of cue reactivity profiles. This study examined the influence of three risk factors consistently associated with heavy adolescent drinking on alcohol cue reactivity. Youth were first assessed while still naïve to alcohol (12-14 years old) and followed after transitioning into alcohol use (17-21 years old). The effects of family history of substance use disorder, sex, and history of early of dating (i.e., before 14 years of age) on BOLD response contrast to alcohol picture cues were examined in a linear mixed model, controlling for age and alcohol use patterns at follow-up. Activation to alcohol picture cues differed as a function of risk factor and time. At baseline, family history positive youth showed greater activation to alcohol cues than family history negative peers in the right middle occipital and anterior cingulate gyri. Youth with a history of early-dating showed greater activation to alcohol cues, compared to non-early daters, in the left anterior cingulate/white matter region. Girls showed greater activation to alcohol than boys at baseline in left middle frontal gyrus. At follow-up, after drinking started, patterns reversed for each risk factor. These results indicate that even prior to initiating alcohol use, adolescents showed differences in activation to alcohol cues based on their family history, dating history, and sex.
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Affiliation(s)
- Tam T Nguyen-Louie
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA.,Clinical Psychology, San Diego State University-University of California San Diego Joint Doctoral Program, 6363 Alvarado Ct, San Diego, CA, USA
| | - Kelly E Courtney
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Ashley Ave, Charleston, SC, USA
| | - Kara Bagot
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Sonja Eberson
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Robyn Migliorini
- Clinical Psychology, San Diego State University-University of California San Diego Joint Doctoral Program, 6363 Alvarado Ct, San Diego, CA, USA
| | - Alexis R Alcaraz
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA. .,Clinical Psychology, San Diego State University-University of California San Diego Joint Doctoral Program, 6363 Alvarado Ct, San Diego, CA, USA.
| | - Carmen Pulido
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, USA
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Dir AL, Hulvershorn LA, Aalsma MC. The Role of Pregnancy Concerns in the Relationship between Substance Use and Unprotected Sex among Adolescents. Subst Use Misuse 2019; 54:1060-1066. [PMID: 30957674 PMCID: PMC6498425 DOI: 10.1080/10826084.2018.1524912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Substance use and unprotected sex are prevalent among adolescents. The link between substance use and unprotected sex is well-established. Research has also highlighted how adolescents' attitudes and risk perceptions regarding unprotected sex, including concerns about pregnancy ("Getting pregnant would force me to grow up too fast"), are associated with unprotected sex and unplanned pregnancy. However, less research has examined the potential relationship between pregnancy concerns and substance use among adolescents. OBJECTIVES The study prospectively examined (1) differences in pregnancy concerns across patterns of substance use and (2) whether pregnancy concerns mediate the relationship between substance use and later unprotected sex among a sample of middle and high school students. METHOD 98 adolescents [M(SD) age = 14.28(1.68), 59.4% female, 59.4% black/African American] completed self-report measures of marijuana and alcohol use, pregnancy concerns, and unprotected sex across three time points over 6 months (T1-T3). RESULTS Substance users (alcohol/marijuana) reported fewer pregnancy concerns compared to non-substance users (t = 2.99, p = .04). Pregnancy concerns at T2 mediated the relationship between T1 lifetime substance use and later unprotected sex (T3) (indirect effect: b = 0.10, CI[.01-.41]; direct effect: b = 0.15, p = .32), controlling for gender, age, and race. More frequent substance use (T1) was related to fewer pregnancy concerns at T2 (b = -0.10, p = .04); fewer pregnancy concerns were related to increased likelihood of later unprotected sex (b = -1.02, p = .02). CONCLUSIONS Findings offer new insight into associations between substance use and unprotected sex and suggest that substance use and sexual health interventions should target pregnancy concerns.
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Affiliation(s)
- Allyson L Dir
- a Department of Pediatrics, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.,b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Leslie A Hulvershorn
- b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA.,c Department of Psychiatry, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Matthew C Aalsma
- a Department of Pediatrics, Section of Adolescent Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.,b Adolescent Behavioral Health Research Program , Indiana University School of Medicine , Indianapolis , IN , USA
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12
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Rai S, Mishra BR, Sarkar S, Praharaj SK, Das S, Maiti R, Agrawal N, Nizami SH. Higher Impulsivity and HIV-Risk Taking Behaviour in Males with Alcohol Dependence Compared to Bipolar Mania: A Pilot Study. Community Ment Health J 2018; 54:218-223. [PMID: 28456858 DOI: 10.1007/s10597-017-0139-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 04/25/2017] [Indexed: 11/26/2022]
Abstract
To study the association of impulsivity, high-risk behaviours and incidence of HIV infection in patients with alcohol dependence and bipolar mania. This was a cross-sectional hospital-based pilot study and the sample consisted of male patients divided into three groups: 25 patients with alcohol dependence and 25 with bipolar mania as per ICD-10 Diagnostic Criteria for Research and 25 normal controls. Severity of Alcohol Dependence Questionnaire (SADQ) and Young Mania Rating Scale (YMRS) were administered on alcohol dependent and bipolar patients, respectively. All three groups were rated on Barrett's Impulsivity Scale (BIS) and HIV Risk-taking Behaviour Scale (HRBS). None of the patients tested positive for either HIV 1 or 2. BIS motor impulsivity, BIS total score and HRBS total score were significantly higher in alcohol dependent patients as compared to bipolar mania patients. In the Alcohol dependent group, BIS score significantly correlated with education years, age of onset of alcohol use and SADQ, whereas, HRBS total score significantly correlated with SADQ scores. In the bipolar mania group, BIS significantly correlated with YMRS, and total number of episodes, whereas, there was no significant correlation of HRBS total score with any clinical variable. The findings of this pilot study underscore the link between alcohol use disorder and the impulsive behaviours that can lead to HIV infection, and highlight that those risks are higher for individuals with alcohol dependency than for individuals with bipolar disorder.
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Affiliation(s)
- Sakshi Rai
- Department of Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, 834006, India
| | - Biswa Ranjan Mishra
- Department of Psychiatry, AIIMS, Bhubaneswar, Bhubaneswar, Odisha, 751019, India.
| | - Sukanto Sarkar
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry, 607402, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, KMC, Manipal, Manipal, Udupi, Karnataka, 576104, India
| | - Sudipta Das
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rituparna Maiti
- Department of Pharmacology, AIIMS, Bhubaneswar, Bhubaneswar, Odisha, 751019, India
| | - Nidhi Agrawal
- Department of Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, 834006, India
| | - S Haque Nizami
- Department of Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, 834006, India
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13
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Knox J, Reddy V, Lane T, Lovasi G, Hasin D, Sandfort T. Determinants of hazardous drinking among black South African men who have sex with men. Drug Alcohol Depend 2017; 180:14-21. [PMID: 28850902 PMCID: PMC5648600 DOI: 10.1016/j.drugalcdep.2017.07.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/19/2017] [Accepted: 07/29/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a known heavy burden of hazardous drinking and its associated health risks among black South African MSM; however, no study to date has identified risk factors for hazardous drinking among this nor any other African MSM population. METHODS A cross-sectional survey was conducted among 480 black South African MSM recruited using respondent-driven sampling. All analyses were adjusted using an RDS II estimator. Multivariable logistic regression was used to assess the relationship between demographic characteristics, psychosocial factors, behavioral attributes and hazardous drinking. RESULTS More than half of the men (62%, 95%CI=56%-68%) screened positive as hazardous drinkers. In multivariable analyses, living in a township (versus the city of Pretoria) (aOR=1.9, 95%CI=1.2-3.1, p<.01), more gender dysphoria (aOR=1.4, 95%CI=1.0-1.8, p=.03), having ever received money or other incentives in return for sex (aOR=2.4, 95%CI=1.3-4.3, p<.01), having been sexually abused as a child (aOR=2.6, 95%CI=1.1-6.4, p=.03), having anxiety (aOR=5.4, 95%CI=1.2-24.3, p=.03), and social network drinking behavior (aOR=5.4, 95%CI=1.2-24.3, p=.03) were positively associated with hazardous drinking. Being sexually attracted only to men (aOR=0.3, 95%CI=0.1-0.8, p=.01) was negatively associated with hazardous drinking. DISCUSSION Hazardous drinking is highly prevalent among black South African MSM. Multiple indicators of social vulnerability were identified as independent determinants of hazardous drinking. These findings are of heightened concern because these health problems often work synergistically to increase risk of HIV infection and should be taken into consideration by efforts aimed at reducing hazardous drinking among this critical population.
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Affiliation(s)
- Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
| | - Vasu Reddy
- Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Tim Lane
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Gina Lovasi
- Department of Epidemiology, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Theo Sandfort
- HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, United States
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Corbin WR, Scott CJ, Treat TA. Sociosexual Attitudes, Sociosexual Behaviors, and Alcohol Use. J Stud Alcohol Drugs 2017; 77:629-37. [PMID: 27340968 DOI: 10.15288/jsad.2016.77.629] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Prior studies have demonstrated an association between high-risk sexual behavior and alcohol use, and there is emerging evidence that dating status and sexual behavior are related to risk for subsequent alcohol use. However, relatively little is known regarding the specific attitudinal or behavioral indicators of alcohol-related risk associated with sexual behavior. The present study distinguished between sociosexual attitudes and sociosexual behaviors, two aspects of sexual risk that may contribute to individual differences in drinking behavior. The primary hypothesis was that sociosexual attitudes would indirectly contribute to heavier drinking through greater engagement in sociosexual behaviors. METHOD Study hypotheses were tested using baseline data from an alcohol challenge study in a sample of young adult heavy drinkers (n = 211, 73.7% male). Participants completed surveys assessing typical drinking behavior and both sociosexual attitudes and sociosexual behaviors. RESULTS As hypothesized, sociosexual attitudes were indirectly related to heavier alcohol use through greater engagement in sociosexual behavior. However, the relation between sociosexual attitudes and sociosexual behaviors was stronger for men, as were the indirect effects of sociosexual attitudes on drinking behavior. CONCLUSIONS Engagement in sociosexual behavior appears to be a risk factor for heavy alcohol use. This highlights the potential utility of targeted alcohol interventions in settings associated with sexual risk, including sexually transmitted infection clinics and college campuses. Future research should explore the mechanisms through which sociosexual behaviors contribute to drinking outcomes to further inform targeted alcohol interventions and to bolster protective factors among those who engage in sociosexual behaviors.
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Affiliation(s)
- William R Corbin
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Caitlin J Scott
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Teresa A Treat
- Department of Psychological & Brain Sciences, The University of Iowa, Iowa City, Iowa
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15
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Bello B, Moultrie H, Somji A, Chersich MF, Watts C, Delany-Moretlwe S. Alcohol use and sexual risk behaviour among men and women in inner-city Johannesburg, South Africa. BMC Public Health 2017; 17:548. [PMID: 28832283 PMCID: PMC5498865 DOI: 10.1186/s12889-017-4350-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Alcohol misuse is a key factor underlying the remarkable vulnerability to HIV infection among men and women in sub-Saharan Africa, especially within urban settings. Its effects, however, vary by type of drinking, population group and are modified by socio-cultural co-factors. METHODS We interviewed a random sample of 1465 men living in single-sex hostels and 1008 women in adjacent informal settlements in inner-city, Johannesburg, South Africa. Being drunk in the past week was used as an indicator of heavy episodic drinking, and frequency of drinking and number of alcohol units/week used as measures of volume. Associations between dimensions of alcohol use (current drinking, volume of alcohol consumed and heavy episodic drinking patterns) and sexual behaviours were assessed using multivariate logistic regression. RESULTS Most participants were internal migrants from KwaZulu Natal province. About half of men were current drinkers, as were 13% of women. Of current male drinkers, 18% drank daily and 23% were drunk in the past week (women: 14% and 29% respectively). Among men, associations between heavy episodic drinking and sexual behaviour were especially pronounced. Compared with non-drinkers, episodic ones were 2.6 fold more likely to have transactional sex (95%CI = 1.7-4.1) and 2.2 fold more likely to have a concurrent partner (95%CI = 1.5-3.2). Alcohol use in men, regardless of measure, was strongly associated with having used physical force to have sex. Overall effects of alcohol on sexual behaviour were larger in women than men, and associations were detected between all alcohol measures in women, and concurrency, transactional sex and having been forced to have sex. CONCLUSIONS Alcohol use and sexual behaviours are strongly linked among male and female migrant populations in inner-city Johannesburg. More rigorous interventions at both local and macro level are needed to alleviate alcohol harms and mitigate the alcohol-HIV nexus, especially among already vulnerable groups. These should target the specific dimensions of alcohol use that are harmful, assist women who drink to do so more safely and address the linkages between alcohol and sexual violence.
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Affiliation(s)
- Braimoh Bello
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Harry Moultrie
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aleefia Somji
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Matthew F. Chersich
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Sinead Delany-Moretlwe
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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16
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Knox J, Reddy V, Lane T, Hasin D, Sandfort T. Substance Use and Sexual Risk Behavior Among Black South African Men Who Have Sex With Men: The Moderating Effects of Reasons for Drinking and Safer Sex Intentions. AIDS Behav 2017; 21:2023-2032. [PMID: 28025737 DOI: 10.1007/s10461-016-1652-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Research studies suggest an association between substance use and sexual risk behavior, but are not completely consistent. The moderating effects of other psychosocial factors might help explain these inconsistencies. The current study therefore assessed whether substance use is associated with sexual risk behavior, and whether this relationship is modified by expectancies about the effects of alcohol, reasons for consuming alcohol, or intentions to engage in safe sex. A cross-sectional survey was conducted among 480 black South African men who have sex with men recruited using respondent-driven sampling. In multivariable analyses, the effect of alcohol use on unprotected receptive anal intercourse (URAI) was modified by drinking to enhance social interaction (R2 change = 0.03, p < 0.01). The effect of drug use on URAI was modified by safe sex intentions (R2 change = 0.03, p < 0.001). Alcohol use was positively associated with URAI only among those who drink to enhance social interaction (β = 0.08, p < 0.05). Drug use was positively associated with URAI only among those with high safe sex intentions (β = 0.30, p < 0.001). Our findings suggest that efforts to minimize the impact of substance use on HIV risk behavior should target men who drink to enhance social interaction and men who intend to engage in safer sex. Efforts made to increase safer sex intentions as a way to reduce HIV risk behavior should additionally consider the effects of substance use.
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Affiliation(s)
- Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA.
| | - Vasu Reddy
- Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Tim Lane
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Theo Sandfort
- HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, USA
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17
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Ham LS, Zamboanga BL, Meca A, Blumenthal H, Hardy SA, Hurd LE. Factor Structure of the Brief Comprehensive Effects of Alcohol Scale in Adolescents. Assessment 2017; 26:604-618. [PMID: 29214852 DOI: 10.1177/1073191117694454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Alcohol use among adolescents is a public health concern; therefore, it is important that studies that examine factors associated with adolescent drinking behaviors utilize measures that are well-validated for use with this population. The current study examined the factor structure and convergent validity of the Brief Comprehensive Effects of Alcohol scale, a measure of alcohol outcome expectancies and evaluations of expected outcomes, among adolescents ( N = 1,074; 50% girls; Mage = 15.96 years, SD = 1.13, range = 13-18; 74% White) drawn from three independent studies ( nsite 1 = 594; nsite 2 = 97; and nsite 3 = 383). Results yielded support for a four-factor structure for alcohol expectancies and two-factor structure for valuations. Moreover, the factor structure was partially or fully invariant across gender, age, and site. Thus, findings are similar, yet unique, to those identified in college samples. The convergent validity of the modified measure was supported, suggesting that the Brief Comprehensive Effects of Alcohol scale may be useful for assessing adolescents' beliefs about alcohol.
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Affiliation(s)
| | | | - Alan Meca
- 3 University of Miami, Coral Gables, FL, USA
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18
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Nikfarjam A, Hajimaghsoudi S, Rastegari A, Haghdoost AA, Nasehi AA, Memaryan N, Tarjoman T, Baneshi MR. The Frequency of Alcohol Use in Iranian Urban Population: The Results of a National Network Scale Up Survey. Int J Health Policy Manag 2017; 6:97-102. [PMID: 28812784 PMCID: PMC5287934 DOI: 10.15171/ijhpm.2016.103] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 08/01/2016] [Indexed: 12/12/2022] Open
Abstract
Background: In Islamic countries alcohol consumption is considered as against religious values. Therefore, estimation of frequency of alcohol consumptions using direct methods is prone to different biases. In this study, we indirectly estimated the frequency of alcohol use in Iran, in network of a representative sample using network scale up (NSU) method.
Methods: In a national survey, about 400 participants aged above 18 at each province, around 12 000 in total, were recruited. In a gender-match face to face interview, respondents were asked about the number of those who used alcohol (even one episode) in previous year in their active social network, classified by age and gender. The results were corrected for the level of visibility of alcohol consumption. Results: The relative frequency of alcohol use at least once in previous year, among general population aged above 15, was estimated at 2.31% (95% CI: 2.12%, 2.53%). The relative frequency among males was about 8 times higher than females (4.13% versus 0.56%). The relative frequency among those aged 18 to 30 was 3 times higher than those aged above 30 (3.97% versus 1.36%). The relative frequency among male aged 18 to 30 was about 7%.
Conclusion: It seems that the NSU is a feasible method to monitor the relative frequency of alcohol use in Iran, and possibly in countries with similar culture. Alcohol use was lower than non-Muslim countries, however, its relative frequency, in particular in young males, was noticeable.
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Affiliation(s)
- Ali Nikfarjam
- Emergency Medical Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Saiedeh Hajimaghsoudi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azam Rastegari
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Ali Nasehi
- Iran Helal Institute of Applied-Science and Technology, Tehran, Iran
| | - Nadereh Memaryan
- Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Terme Tarjoman
- Department of Community Medicine, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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19
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Green KM, Musci RJ, Matson PA, Johnson RM, Reboussin BA, Ialongo NS. Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood. J Urban Health 2017; 94:115-124. [PMID: 28083726 PMCID: PMC5359168 DOI: 10.1007/s11524-016-0108-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Urban populations disproportionately experience poor sexual outcomes, including high rates of teenage pregnancy and sexually transmitted infections. However, the contribution of substance use across adolescence to poor sexual outcomes in young adulthood has not been investigated in depth, despite offering opportunities for more targeted prevention. This study aimed to estimate joint trajectories of adolescent alcohol and marijuana use to determine if they relate differently to four sexual outcomes: multiple sexual partners, sex without a condom, teenage pregnancy, and contraction of a sexually transmitted infection in young adulthood (by age 25). Data came from a longitudinal study of urban youth followed from age 6 to age 25, with annual assessments during adolescence and young adulthood (n = 608). The sample showed high levels of sexual risk, with young adults on average having sex without a condom once in the past month, 28.5% having multiple sexual partners in the past month, one quarter having contracted a sexually transmitted infection, and over 60% of the women being pregnant as a teenager and 36% of the men having gotten a partner pregnant. Applying longitudinal latent profile analysis to estimate joint trajectories of alcohol and marijuana use from grades 8-12, we identified four classes representing high dual use, moderate alcohol use, moderate alcohol use with increasing marijuana use, and non-use. Class membership differently predicted all four outcomes investigated with high dual users having the highest level of teenage pregnancy and the increasing marijuana trajectory having the highest risk of engaging with multiple sexual partners in the past month. Results suggest implications for both sexual risk and substance use prevention for urban youth.
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Affiliation(s)
- Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, SPH Building, Valley Drive, College Park, MD, 20742, USA.
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA
| | - Pamela A Matson
- Department of Pediatrics, Johns Hopkins School of Medicine, 200 N. Wolfe St, Rm 2025, Baltimore, MD, 21287, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA
| | - Beth A Reboussin
- Department of Biostatistical Sciences and Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD, 21205, USA
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20
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The Association between Alcohol and Sexual Risk Behaviors among College Students: A Review. CURRENT ADDICTION REPORTS 2016; 3:349-355. [PMID: 27896039 DOI: 10.1007/s40429-016-0125-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Alcohol use is prevalent among college students and may contribute to sexual risk behavior engagement. A narrative review of the recent empirical literature examining the association between alcohol use and sexual risk behaviors among college student samples was conducted. The purpose of this review was to: (a) review studies examining the association between alcohol use and risky sexual behaviors; and (b) overview research investigating alcohol expectancies and partner characteristics as factors that may influence the alcohol-risky sex relation among college students. RECENT FINDINGS Findings regarding the direct link between alcohol use and sexual risk behaviors were mixed. Results suggest a more nuanced association between alcohol and risky sexual behaviors that is influenced by alcohol expectancies and partner characteristics. SUMMARY Results highlight the importance of considering additional factors that may influence the alcohol-risky sex relation. Future interventions targeting alcohol-related sexual risk behavior engagement among college students are needed.
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21
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Brown JL, Talley AE, Littlefield AK, Gause NK. Young women's alcohol expectancies for sexual risk-taking mediate the link between sexual enhancement motives and condomless sex when drinking. J Behav Med 2016; 39:925-30. [PMID: 27342615 DOI: 10.1007/s10865-016-9760-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/17/2016] [Indexed: 11/25/2022]
Abstract
Alcohol use is prevalent among young women. Alcohol expectancies for sexual risk-taking and sexual enhancement motives have been associated with decreased condom use. This study investigated whether alcohol expectancies for sexual risk-taking mediated the association between sexual enhancement motives and condom use. Young women (N = 287, M age = 20.1) completed a survey assessing alcohol expectancies for sexual risk-taking, sexual enhancement motives, and characteristics of their most recent sexual encounter involving alcohol. Most participants (66.9 %) reported unprotected sex during their last sexual encounter involving alcohol. Higher sexual enhancement motives (OR = 1.35, p = .019) and alcohol expectancies for sexual risk-taking (OR = 1.89, p < .001) were associated with increased likelihood of condomless sex. Alcohol expectancies for sexual risk-taking mediated the association between sexual enhancement motives and condomless vaginal sex. Within the context of sexual encounters involving alcohol, expectancies that drinking may result in sexual risk-taking may account for why sexual enhancement motives relate to decreased condom use.
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Affiliation(s)
- Jennifer L Brown
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, 3131 Harvey Avenue, Suite 104, Cincinnati, OH, 45229, USA.
| | - Amelia E Talley
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Nicole K Gause
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
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22
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Kaljee L, Wang B, Deveaux L, Lunn S, Rolle G, Villar ME, Stanton B. Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas. Int J Adolesc Med Health 2016; 28:133-40. [PMID: 25781669 DOI: 10.1515/ijamh-2014-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/17/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND While The Bahamas have significantly reduced poor reproductive health outcomes among adolescents and emerging adults, data indicate that youth are engaged in sexual risk behaviors. Substance use has been linked to increased risk for HIV and sexually transmitted infections in other contexts. There are limited data on Bahamian youth in relation to consumption of alcohol and marijuana use and engagement in sexual behaviors. OBJECTIVE This study aimed to assess potential relationships between alcohol and marijuana use and engagement in sexual behavior among government secondary school students in New Providence, The Bahamas. MATERIALS AND METHODS Total sample size was 2572, and about 56% of respondents were female. Mean age was 14.2 (SD 2.7 years). Cross-sectional data came from a baseline survey conducted as part of a longitudinal randomized controlled evaluation of a school-based HIV prevention and reproductive health program in New Providence. RESULTS Overall, 46.5% (519) males and 44.8% (652) females reported alcohol consumption; 7.3% (82) males and 1.7% (25) females reported use of marijuana in the last 6 months. About 43% (477) male respondents and 16% (231) female respondents reported ever having vaginal sex. Logistic regression analysis indicates that increased likelihood of engaging in sex during the past 6 months is associated with being older, male, and consuming alcohol and marijuana. CONCLUSION These data provide a 'global correlation' between substance use and engagement in sexual behaviors among Bahamian adolescents. Longitudinal research is needed to assess event specific risks and identify mediating and moderating factors. These findings indicate the importance of integrating reproductive health and substance use education.
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23
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Sileo KM, Kintu M, Chanes-Mora P, Kiene SM. "Such Behaviors Are Not in My Home Village, I Got Them Here": A Qualitative Study of the Influence of Contextual Factors on Alcohol and HIV Risk Behaviors in a Fishing Community on Lake Victoria, Uganda. AIDS Behav 2016; 20:537-47. [PMID: 25921303 PMCID: PMC4626436 DOI: 10.1007/s10461-015-1077-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Uganda, elevated HIV prevalence in fishing communities along Lake Victoria have been attributed in part to heavy alcohol use, but qualitative research is needed to understand the contextual factors influencing alcohol and sexual risk. Eight focus group discussions were conducted (n = 50; 23 male, 27 female) in Gerenge, Uganda with five occupational groups: fishermen, fishmongers, alcohol-sellers, commercial sex workers, and restaurant owners. Data was analyzed using content analysis. Alcohol use was prevalent and said to influence risky sex. Sex-related alcohol expectancies and occupational factors influenced individuals to drink during sex and structural factors related to the built environment, economy, and policy were identified as key contributors to both alcohol use and sexual risk in general. The findings highlight alcohol reduction as an important component of HIV/AIDS prevention and suggest structural interventions should be prioritized in this context.
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Affiliation(s)
- Katelyn M Sileo
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Michael Kintu
- Wakiso Integrated Rural Development Association, Entebbe, Uganda
| | - Paola Chanes-Mora
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA
| | - Susan M Kiene
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA.
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA.
- Alcohol Research Center on HIV, Brown University School of Public Health, Providence, RI, USA.
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24
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Abdala N, Li F, Shaboltas AV, Skochilov RV, Krasnoselskikh TV. History of Childhood Abuse, Drinking Motives, Alcohol Use, and Sexual Risk Behavior Among STD Clinic Patients in St. Petersburg, Russia: A Cross-Sectional Study. AIDS Behav 2016; 20:512-22. [PMID: 25801476 DOI: 10.1007/s10461-015-1043-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The relationship between level of childhood abuse (physical and emotional) and sexual risk behavior of sexually transmitted disease clinic patients in St. Petersburg, Russia was examined through path analyses. Mediating variables investigated were: Alcohol Use Disorder Identification Test (AUDIT), drinking motives (for social interaction, to enhance mood, to facilitate sexual encounters), intimate partner violence (IPV), anxiety, and depression symptoms. Results showed a significant indirect effect of childhood abuse on women's sexual risk behavior: higher level of childhood abuse was associated with a greater likelihood of IPV, motivations to drink, leading to higher AUDIT scores and correlated to higher likelihood of having multiple, new or casual sexual partner(s). No significant effect was identified in paths to condom use. Among men, childhood abuse had no significant effect on sexual risk behavior. Reduction in alcohol-related sexual risk behavior may be achieved by addressing the effects of childhood abuse among female participants.
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Affiliation(s)
- Nadia Abdala
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Fangyong Li
- Yale Center for Analytical Sciences, Yale School of Public Health, 300 George Street, New Haven, CT, 06520, USA
| | - Alla V Shaboltas
- Department of Psychology, Saint Petersburg State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Roman V Skochilov
- Department of Psychology, Saint Petersburg State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Tatiana V Krasnoselskikh
- Department of Dermatology and Venereology, First Pavlov State Medical University of St. Petersburg, 6-8 L'va Tolstogo Str., St Petersburg, 197022, Russian Federation
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25
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Celio MA, MacKillop J, Caswell AJ, Mastroleo NR, Kahler CW, Barnett NP, Colby SM, Operario D, Monti PM. Interactive Relationships Between Sex-Related Alcohol Expectancies and Delay Discounting on Risky Sex. Alcohol Clin Exp Res 2016; 40:638-46. [PMID: 26891345 DOI: 10.1111/acer.12988] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 12/13/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affect her or his sexual behavior. Sex-related alcohol expectancies have been found to be predictors of drinking in sexual situations and engagement in risky sexual behavior after drinking. However, less is known about individual characteristics that may moderate these associations. Building upon recent evidence that steep delay discounting is associated with alcohol-related sexual risk taking, this study aimed to test the hypothesis that the associations between sex-related alcohol expectancies and alcohol-related sexual risk taking would be stronger among individuals who discount delayed rewards more steeply. METHODS The current sample comprised 126 Emergency Department patients (Mage = 27.37; 55% male) who reported high-risk alcohol use and sexual behavior during the past 3 months. Sex-related alcohol expectancies were assessed in 3 behavioral domains: increased riskiness, decreased nervousness, and enhanced sexuality. RESULTS All 3 expectancy domains were associated with quantity and frequency of alcohol use, as well as percentage of alcohol-related condomless sex. Delay discounting moderated 2 of these relationships, such that the associations between expectancies for alcohol-induced sexual risk taking and the enhancement of sexuality and percentage of alcohol-related sexual risk-taking were significantly stronger in individuals who exhibited steeper delay discounting. CONCLUSIONS These findings suggest that individuals who both discount delayed rewards more steeply and hold strong sex-related alcohol expectancies are a particularly high-risk population. Such individuals may benefit from a combination of novel preventive strategies targeting sex-related alcohol expectancies and impulsive decision making.
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Affiliation(s)
- Mark A Celio
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - James MacKillop
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.,Peter Boris Centre for Addictions Research, McMaster University, Hamilton, Ontario, Canada
| | - Amy J Caswell
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Nadine R Mastroleo
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Nancy P Barnett
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Don Operario
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
| | - Peter M Monti
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
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Freeman RC. Toward Development of Enhanced Preventive Interventions for HIV Sexual Risk among Alcohol-Using Populations: Confronting the 'Mere Pause from Thinking'. AIDS Behav 2016; 20 Suppl 1:S1-18. [PMID: 26362168 DOI: 10.1007/s10461-015-1179-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The papers in this issue detail state-of-the science knowledge regarding the role of alcohol use in HIV/AIDS risk, as well as offer suggestions for ways forward for behavioral HIV prevention for at-risk alcohol-using populations. In light of recent evidence suggesting that the anticipated uptake of the newer biomedical HIV prevention approaches, prominently including pre-exposure prophylaxis, has been stalled owing to a host of barriers, it has become ever more clear that behavioral prevention avenues must continue to receive due consideration as a viable HIV/AIDS prevention approach. The papers collected here make a valuable contribution to "combination prevention" efforts to curb HIV spread.
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Affiliation(s)
- Robert C Freeman
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 2073 MSC 9304, Bethesda, MD, 20892-9304, USA.
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Alcohol Use Predicts Number of Sexual Partners for Female but not Male STI Clinic Patients. AIDS Behav 2016; 20 Suppl 1:S52-9. [PMID: 26310596 DOI: 10.1007/s10461-015-1177-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study tested the hypothesis that greater alcohol involvement will predict number of sexual partners to a greater extent for women than for men, and that the hypothesized sex-specific, alcohol-sexual partner associations will hold when controlling for alternative sex-linked explanations (i.e., depression and drug use). We recruited 508 patients (46 % female, 67 % African American) from a public sexually transmitted infections (STI) clinic. Participants reported number of sexual partners, drinks per week, maximum drinks per day, frequency of heavy drinking; they also completed the AUDIT-C and a measure of alcohol problems. As expected, men reported more drinking and sexual partners. Also as expected, the association between alcohol use and number of partners was significant for women but not for men, and these associations were not explained by drug use or depression. A comprehensive prevention strategy for women attending STI clinics might include alcohol use reduction.
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Kiene SM, Simbayi LC, Abrams A, Cloete A. Alcohol Expectancies and Inhibition Conflict as Moderators of the Alcohol-Unprotected Sex Relationship: Event-Level Findings from a Daily Diary Study Among Individuals Living with HIV in Cape Town, South Africa. AIDS Behav 2016; 20 Suppl 1:S60-73. [PMID: 26280530 DOI: 10.1007/s10461-015-1157-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Literature from sub-Saharan Africa and elsewhere supports a global association between alcohol and HIV risk. However, more rigorous studies using multiple event-level methods find mixed support for this association, suggesting the importance of examining potential moderators of this relationship. The present study explores the assumptions of alcohol expectancy theory and alcohol myopia theory as possible moderators that help elucidate the circumstances under which alcohol may affect individuals' ability to use a condom. Participants were 82 individuals (58 women, 24 men) living with HIV who completed daily phone interviews for 42 days which assessed daily sexual behavior and alcohol consumption. Logistic generalized estimating equation models were used to examine the potential moderating effects of inhibition conflict and sex-related alcohol outcome expectancies. The data provided some support for both theories and in some cases the moderation effects were stronger when both partners consumed alcohol.
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Guzmán BL, Kouyoumdjian C. Inhalant Use in Latina Early Adolescent Girls. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015. [DOI: 10.1080/1067828x.2014.918004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nash SD, Katamba A, Mafigiri DK, Mbulaiteye SM, Sethi AK. Sex-related alcohol expectancies and high-risk sexual behaviour among drinking adults in Kampala, Uganda. Glob Public Health 2015; 11:449-62. [PMID: 26315308 DOI: 10.1080/17441692.2015.1068824] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Alcohol consumption, a risk factor for HIV transmission in sub-Saharan Africa, is considered high in Uganda. A cross sectional study was conducted to determine whether sex-related expectations about the effects of alcohol explain the association between alcohol use and risky sexual behaviours in a population-based sample of adults in Kampala. Associations between alcohol use (current and higher risk drinking) and high-risk sexual behaviours (multiple regular partners and casual sex) were tested. In age-sex-adjusted models, having multiple regular partners was associated with current drinking (odds ratio [OR] = 2.76, 95% confidence intervals [CIs] = 1.15, 6.63) and higher risk drinking (OR = 3.35, 95% CI = 1.28, 8.71). Associations were similar but not statistically significant for having a causal sex partner. Sex-related alcohol outcome expectancy was associated with both alcohol use and high-risk sexual behaviour and attenuated relationships between multiple regular partners and both current drinking (OR = 1.94, 95% CI = 0.57, 6.73) and higher risk drinking (OR = 2.44, 95% CI = 0.68, 8.80). In this setting sexual behaviours related with alcohol consumption were explained, in part, by sex-related expectations about the effects of alcohol. These expectations could be an important component to target in HIV education campaigns.
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Affiliation(s)
- Scott D Nash
- a Trachoma Control Program, The Carter Center , Atlanta , GA , USA
| | - Achilles Katamba
- b Department of Medicine , Makerere University School of Medicine , Kampala , Uganda
| | - David Kaawa Mafigiri
- c Department of Social Work and Social Administration, Center for Social Science Research on AIDS , Makerere University School of Social Sciences , Kampala , Uganda
| | - Sam M Mbulaiteye
- d Division of Cancer Epidemiology and Genetics, Department of Health and Human Services , National Cancer Institute, National Institutes of Health , Bethesda , MD , USA
| | - Ajay K Sethi
- e Department of Population Health Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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Underage college students' alcohol displays on Facebook and real-time alcohol behaviors. J Adolesc Health 2015; 56:646-51. [PMID: 26003580 PMCID: PMC4492797 DOI: 10.1016/j.jadohealth.2015.02.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE College is often a time of alcohol use initiation and displayed Facebook alcohol references. The purpose of this longitudinal study was to determine associations between initial references to alcohol on social media and college students' self-reported recent drinking, binge drinking, and excessive drinking. METHODS First-year students from two U.S. public universities were randomly selected from registrar lists for recruitment. Data collection included 2 years of monthly Facebook evaluation. When an initial displayed Facebook alcohol reference was identified, these "New Alcohol Displayers" were contacted for phone interviews. Phone interviews used the validated timeline followback method to evaluate recent alcohol use, binge episodes, and excessive drinking. Analyses included calculation of positive predictive value and Poisson regression. RESULTS A total of 338 participants were enrolled; 56.1% participants were female, 74.8% were Caucasian, and 58.8% were from the Midwestern University. A total of 167 (49.4%) participants became new alcohol displayers during the first 2 years of college. Among new alcohol displayers, 78.5% reported past 28-day alcohol use. Among new alcohol displayers who reported recent alcohol use, 84.9% reported at least one binge episode. Posting an initial Facebook alcohol reference as a profile picture or cover photo was positively associated with excessive drinking (risk ratio = 2.34; 95% confidence interval, 1.54-3.58). CONCLUSIONS Findings suggest positive associations between references to alcohol on social media and self-reported recent alcohol use. Location of initial reference as a profile picture or cover photo was associated with problematic drinking and may suggest that a student would benefit from clinical investigation or resources.
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Patrick ME, Maggs JL, Lefkowitz ES. Daily Associations Between Drinking and Sex Among College Students: A Longitudinal Measurement Burst Design. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2015; 25:377-386. [PMID: 26052189 PMCID: PMC4452129 DOI: 10.1111/jora.12135] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Daily links between alcohol use and sexual behaviors were examined in a longitudinal study of college students. Hierarchical linear models predicted sexual behaviors by characteristics of persons (N=731; Level 3), semesters (N=4,345, Level 2), and days (N=56,372, Level 1). On a given day, consuming more drinks and binge drinking were associated with greater odds of kissing, touching, oral sex, and penetrative sex. Consistent with alcohol myopia and expectancy theories, associations between binge drinking and sexual behaviors were stronger for students not in romantic relationships, for students with stronger alcohol-sex expectancies, and for oral and penetrative sex. Findings suggest that within-day links between alcohol use and sexual behaviors are evident across college, with variations based on individual and relationship factors.
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Affiliation(s)
- Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106-1248; Phone: 1-734-763-7107; Fax: 1-734-936-0043
| | - Jennifer L. Maggs
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA 16802
| | - Eva S. Lefkowitz
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA 16802
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Eaton NR, Thompson RG, Hu MC, Goldstein RB, Saha TD, Hasin DS. Regularly Drinking Alcohol Before Sexual Activity in a Nationally Representative Sample: Prevalence, Sociodemographics, and Associations With Psychiatric and Substance Use Disorders. Am J Public Health 2015; 105:1387-93. [PMID: 25973812 DOI: 10.2105/ajph.2015.302556] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We addressed regular drinking before sex and its associated risk factors. METHODS From the wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative adult US sample (fielded 2004-2005), we determined the 12-month prevalence of regularly drinking alcohol before sexual activity. Among 17,491 sexually active drinkers, we determined the sociodemographic, psychiatric, and substance use correlates of regularly drinking before sex. RESULTS Regular presex drinking's 12-month prevalence was 1.8%. Significant bivariate sociodemographic correlates were age, gender, race/ethnicity, education, family income, marital status, and employment status. Generalized anxiety disorder and alcohol dependence were associated with significantly increased odds of being a regular presex drinker after controlling for covariates. CONCLUSIONS We estimate that 4.3 million American adults are regular presex drinkers. Future research should examine this public health issue at the population level, with particular focus on pathways that link it to psychopathology.
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Affiliation(s)
- Nicholas R Eaton
- Nicholas R. Eaton is with the Department of Psychology, Stony Brook University, Stony Brook, NY. Ronald G. Thompson Jr, Mei-Chen Hu, and Deborah S. Hasin are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY. Risë B. Goldstein and Tulshi D. Saha are with the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD
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Logan DE, Koo KH, Kilmer JR, Blayney JA, Lewis MA. Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students. JOURNAL OF SEX RESEARCH 2014; 52:558-569. [PMID: 25350078 PMCID: PMC4412788 DOI: 10.1080/00224499.2014.964167] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.
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Affiliation(s)
- Diane E. Logan
- Department of Behavioral and Social Sciences; Brown University
| | - Kelly H. Koo
- Department of Mental Health; San Francisco VA Medical Center
- Department of Psychiatry; University of California, San Francisco
| | - Jason R. Kilmer
- Department of Psychiatry and Behavioral Sciences; University of Washington
- Health & Wellness, Division of Student Life; University of Washington
| | | | - Melissa A. Lewis
- Department of Psychiatry and Behavioral Sciences; University of Washington
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Hutton HE, McCaul ME, Norris J, Valliant JD, Abrefa-Gyan T, Chander G. Sex-Related Alcohol Expectancies Among African American Women Attending an Urban STI Clinic. JOURNAL OF SEX RESEARCH 2014; 52:580-589. [PMID: 25110958 PMCID: PMC4324376 DOI: 10.1080/00224499.2014.931336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
African American women are disproportionately affected by human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and sexually transmitted infections (STIs). Alcohol use is a significant risk factor for HIV/STI acquisition. Sex-related alcohol expectancies (SRAEs) may partially account for alcohol-related risky sexual behaviors. Using qualitative interviews we explored the link between alcohol use and risky sex among 20 African American women attending an STI clinic who had consumed four or more alcoholic drinks per drinking day (binge drinking) and/or reported vaginal or anal sex while under the influence of alcohol. Four SRAEs emerged, which we named drink for sexual desire, drink for sexual power, drink for sexual excuse, and drink for anal sex. While the desire SRAE has been documented, this study identified three additional SRAEs not currently assessed by expectancy questionnaires. These SRAEs may contribute to high-risk sex when under the influence of alcohol and suggests the importance of developing integrated alcohol-sexual risk reduction interventions for high-risk women.
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Affiliation(s)
- Heidi E. Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD 21287 USA
| | - Mary E. McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD 21287 USA
| | - Jeanette Norris
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA 98105 USA
| | - Julia D. Valliant
- Illinois Children's Environmental Health Research Center, and Family Resiliency Center, University of Illinois, Urbana-Champagne, Urbana, IL 61801 USA
| | - Tina Abrefa-Gyan
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD 21201 USA
| | - Geetanjali Chander
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
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Abstract
This study uses data from the 2004-05 Tanzanian Demographic and Health Survey to examine whether men's traditional gender role attitudes contribute to their sexual risk behaviours for HIV. Logistic regression with random effects were used to analyze effects on risk behaviours at last sex (partners being drunk and condom use) with the three most recent sexual relationships. Men's traditional gender attitudes increased risky sexual behaviours (e.g., not using a condom) even when they had accurate knowledge regarding HIV risks. The impact of men's gender attitudes and HIV knowledge on risky sexual behaviours did not vary by relationship type. Unexpectedly, condom use was more likely when either partner was drunk compared to neither being drunk, though the protective impact of HIV knowledge remained. Overall, these findings suggest that traditional gender attitudes present barriers to preventing HIV/AIDS that even increased knowledge about HIV risks may not overcome.
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Walsh JL, Fielder RL, Carey KB, Carey MP. Do alcohol and marijuana use decrease the probability of condom use for college women? JOURNAL OF SEX RESEARCH 2014; 51:145-58. [PMID: 24164105 PMCID: PMC3946721 DOI: 10.1080/00224499.2013.821442] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Alcohol and marijuana use are thought to increase sexual risk taking, but event-level studies conflict in their findings and often depend on reports from a limited number of people or on a limited number of sexual events per person. With event-level data from 1,856 sexual intercourse events provided by 297 college women (M age = 18 years; 71% White), we used multilevel modeling to examine associations between alcohol and marijuana use and condom use as well as interactions involving sexual partner type and alcohol-sexual risk expectancies. Controlling for alternative contraception use, partner type, regular levels of substance use, impulsivity and sensation seeking, and demographics, women were no more or less likely to use condoms during events involving drinking or heavy episodic drinking than during those without drinking. However, for drinking events, there was a negative association between number of drinks consumed and condom use; in addition, women with stronger alcohol-sexual risk expectancies were marginally less likely to use condoms when drinking. Although there was no main effect of marijuana use on condom use, these data suggest marijuana use with established romantic partners may increase risk of unprotected sex. Intervention efforts should target expectancies and emphasize the dose-response relationship of drinks to condom use.
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Affiliation(s)
- Jennifer L. Walsh
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
| | - Robyn L. Fielder
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
- Center for Health and Behavior, Syracuse University, Syracuse, NY
| | - Kate B. Carey
- Program in Public Health and Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Program in Public Health, Brown University, Providence, RI
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Devos-Comby L, Daniel J, Lange JE. Alcohol Consumption, Dating Relationships, and Preliminary Sexual Outcomes in Collegiate Natural Drinking Groups. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013; 43:2391-2400. [PMID: 26236043 DOI: 10.1111/jasp.12187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study tested the effects of committed relationships and presence of dates on alcohol consumption and preliminary sexual outcomes in natural drinking groups (NDGs). Undergraduate drinkers (N = 302) answered an online questionnaire on their most recent participation in a NDG. The interaction between relationship commitment and presence of a date on alcohol consumption was significant. Among students not in committed relationships, those dating within their NDG reported heavier drinking than those not dating. Students in committed relationships drank less than those who were not committed only when their partners were present. The positive correlation between drinking and sexual contact was significant only for those who were not in committed relationships. Implications for future research and interventions are discussed.
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Affiliation(s)
- Loraine Devos-Comby
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
| | - Jason Daniel
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
| | - James E Lange
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
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Mutchler MG, McDavitt B, Gordon KK. "Becoming bold": alcohol use and sexual exploration among Black and Latino young men who have sex with men (YMSM). JOURNAL OF SEX RESEARCH 2013; 51:696-710. [PMID: 23730733 PMCID: PMC3766459 DOI: 10.1080/00224499.2013.772086] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Alcohol use is correlated with unprotected sex, which may place young men who have sex with men (YMSM) who use alcohol with sex at increased risk for contracting HIV. However, little is known about how this link develops. This study used qualitative interviews to explore how alcohol became associated with sex and sexual risk among YMSM. We purposively sampled 20 Black and 20 Latino YMSM (N = 40), ages 21 to 24, who used substances (alcohol, marijuana, and crystal methamphetamine) with sex. Interviews focused on participants' personal histories to trace how these associations developed for each individual. Drawing on sexual script, emotion regulation, and alcohol expectancy theories, analyses followed a modified grounded theory approach. Participants stated that alcohol enabled them to engage in sexual behaviors with men that they wanted to try, allowing them to be more "bold," overcome stigma about homosexuality, and feel increased comfort with their sexual desires and identities. The use of alcohol during sex was helpful to some of the participants but could also lead to sexual risk behaviors. Intervention programs seeking to reduce alcohol misuse and sexual risk should take into account how YMSM conceptualize associations between alcohol and sex. These programs may be more effective if they provide support for sexual identity exploration.
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Affiliation(s)
- Matt G. Mutchler
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
| | - Bryce McDavitt
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
- Pacifica Graduate Institute, Carpinteria, California
| | - Kristie K. Gordon
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
- University of Alabama, Tuscaloosa
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Walsh K, Messman-Moore T, Zerubavel N, Chandley RB, DeNardi KA, Walker DP. Perceived sexual control, sex-related alcohol expectancies and behavior predict substance-related sexual revictimization. CHILD ABUSE & NEGLECT 2013; 37:353-9. [PMID: 23312991 PMCID: PMC3640682 DOI: 10.1016/j.chiabu.2012.11.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 11/19/2012] [Accepted: 11/20/2012] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Although numerous studies have documented linkages between childhood sexual abuse (CSA) and later sexual revictimization, mechanisms underlying revictimization, particularly assaults occurring in the context of substance use, are not well-understood. Consistent with Traumagenic Dynamics theory, the present study tested a path model positing that lowered perceptions of sexual control resulting from CSA may be associated with increased sex-related alcohol expectancies and heightened likelihood of risky sexual behavior, which in turn, may predict adult substance-related rape. METHODS Participants were 546 female college students who completed anonymous surveys regarding CSA and adult rape, perceptions of sexual control, sex-related alcohol expectancies, and likelihood of engaging in risky sexual behavior. RESULTS The data fit the hypothesized model well and all hypothesized path coefficients were significant and in the expected directions. As expected, sex-related alcohol expectancies and likelihood of risky sexual behavior only predicted substance-related rape, not forcible rape. CONCLUSIONS Findings suggested that low perceived sexual control stemming from CSA is associated with increased sex-related alcohol expectancies and a higher likelihood of engaging in sexual behavior in the context of alcohol use. In turn these proximal risk factors heighten vulnerability to substance-related rape. Programs which aim to reduce risk for substance-related rape could be improved by addressing expectancies and motivations for risky sexual behavior in the context of substance use. Implications and future directions are discussed.
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Affiliation(s)
- Kate Walsh
- Department of Epidemiology, Columbia University
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41
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Patel SA, Bangorn S, Aramrattana A, Limaye R, Celentano DD, Lee J, Sherman SG. Elevated alcohol and sexual risk behaviors among young Thai lesbian/bisexual women. Drug Alcohol Depend 2013; 127:53-8. [PMID: 22770462 PMCID: PMC3486947 DOI: 10.1016/j.drugalcdep.2012.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 05/21/2012] [Accepted: 06/07/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little empirical data have been published about drinking or sexual behaviors among Thai lesbians. We examine the association of sexual identity with established indicators of alcohol- and sexual-related health behaviors among female bar patrons. METHODS We conducted a cross-sectional study among women (N=121) aged 18-24 who frequented popular drinking establishments in Chiang Mai, Thailand. We used general linear modeling techniques to estimate associations between sexual identity and positive alcohol expectancy, harmful drinking, age at sexual debut, and number of lifetime sexual partners. RESULTS Nearly one-third of women aged 18-24 recruited from Chiang Mai drinking venues identified as lesbian/bisexual. As compared to their heterosexual counterparts, lesbian/bisexuals reported higher positive alcohol expectancy scores, more harmful drinking, earlier age at sexual debut, and higher number of lifetime sexual partners. In adjusted models, lesbian/bisexual identity was associated with higher positive alcohol expectancy (β=1.94 points; 95% CI: 0.75, 3.13), earlier age at sexual debut (β=-0.85 years; 95% CI: -1.46, -0.23), and higher number of lifetime sexual partners (rate ratio=1.70; 95% CI: 1.22, 2.37). CONCLUSION Lesbian/bisexual women in this study engaged in multiple behaviors that are potentially harmful to health, which may in turn place this group at heightened risk for alcohol abuse and sexually transmitted infections in Thailand. The clustering of alcohol- and sexual-related risk behaviors, and its consequences for health outcomes in this population, should be explored in future research and may be an important point of intervention.
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Affiliation(s)
- Shivani A. Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
| | - Sirirojn Bangorn
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavarorose, Muang, Chiang Mai, 50202, Thailand
| | - Apinun Aramrattana
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavarorose, Muang, Chiang Mai, 50202, Thailand
| | - Rupali Limaye
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore Maryland, 21205, USA
| | - David D. Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
| | - Jennifer Lee
- Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287
| | - Susan G. Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
- Corresponding author: Susan G. Sherman, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA, Phone: 410-614-3518, Fax: 410-955-1383,
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Abdala N, Hansen NB, Toussova OV, Krasnoselskikh TV, Kozlov AP, Heimer R. Age at first alcoholic drink as predictor of current HIV sexual risk behaviors among a sample of injection drug users (IDUs) and non-IDUs who are sexual partners of IDUs, in St. Petersburg, Russia. AIDS Behav 2012; 16:1597-604. [PMID: 21800183 DOI: 10.1007/s10461-011-0013-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study investigates whether age at first alcoholic drink is associated with sexual risk behaviors among injection drug users (IDUs) and non-IDUs who are sexual partners of IDUs in St. Petersburg, Russia. A path analysis was used to test a model of age at first drink, age at sexual debut, age at first drug use, current substance use patterns and current sexual risk behaviors among 558 participants. Results revealed that age at first drink had an effect on multiple sex partners through age at sexual debut and injection drug use, but no effect on unprotected sex. Age at first drug use was not related to sexual risk behaviors. Investigation of age of drinking onset may provide useful information for programs to reduce sexual risk behaviors and injection drug use. Different paths leading to unprotected sex and multiple sexual partners call for different approaches to reduce sexual risk behaviors among this population.
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Miller KE. Alcohol Mixed with Energy Drink Use and Sexual Risk-Taking: Casual, Intoxicated, and Unprotected Sex. JOURNAL OF CAFFEINE RESEARCH 2012; 2:62-69. [PMID: 24761266 PMCID: PMC3621311 DOI: 10.1089/jcr.2012.0015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study examined the confluence of several behaviors common to U.S. young adults: caffeinated energy drink use, alcohol use, and sexual risk-taking. The author examined relationships between the use of energy drinks mixed with alcohol (AmEDs) and three sexual risk behaviors: casual sex (i.e., intercourse with a nonexclusive and/or nonromantic partner), intoxicated sex (i.e., intercourse while under the influence of alcohol and/or illicit drugs), and unprotected sex (i.e., intercourse without use of a condom). METHOD Logistic regression analyses were employed to analyze data from a cross-sectional survey of 648 sexually active undergraduate students at a large public university. RESULTS After controlling for risk-taking norms and frequency of noncaffeinated alcohol use, AmED use was associated with elevated odds of casual sex and intoxicated sex but not unprotected sex. CONCLUSIONS Although further studies are needed to test for event-level relationships, AmED use should be considered a possible risk factor for potentially health-compromising sexual behaviors.
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Affiliation(s)
- Kathleen E Miller
- Department of Research Institute on Addictions, University at Buffalo, The State University of New York , Buffalo, New York
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Orchowski LM, Mastroleo NR, Borsari B. Correlates of alcohol-related regretted sex among college students. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:782-90. [PMID: 22448762 DOI: 10.1037/a0027840] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prevalence of alcohol-related regretted sex in college students warrants a better understanding of the characteristics of students who report such experiences. Therefore, the present study examined correlates of regretted sexual experiences involving alcohol use among 2 specific high-risk college student samples: students mandated to alcohol intervention (n = 522) and volunteer 1st-year students transitioning to college (n = 481). Results indicated that alcohol-related regretted sex occurred at similar rates in mandated and volunteer students, with approximately 25% of the students reporting at least 1 occurrence in the past month. Women were more likely to report alcohol-related regretted sex compared with men. The belief that alcohol use would result in "liquid courage" was associated with alcohol-related regretted sex among college students, even after accounting for greater alcohol use and problem alcohol use behaviors. These findings have significant implications for intervention efforts and future research.
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Affiliation(s)
- Lindsay M Orchowski
- Center for Alcohol and Addiction Studies, Warren Alpert Medical School of Brown University, Providence, RI 02912-9001, USA
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45
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Dermen KH, Thomas SN. Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2011; 25:583-94. [PMID: 21928866 PMCID: PMC3232340 DOI: 10.1037/a0025472] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.
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Affiliation(s)
- Kurt H Dermen
- Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
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46
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Daily assessment of alcohol consumption and condom use with known and casual partners among young female bar drinkers. AIDS Behav 2011; 15:1332-41. [PMID: 20949313 DOI: 10.1007/s10461-010-9829-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The relationship between alcohol and condom use has been studied extensively over the past several decades. Reviews of event-level studies suggest that alcohol's effect on risky sexual behavior are not due to simple main effects, but appear to be dependent upon individual characteristics, and situational or contextual factors. In the current study, we assessed the temporal relationship between daily alcohol consumption and unprotected sexual behavior, taking into account sexual partner type (casual or known) as well as individual and situational characteristics among a group of young female bar drinkers. Greater alcohol consumption was not associated with unprotected sex. However, greater alcohol consumption was associated with an increase in sex (protected and unprotected) with casual partners. Having less HIV knowledge was associated with increased unprotected sex, while greater frequency of drinking in bars was associated with increased protected sex with casual partners. These findings are discussed in terms of possible prevention programs that increase HIV knowledge and decrease alcohol consumption to reduce young women's risky sexual behavior.
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47
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Lopez V, Kopak A, Robillard A, Gillmore MR, Holliday RC, Braithwaite RL. Pathways to sexual risk taking among female adolescent detainees. J Youth Adolesc 2011; 40:945-57. [PMID: 21188488 PMCID: PMC3209805 DOI: 10.1007/s10964-010-9623-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 12/10/2010] [Indexed: 11/24/2022]
Abstract
Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.
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Affiliation(s)
- Vera Lopez
- Justice & Social Inquiry, Arizona State University, Tempe, AZ, USA.
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Longitudinal examination of alcohol use: a predictor of risky sexual behavior and Trichomonas vaginalis among African-American female adolescents. Sex Transm Dis 2011; 38:96-101. [PMID: 20739910 DOI: 10.1097/olq.0b013e3181f07abe] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcohol use has been linked to risky sexual practices among adolescents. However, limited research on alcohol use and risky sexual behavior has been conducted on African-American female adolescents. This study examined high quantity of alcohol as a longitudinal predictor of risky sexual behavior and sexually transmitted diseases (STDs) among African-American female adolescents, a high-risk population for STDs. METHODS Three hundred ninety-three adolescent females, 15 to 21 years, were assessed on sociodemographics, alcohol use, and risky sexual behaviors. Participants also provided 2 swab specimens that were assayed for STDs. High quantity of alcohol use was defined as ≥ 3 drinks in 1 sitting. RESULTS Binary generalized estimating equation models were conducted assessing the impact of alcohol use at baseline on risky sexual behavior and STDs over a 12-month period. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high quantity of alcohol use predicted positive TV test results, inconsistent condom use, high sexual sensation seeking, multiple sexual partners, sex while high on alcohol or drugs, and having anal sex over a 12-month follow-up period. CONCLUSIONS These findings suggest that HIV/STD-related behavioral interventions for African-American adolescents should discuss the link between alcohol and HIV/STD-risk behavior. A deeper understanding is paramount to the development of efficacious prevention programs at individual and community levels.
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Dogan SJ, Stockdale GD, Widaman KF, Conger RD. Developmental relations and patterns of change between alcohol use and number of sexual partners from adolescence through adulthood. Dev Psychol 2011; 46:1747-59. [PMID: 20677862 DOI: 10.1037/a0019655] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We explored two unanswered questions about the role of alcohol use in sexual behavior. First, we considered whether alcohol use temporally precedes and predicts changes in sexual behavior assessed as the number of sexual partners, whether the reverse pattern holds, or whether the association reflects a common, external cause. Second, we assessed whether associations between these behaviors change as adolescents transition to adulthood. These questions were addressed with a bivariate dual change latent difference score model. Drinking frequency and number of yearly sex partners were assessed 8 times across a 13-year period in a sample of 553 individuals. Assessment began when participants were in the 9th grade (age: M = 15.11 years, SD = 0.43). In addition to an association between the individual growth trajectories of these behaviors, alcohol use was a leading indicator of changes in number of sex partners throughout adolescence, but the reverse pattern was not supported. Of importance, the predictive association could not be explained by individual differences in impulsivity, excitement seeking, conduct problems, hostility/aggression, conventional attitudes, gender, or divorce. Finally, in a developmentally meaningful pattern, alcohol use ceased to significantly predict changes in the number of sexual partners as adolescents transitioned to adulthood.
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Affiliation(s)
- Shannon J Dogan
- University of California Cooperative Extension-Placer County, Auburn, CA 95603, USA.
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Kaljee LM, Green MS, Zhan M, Riel R, Lerdboon P, Lostutter TW, Tho LH, Van Luong V, Minh TT. Gender, Alcohol Consumption Patterns, and Engagement in Sexually Intimate Behaviors Among Adolescents and Young Adults in Nha Trang, Viet Nam. YOUTH & SOCIETY 2011; 43:118-141. [PMID: 21373363 PMCID: PMC3045200 DOI: 10.1177/0044118x09351285] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A randomly selected cross-sectional survey was conducted with 880 youth (16 to 24 years) in Nha Trang City to assess relationships between alcohol consumption and sexual behaviors. A timeline followback method was employed. Chi-square, generalized logit modeling and logistic regression analyses were performed. Of the sample, 78.2% male and 56.1% female respondents ever consumed alcohol. Males reporting sexual behaviors (vaginal, anal, oral sex) had a significantly higher calculated peak BAC of 0.151 compared to 0.082 for males reporting no sexual intimacy (p < .0001). Females reporting sexual behaviors had a peak BAC of 0.072 compared to 0.027 for those reporting no sexual intimacy (p = .016). Fifty percent of (33/66) males and 30.4% (7/23) females report event specific drinking and engagement in sexual behaviors. Males reporting 11+ drinks in 30 days had more sexual partners than those reporting 1 to 10 drinks (p = .037). Data suggest different physical and psychosocial mediators between alcohol consumption and sexual behaviors by gender.
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