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Jepsen D, Healy KV, Bernard M, Markert J, Brzank PJ. Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02877-7. [PMID: 38816590 DOI: 10.1007/s10508-024-02877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 06/01/2024]
Abstract
Sexual risk behavior (SRB) includes behavioral (sex without contraception, sexualized substance use, sex work, sexual partner violence, other sexual activities that harm oneself or others) and affective subtypes (sexuality-related feelings of shame/guilt, relationship impairments) and leads to psychosocial and health-related consequences. Young adults comprise a vulnerable group regarding the development of SRB. The study aimed to identify SRB patterns among young adults and their relation to sexuality-related risk factors. A cross-sectional online survey measured behavioral and affective aspects of SRB with nine items. Latent class analysis was conducted to identify patterns of SRB. Gender, sexual orientation, age of first intercourse, number of sexual partners, hypersexuality, and sexual dysfunction were captured as risk factors via multinomial logistic regression. Within this convenience sample (n = 609; nfemale = 365; nmale = 245; Mage = 23.1 years), the SRB patterns unremarkable (67%; low values in all SRB subtypes), shame-ridden (17%; high values in sexual feelings of shame/guilt) and risky sexual behavior (16%; high values in all subtypes of SRB, especially sexualized drug use) were identified. The shame-ridden and risky patterns were strongly associated with higher hypersexuality values, the risky pattern moreover with being non-heterosexual, of younger age at first sexual experience, and a higher number of sexual partners. Male and sexual minority participants demonstrated SRB more often than females and heterosexuals. Within prevention and treatment of SRB, it seems beneficial to address sexuality-related feelings of shame/guilt and addictive patterns (concerning sexual behaviors/substances) via gender- and diversity-sensitive measurements.
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Affiliation(s)
- Dennis Jepsen
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany.
| | - Karl Vince Healy
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Marie Bernard
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Jenny Markert
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Petra J Brzank
- Institue of Social Medicine, Rehabilitation Sciences and Healthcare Research, University of Applied Sciences Nordhausen, Nordhausen, Germany
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Smith BD, Spencer BH, Nur-Singletary Z, Adane N, Moser N, Powell TW. Assessing the association between safety perceptions and communication about sex and drugs among Black adolescents exposed to adversity. J Trauma Stress 2024. [PMID: 38602222 DOI: 10.1002/jts.23044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
The present study examined the association between safety perceptions and communication with a trusted adult about sex and drugs among Black adolescents exposed to adverse childhood experiences (ACEs) and the role of gender as a potential moderator in this association. Data were drawn from a small, randomized control pilot test of an adapted evidence-based intervention conducted from 2022 to 2023 in Baltimore, Maryland. The sample included 57 Black adolescents who had been exposed to ACEs (Mage = 15.14 years, SD = 0.81l; 47.4% female, 52.6% male). Information about safety perceptions, health communication, health behaviors, and demographic characteristics was measured using an electronic survey at baseline. Group differences by gender emerged among ACEs and substance use behaviors. Safety perceptions were significantly associated with communication with a trusted adult, B = 0.31, SE = 0.24, p = .039. As youth felt more unsafe, their communication with a trusted adult about sex and drugs increased; this association did not differ by gender. Health communication was also associated with ACEs. Black adolescents living with a parent with mental health challenges reported increased communication, B = 0.60, SE = 0.20, p = .005, whereas youth experiencing homelessness had reduced health communication, B = -0.63, SE = 0.24, p = .012. A lack of perceived safety significantly impacts health communication; however, having trusted adults outside of the home, school, and neighborhood can serve as a protective factor in reducing substance use and sexual risk-taking among this population.
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Affiliation(s)
- Bianca D Smith
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bailey Holmes Spencer
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Nancy Adane
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Naya Moser
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Terrinieka W Powell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bishop AS, Nurius PS, Walker SC, Oxford ML. Sexual health variation among gang-involved youth in Washington state: Social ecological implications for research and practice. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024; 56:16-29. [PMID: 38391121 PMCID: PMC11026090 DOI: 10.1111/psrh.12251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Gang-involved youth experience greater disparities in sexual health compared to non-gang-involved youth. Yet, little is known about how and why sexual behaviors vary within the youth gang population. Developing relevant and effective service approaches requires an understanding of this variation and the environmental factors that influence patterns of sexual health risk. METHODOLOGY AND RESULTS Using latent class analysis, we identified four sexual behavior classes within a school-based sample of gang-involved youth in Washington State (N = 2060): Non-Sexually Active (54%), Limited Partners with Condom Use (14%), Multiple Partner with Sexting (19%), and High Sexual Vulnerability (13%). These classes were distinguished by age at sexual debut, number of sexual partners, condom use, and sexting. Interpersonal and macrosocial factors differentiated the classes, including multiform violence exposures, limited social support, and socioeconomic instability. We also found differences according to sexual identity and substance use. DISCUSSION Findings highlight the need for service approaches that are responsive to both the individual needs of gang-involved youth and the factors that shape their living environments. We discuss the implications for research and practice, including the potential utility of a harm reduction framework to promote sexual health and reduce disparities in the youth gang population.
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Affiliation(s)
- Asia S Bishop
- School of Social Work and Criminal Justice, University of Washington Tacoma, Tacoma, Washington, USA
- School of Social Work, University of Washington Seattle, Seattle, Washington, USA
| | - Paula S Nurius
- School of Social Work, University of Washington Seattle, Seattle, Washington, USA
| | - Sarah C Walker
- CoLab for Community and Behavioral Health Policy, Department of Psychiatry and Behavioral Health Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Monica L Oxford
- Barnard Center for Infant Mental Health and Development, School of Nursing, University of Washington, Seattle, Washington, USA
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Lardier DT, Davis AN, Verdezoto CS, Cruz L, Magliulo S, Herrera A, Garcia-Reid P, Reid RJ. Latent Class Groups of Concurrent Substance Use Among Adolescents in an Urban Community: Correlates With Mental Health, Access to Drugs and Alcohol, and Risk Perception. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:124-135. [PMID: 38258859 DOI: 10.1177/29767342231207192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of this study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations. METHOD This study examined data among adolescents in an underserved urban community (N = 1789; 56.90% female; 70.86% Hispanic/Latino/a; meanage = 15.96 ± 1.56). Using latent class analysis (LCA) and multinomial logistic regression modeling, analyses identified independent correlates of latent class membership. RESULTS Five latent classes (LC) were identified including LC group 1: Predominant alcohol use and limited to no concurrent-drug use (n = 213; 11.9%); LC group 2: Concurrent drug and alcohol use including methamphetamine, marijuana and synthetic marijuana use, and alcohol use (n = 74; 4.2%); LC group 3: Concurrent drug and alcohol use, with no marijuana use (n = 204; 11.39%); LC group 4: High Concurrent drug use and alcohol use (n = 204; 11.40%); and LC group 5: Concurrent drug use without alcohol use (n = 1101; 61.52%). Significant between group differences were noted between latent class groups and sociodemographic characteristics. Multinomial logistic regression models identified the associations between sociodemographic characteristics and corollary clinical features of substance use on latent class groupings of alcohol and concurrent drug use. CONCLUSION Understanding concurrent substance use LC groups among adolescents is essential to providing targeted interventions and treatment programs, as well as early intervention programs that may help reduce substance use during adolescence.
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Affiliation(s)
- David T Lardier
- Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health, The University of New Mexico School of Medicine, The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Alexandra N Davis
- College of Education and Human Sciences, Department of Individual, Family and Community Education, The University of New Mexico, Albuquerque, NM, USA
| | - Carolina S Verdezoto
- Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health, The University of New Mexico School of Medicine, The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- College of Education and Human Sciences, Department of Individual, Family and Community Education, The University of New Mexico, Albuquerque, NM, USA
| | - Lynda Cruz
- College of Education and Human Sciences, Department of Individual, Family and Community Education, The University of New Mexico, Albuquerque, NM, USA
| | - Sabrina Magliulo
- College for Community Health, Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Andriana Herrera
- College for Community Health, Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Pauline Garcia-Reid
- College for Community Health, Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Robert J Reid
- College for Community Health, Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
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Beal SJ, Greiner MV, Ammerman RT, Mara CA, Nause K, Schulenberg J, Noll JG. Patterns of substance use among adolescents in and out of foster care: An analysis of linked health and child welfare administrative data. CHILD ABUSE & NEGLECT 2023; 146:106473. [PMID: 37801757 PMCID: PMC10841651 DOI: 10.1016/j.chiabu.2023.106473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Young adults with a history of foster care have higher risk for substance use disorders. Social systems can deliver substance use prevention to youth; however, the timing of intervention delivery and how needs differ for youth in foster care are unclear. OBJECTIVE To compare initiation and rates of substance use among adolescents in foster care to demographically similar adolescents never in foster care as identified by the healthcare system, and identify factors associated with increased substance use. PARTICIPANTS AND SETTING Youth in foster care (n = 2787, ages 10-20, inclusive) and demographically matched youth never in foster care (n = 2787) were identified using linked child welfare and electronic health records from a single pediatric children's hospital and county over a five-year period (2012-2017). METHODS All healthcare encounters were reviewed and coded for substance use by type (alcohol, tobacco, cannabis, other). Age of first reported or documented substance use was also captured. Demographic and child welfare information was extracted from administrative records. Survival and logistic regression models were estimated. RESULTS In adjusted models, youth in foster care initiated substance use at earlier ages (HR = 2.50, p < .01) and had higher odds of engaging in use (AOR = 1.54; p < .01) than youth never in care. By age 12, substance use initiation was more likely while youth were in foster care than when they were not in foster care (HR = 1.42, p < .01). Placement stability and family care settings reduced odds of lifetime substance use. CONCLUSIONS Foster care placement is associated with substance use. Screening may be important for prevention.
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Affiliation(s)
- Sarah J Beal
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
| | - Mary V Greiner
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Robert T Ammerman
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Constance A Mara
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Katie Nause
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - John Schulenberg
- Human Development and Family Studies, Child Maltreatment Solutions Network, Pennsylvania State University, State College, PA, USA
| | - Jennie G Noll
- Department of Psychology, University of Rochester, Rochester, NY, USA; Human Development and Family Studies, Child Maltreatment Solutions Network, Pennsylvania State University, State College, PA, USA
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Kundu LR, Al Masud A, Islam Z, Hossain J. Clustering of health risk behaviors among school-going adolescents in Mymensingh district, Bangladesh. BMC Public Health 2023; 23:1850. [PMID: 37740226 PMCID: PMC10517506 DOI: 10.1186/s12889-023-16766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Adolescents frequently engage in risky behaviors that negatively influence their health and pose a serious public health concern. This study aimed to examine the clustering pattern of health risk behaviors among school-going adolescents in Bangladesh. METHODS A cross-sectional study was conducted from 15 April to 27 June 2022 among 412 school-going adolescents in Mymensingh district of Bangladesh through a convenience sampling technique. Data were collected via face-to-face interviews using a modified Global School-Based Student Health Survey (GSHS) 2021 questionnaire. Cluster membership was identified using the k-means clustering algorithm. The chi-square test was adopted to explore the association between sociodemographic variables and each cluster membership. The ordinal logistic regression model was employed to examine the predictors associated with cluster membership. RESULTS Most of the respondents were female (55.3%) and belonged to the 16-19 years (74.5%) age group. Three behavioral clusters were identified, including Cluster 1: Low-risk taker (50.2%), Cluster 2: Moderate risk taker (39.6%), and Cluster 3: High-risk taker (10.2%). Influential factors of high-risk behavior among adolescents were significantly associated with their age (p = 0.03), father's education who were illiterate (p = 0.02), monthly family income >30000 BDT (p = 0.04), parent's those were understanding their child's problems in most of the time (p = 0.001). CONCLUSIONS The study found that high-risk behaviors are significantly higher among late adolescents, those whose fathers are illiterate, whose monthly income is higher, those whose parents or guardians never realize their child's complications and worries, and those whose parents or guardians never recognize what they did in their leisure time. These findings will help to develop intervention programs, policies, strategies, and curricula in school by the experts following the necessity to adopt the adolescent toward healthy behavior and help to reduce the prevalence of health risk behavior.
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Affiliation(s)
- Lakshmi Rani Kundu
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Abdullah Al Masud
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Zohurul Islam
- Department of Public Health, Hamdard University Bangladesh, Gazaria, Munshiganj, 1510, Bangladesh
| | - Jamil Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
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Kintu TM, Kaggwa MM, Namagembe R, Muganzi DJ, Kihumuro BR, Luyinda GS, Nabwana BW, Moses M, Nnyombi M, Kirega A, Kabakyenga JK, Maling S. Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior. BMC Psychiatry 2023; 23:505. [PMID: 37438721 DOI: 10.1186/s12888-023-04989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population. METHODS This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio. RESULTS We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ2 = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001). CONCLUSION AUD, depression and anxiety are a significant burden in this health professional student population and there's need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.
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Affiliation(s)
- Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Robinah Namagembe
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Bernard Raymond Kihumuro
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Garvin Ssali Luyinda
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | | | - Muwanguzi Moses
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Marvin Nnyombi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Alex Kirega
- Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Jerome Kahuma Kabakyenga
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Baiden P, Onyeaka HK, Aneni K, Wood B, LaBrenz CA, Muoghalu C, Peoples JE, Szlyk HS, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA, Cavazos-Rehg P. Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States. Drug Alcohol Depend 2023; 248:109894. [PMID: 37167795 PMCID: PMC11003345 DOI: 10.1016/j.drugalcdep.2023.109894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample. METHODS Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents. RESULTS About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use. CONCLUSION Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA02478, USA
| | | | - Bethany Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Chioma Muoghalu
- Plains Regional Medical Center, Clovis, New Mexico, NM88101, USA
| | - JaNiene E Peoples
- The Brown School at Washington University in St. Louis, One Brookings Drive, St. Louis, MO63130, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
| | | | - John F Baiden
- East Airport International School, P.O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, OntarioN6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P.O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX76019, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
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Brick LA, Benca-Bachman CE, Johnson EC, Gustavson DE, Carper M, Palmer RHC. Genetic associations among internalizing and externalizing traits with polysubstance use among young adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.04.23287779. [PMID: 37066212 PMCID: PMC10104191 DOI: 10.1101/2023.04.04.23287779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Though most genetic studies of substance use focus on specific substances in isolation or generalized vulnerability across multiple substances, few studies to date focus on the concurrent use of two or more substances within a specified time frame (i.e., polysubstance use; PSU). We evaluated whether distinct genetic factors underlying internalizing and externalizing traits were associated with past 30-day PSU above variance shared across general psychopathology and substance use (SU). Using Genomic Structural Equation Modeling, we constructed theory-driven, multivariate genetic factors of 16 internalizing, externalizing, and SU traits using genome-wide association studies (GWAS) summary statistics. Next, we fit a model with a higher order SU-related psychopathology factor as well as genetic variance specific to externalizing and internalizing (i.e., residual genetic variance not explained by SU or general psychopathology). GWAS-by-subtraction was used to obtain single nucleotide polymorphism effects on each of these factors. Polygenic scores (PGS) were then created in an independent target sample with data on PSU, the National Longitudinal Study of Adolescent to Adult Health. To evaluate the effect of genetic variance due to internalizing and externalizing traits independent of variance related to SU, we regressed PSU on the PGSs, controlling for sex, age, and genetic principal components. PGSs for SU-related psychopathology and non-SU externalizing traits were associated with higher PSU factor scores, while the non-SU internalizing PGS was not significantly associated with PSU. In total, the three PGSs accounted for an additional 4% of the variance in PSU above and beyond a null model with only age, sex, and genetic principal components as predictors. These findings suggest that there may be unique genetic variance in externalizing traits contributing to liability for PSU that is independent of the genetic variance shared with SU.
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Affiliation(s)
- Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Providence VA Medical Center, Providence, Rhode Island, USA
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, Georgia, USA
| | - Chelsie E Benca-Bachman
- Providence VA Medical Center, Providence, Rhode Island, USA
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, Georgia, USA
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Daniel E. Gustavson
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Matthew Carper
- Department of Clinical Psychology, William James College, Newton, Massachusetts, USA
| | - Rohan HC Palmer
- Providence VA Medical Center, Providence, Rhode Island, USA
- Behavioral Genetics of Addiction Laboratory, Department of Psychology at Emory University, Atlanta, Georgia, USA
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Reis LF, Surkan PJ, Atkins K, Garcia-Cerde R, Sanchez ZM. Risk Factors for Early Sexual Intercourse in Adolescence: A Systematic Review of Cohort Studies. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01519-8. [PMID: 36966237 PMCID: PMC10039773 DOI: 10.1007/s10578-023-01519-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/27/2023]
Abstract
This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse.
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Affiliation(s)
- Larissa F Reis
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, 4° andar, São Paulo, SP, Brasil
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Sao Paulo, Brazil
| | - Kaitlyn Atkins
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Sao Paulo, Brazil
| | - Rodrigo Garcia-Cerde
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, 4° andar, São Paulo, SP, Brasil
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, 4° andar, São Paulo, SP, Brasil.
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Kang W. Illegal drug use is associated with poorer life satisfaction and self-rated health (SRH) in young people. Front Psychiatry 2023; 14:955626. [PMID: 36896345 PMCID: PMC9988934 DOI: 10.3389/fpsyt.2023.955626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Illegal drugs can bring negative health and psychological health consequences to people who use them. However, much less is known about illegal drug use and its association with life satisfaction and self-rated health (SRH) in young people in the context of the United Kingdom, which is important because SRH and life satisfaction are associated with important outcomes including morbidity and mortality. By analyzing data from a nationally representative sample with 2,173 people who do not use drugs and 506 people who use illegal drugs aged between 16 and 22 (mean = 18.73 ± 1.61) years old from Understanding Society: the UK Household Longitudinal Study (UKHLS) using a train-and-test approach and one-sample t-tests, the current study found that illegal drug use is negatively associated with life satisfaction (t(505) = -5.95, p < 0.001, 95% CI [-0.58, -0.21], Cohen's d = -0.26) but not with SRH. Intervention programs and campaigns should be developed to prevent people from using illegal drugs, which may then avoid the negative consequence of poor life satisfaction associated with illegal drug use.
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Affiliation(s)
- Weixi Kang
- Imperial College London, London, United Kingdom
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Gill A, Felker-Kantor E, Cunningham-Myrie C, Greene LG, Lyew-Ayee P, Atkinson U, Abel W, Anderson SG, Theall KP. Neighborhoods and adolescent polysubstance use in Jamaica. PeerJ 2023; 11:e14297. [PMID: 36815978 PMCID: PMC9933737 DOI: 10.7717/peerj.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 10/03/2022] [Indexed: 02/15/2023] Open
Abstract
Background The purpose of this study was to identify latent classes of polysubstance use among adolescents in Jamaica and the role of neighborhood factors in the association with polysubstance use class membership. Methods This secondary analysis utilized a national cross-sectional household drug use survey conducted across 357 households in Jamaica (April 2016-July 2016) among a total of 4,625 individuals. A total of 750 adolescents (11-17 years) were included in this analysis. Latent class analysis (LCA) was conducted to identify polysubstance use patterns as well as latent neighborhood constructs. Neighborhood factors included social disorganization, concentrated disadvantage, community resources, community violence, and police station concentration. Multinomial regression analysis was implemented to evaluate the association between polysubstance use class membership and latent classes of neighborhood factors. Result The prevalence of lifetime polysubstance use was 27.56%. Four classes of polysubstance use were identified by comparing a series of five class models. The Bootstrap Likelihood Ratio Test (BLRT) indicated a good fit for the four-class model (<0.001). The prevalence of alcohol latent classes was: (1) heavy alcohol users and experimental smokers (Class I) (15.20%), (2) most hazardous polysubstance users (Class II) (5.33%), (3) heavy smokers and moderate alcohol users (Class III) (7.07%), and (4) experimental alcohol users (Class IV) (72.44%). Three classes of neighborhoods were identified by comparing a series of four-class models. The prevalence of the neighborhood classes was: (1) low social disorganization and disadvantage (Class I) (58.93%), (2) high social disorganization and moderate disadvantage (Class II) (10.93%), and (3) high social disorganization related to perceived drug use and disadvantage (Class III) (30.13%). The BLRT indicated a good fit for the three-class model (p = < 0.004). Multinomial regression analysis indicated that adolescents living in neighborhoods with high disorder and moderate disadvantage (Class II) were 2.43 times (odds ratio (OR)) = 2.43, confidence interval (CI)) = 1.30-4.56) more likely to be heavy alcohol users and experimental smokers (Class I) compared to experimental alcohol users, adjusting for sex, age, ethnicity, religion, and income. Class II of neighborhood classes presented with the highest levels of community violence (100%), perceived disorder crime (64.6%), police station concentration (6.7%), and community resources (low resources is 87.6%), while the concentrated disadvantage was moderate (14.8%). Conclusions Alcohol polysubstance use latent classes were identified among youth in this context. Neighborhoods with high disorder and moderate disadvantage (Class II) were associated with a higher likelihood of polysubstance use. The role of neighborhood conditions in shaping adolescent polysubstance use should be considered in policy, prevention, and treatment interventions.
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Affiliation(s)
- Amrita Gill
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America
| | - Erica Felker-Kantor
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America
| | - Colette Cunningham-Myrie
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Lisa-Gaye Greene
- Mona Geoinformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona Geoinformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Uki Atkinson
- Ministry of Health and Wellness, National Council on Drug Abuse, Kingston, Jamaica
| | - Wendel Abel
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Simon G. Anderson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom,The George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, University of the West Indies, Cave Hill, Barbados
| | - Katherine P. Theall
- Department of Social, Behavioural and Population Sciences, Tulane University, New Orleans, LA, United States of America,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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13
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Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men. Drug Alcohol Depend 2022; 241:109652. [PMID: 36332595 PMCID: PMC10082566 DOI: 10.1016/j.drugalcdep.2022.109652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). METHODS Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16-25) surveyed semiannually 2016-2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. RESULTS All past 6-month substance use peaked between ages 21-23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17-6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92-3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76-1.85). Marijuana use odds did not differ among groups. CONCLUSION By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms.
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Erickson JH. Birds of a Feather Get High Together: A Reconceptualization of the Social Bond with Latent Class Analysis and a Test with Different Forms of Drug Use. AMERICAN JOURNAL OF CRIMINAL JUSTICE : AJCJ 2022; 47:672-696. [PMID: 36467593 PMCID: PMC9685152 DOI: 10.1007/s12103-022-09699-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/23/2022] [Indexed: 06/17/2023]
Abstract
Social bond theory has received significant empirical support in examinations of drug use for decades. However, research utilizing the theory has often been fragmented and has not incorporated all four dimensions of the social bond. Additionally, much of this research has collapsed drug use into categories rather than examining specific forms of drug use. These concerns confuse the theoretical and practical insights that may be derived from such analyses. I utilize Monitoring the Future (2019) data to examine social bonding wholistically as latent classes in line with the concept of the social bond described by Hirschi (1969) and estimate the effect of the classes on specific forms of drug use. I find there are four distinct classes of social bonding among U.S. seniors most clearly differentiated by levels of attachment and commitment. Logistic regression results indicated different classes of social bonding were associated with different forms of drug use. I discuss the theoretical implications of the results and how they can be applied for criminal justice practitioners.
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Tinner L, Palmer JC, Lloyd EC, Caldwell DM, MacArthur GJ, Dias K, Langford R, Redmore J, Wittkop L, Watkins SH, Hickman M, Campbell R. Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:1111. [PMID: 35658920 PMCID: PMC9165543 DOI: 10.1186/s12889-022-13072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents. METHODS Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC). RESULTS Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results. CONCLUSIONS There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit. TRIAL REGISTRATION Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.
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Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jennifer C Palmer
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Deborah M Caldwell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgie J MacArthur
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Kaiseree Dias
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rebecca Langford
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - James Redmore
- York Teaching Hospitals NHS Foundation Trust, Wiggington Road, York, UK
| | - Linda Wittkop
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Matthew Hickman
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rona Campbell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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Choi HJ, Grigorian H, Garner A, Stuart GL, Temple JR. Polydrug Use and Dating Violence Among Emerging Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2190-2217. [PMID: 32639843 DOI: 10.1177/0886260520934427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We examined sociodemographic and psychosocial risk factors that moderate the (poly) substance use and dating violence victimization and perpetration relationship among emerging adults. Using an ethnically diverse sample (N = 698), we used latent class analyses to identify mutually exclusive groups based on monthly and past-year substance use. We then examined these groups as they relate to dating violence victimization and perpetration and the moderating effect of various risk factors. Five classes were identified based on substance use patterns: (a) Regular Alcohol use, (b) Polysubstance use, (c) Heavy Alcohol and Marijuana use, (d) Mild Alcohol use, and (e) Occasional Alcohol and Marijuana use classes. Participants in the Polysubstance use class were the most likely to perpetrate dating violence followed by Heavy Alcohol and Marijuana use, Occasional Alcohol and Marijuana use, Regular Alcohol, and Mild Alcohol use classes. Similarly, participants in the Polysubstance use class were the most likely to be victims of dating violence followed by Occasional Alcohol and Marijuana, Heavy Alcohol and Marijuana, Regular Alcohol, and Mild Alcohol use classes. Depending on substance use class, gender, ethnicity, socioeconomic status, history of dating violence, and trauma symptoms differentially influenced dating violence perpetration and victimization at 1-year follow-up. Our findings support the need to comprehensively address dating violence among emerging adults. Intimate partner violence prevention and intervention programs may benefit from targeting emerging adults who misuse substances and incorporating substance use interventions into dating violence prevention efforts.
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Affiliation(s)
| | | | | | | | - Jeff R Temple
- The University of Texas Medical Branch at Galveston, USA
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17
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Zhang Y, Wang C, Liang M. A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1351-1361. [PMID: 34750778 DOI: 10.1007/s10508-021-02091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 02/20/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
The incidence of sexually transmitted diseases has alarmingly increased among Chinese youth in the past decade, and newly diagnosed cases of AIDS have almost doubled between 2010 and 2015. However, little is known about classes of sexual behavior among Chinese youth and associations with their other health behavior or experience of sex education. This study aimed to first identify classes of sexual behavior using latent class analysis and then to examine their associations with sex education, smoking, alcohol drinking, and pornography use. Data were from 13,865 unmarried youth aged 18-24 from the 2009 National Youth Reproductive Health Survey. Six indicators were used: timing of the first sexual intercourse, the number of past-year sexual partners, sex outside of a relationship, incidence of pregnancy, and contraceptive use at the latest and the first sexual intercourse. Four classes were identified: no sex (Class 1, 69%), safer sex (Class 2, 13%), early risk (Class 3, 13%), and multiple risk (Class 4, 5%). Smoking, drinking, and regular pornography use were associated with increased odds of being in the multiple risk class relative to the safer sex class. Sex education, smoking, and pornography use were associated with decreased odds of being in the no sex class relative to the safer sex class. The findings revealed qualitatively different classes of sexual behavior among Chinese youth and important roles of sex education, substance use, and pornography use. Reproductive health service providers can offer individually tailored services to serve youth with different profiles and needs.
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Affiliation(s)
- Yudong Zhang
- Institute of Human Development and Social Change, New York University, 627 Broadway Street, New York, NY, 10012, USA.
| | - Cuntong Wang
- School of Social Development, Central University of Finance and Economics, No. 39, College South Road, Haidian District, 100081, Beijing, People's Republic of China
| | - Mengyuan Liang
- Department of Comparative Human Development, University of Chicago, 1101 E 58th St, Chicago, IL, 60637, USA
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Robin L, Timpe Z, Suarez NA, Li J, Barrios L, Ethier KA. Local Education Agency Impact on School Environments to Reduce Health Risk Behaviors and Experiences Among High School Students. J Adolesc Health 2022; 70:313-321. [PMID: 34531096 PMCID: PMC8792165 DOI: 10.1016/j.jadohealth.2021.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study is to assess associations between exposure to a multilevel, socio-ecological health program administered by local education agencies and changes in health behaviors among high school students. METHODS This analysis used a multilevel difference-in-differences approach to compare student health experiences and outcomes between schools selected by local education agencies nationwide to implement the program (exposed schools) and schools that were not (unexposed schools). We measured repeated cross-sectional outcomes using the 2015 and 2017 Youth Risk Behaviors Surveys. The final analytic sample comprised 638 schools in total (N = 64,838 students), with 237 exposed schools (n = 30,336 students) and 401 unexposed schools (n = 34,502 students). RESULTS Students in exposed schools demonstrated significant reduction in odds compared with those in unexposed schools in ever having sex (adjusted odds ratio [aOR] = .88, 95% confidence interval [CI]: .81-.96), having four or more lifetime sexual partners (aOR = .84, 95% CI: .72-.97), being currently sexually active (aOR = .78, 95% CI: .78-.96), and using effective hormonal birth control (aOR = .7, 95% CI: .56-.88). Exposure to the program was associated with significant reduction in odds of not going to school because of safety concerns (aOR = .87, 95% CI: .78-.97), having experienced forced sex (aOR = .76, 95% CI: .68-.86), ever used marijuana (aOR = .89, 95% CI: .81-.98), and currently using marijuana (aOR = .77, 95% CI: .64-.93). CONCLUSIONS Exposure to the program was associated with significant decreases in sexual risk behaviors, experience of violence, and substance use.
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Affiliation(s)
- Leah Robin
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia.
| | - Zachary Timpe
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Nicolas A Suarez
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Jingjing Li
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Lisa Barrios
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Kathleen A Ethier
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
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Kukreti S, Yu T, Chiu PW, Strong C. Clustering of Modifiable Behavioral Risk Factors and Their Association with All-Cause Mortality in Taiwan's Adult Population: a Latent Class Analysis. Int J Behav Med 2021; 29:565-574. [PMID: 34775543 PMCID: PMC9525409 DOI: 10.1007/s12529-021-10041-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 11/15/2022]
Abstract
Background Modifiable risk behaviors, such as smoking, diet, alcohol consumption, physical activity, and sleep, are known to impact health. This study aims toward identifying latent classes of unhealthy lifestyle behavior, exploring the correlations between sociodemographic factors, identifying classes, and further assessing the associations between identified latent classes and all-cause mortality. Methods For this study, the data were obtained from a prospective cohort study in Taiwan. The participants’ self-reported demographic and behavioral characteristics (smoking, physical activity, alcohol consumption, fruit and vegetable intake, and sleep) were used. Latent class analysis was used to identify health-behavior patterns, and Cox proportional hazard regression analysis was used to find the association between the latent class of health-behavior and all-cause mortality. Results A complete dataset was obtained from 290,279 participants with a mean age of 40 (12.4). Seven latent classes were identified, characterized as having a 100% likelihood of at least one unhealthy behavior coupled with the probability of having the other four unhealthy risk behaviors. This study also shows that latent health-behavior classes are associated with mortality, suggesting that they are representative of a healthy lifestyle. Finally, it appeared that multiple risk behaviors were more prevalent in younger men and individuals with low socioeconomic status. Conclusions There was a clear clustering pattern of modifiable risk behaviors among the adults under consideration, where the risk of mortality increased with increases in unhealthy behavior. Our findings can be used to design customized disease prevention programs targeting specific populations and corresponding profiles identified in the latent class analysis. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10041-x.
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Affiliation(s)
- Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Po Wei Chiu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
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Ma A, Comstock SE, Oyeside OA. Typologies of Sexual Health Vulnerability Predicting STI Preventive Behaviors Among Latinx Adults in the U.S.: A Latent Class Analysis Approach. J Immigr Minor Health 2021; 24:1288-1299. [PMID: 34655371 DOI: 10.1007/s10903-021-01293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/25/2022]
Abstract
Vulnerability to poor sexual health among U.S. Latinx populations is poorly understood, despite high STI rates. We examined how vulnerability typologies differ in their STI preventive behaviors. Using data from the 2016 National Health Interview Survey, we performed latent class analysis to test the association between sexual health vulnerability and HIV testing, hepatitis testing or vaccination, and HPV vaccination from a subsample of Latinx adults. Three classes emerged: Under-Employed Females with Health Care Access, Slightly Under-Employed Females with Some Health Care Access, and Employed Males without Health Care Access. Slightly Under-Employed Females with Some Health Care Access were associated with lack of HIV testing, hepatitis B and C testing, and HPV vaccination. Employed Males without Health Care Access were associated with lack of HIV testing and HPV vaccination. Sexual health vulnerability may be associated with certain STI preventive behaviors, which can inform and refine sexual health promotion programming.
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Affiliation(s)
- Alice Ma
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA.
| | - Sara E Comstock
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA
| | - Oluwadamilola A Oyeside
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA
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Williams GC, Patte KA, Ferro MA, Leatherdale ST. Associations between Longitudinal Patterns of Substance Use and Anxiety and Depression Symptoms among a Sample of Canadian Secondary School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910468. [PMID: 34639768 PMCID: PMC8507734 DOI: 10.3390/ijerph181910468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 01/21/2023]
Abstract
The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.
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Affiliation(s)
- Gillian C. Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
- Correspondence:
| | - Karen A. Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada;
| | - Mark A. Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
| | - Scott T. Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.F.); (S.T.L.)
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Desai S, Kulkarni N, Rehmatullah S. The Type of Substance Use Mediates the Difference in the Odds of Sexual Risk Behaviors Among Adolescents of the United States. Cureus 2021; 13:e17264. [PMID: 34462707 PMCID: PMC8389858 DOI: 10.7759/cureus.17264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/05/2022] Open
Abstract
Background Although the relationship between sexual risk behaviors and substance use has been established, It remains to be studied if different types of substances have differences in the odds of sexual risk behaviors. Therefore, we aimed to identify the prevalence of sexual risk behaviors in high school students of the United States (US) and study the difference in the odds of sexual risk behaviors for various substances. Methods We performed a retrospective cross-sectional study using Youth Risk Behavior Surveillance System (YRBSS) data of 2019 that nationally represents US high school students in grades 9-12. We identified individuals with sexual risk behaviors as participants with four or more lifetime sexual partners and who did not use a condom during the last intercourse. Results Out of 11,191 participants, 463 (3.9%) engaged in sexual risk behaviors. The prevalence of substance use, including anabolic steroids (11.5 vs. 1.1%), cocaine (27.2 vs. 2.0%), marijuana (87.1 vs. 34.7%), alcohol (92.4 vs. 54.3%), e-cigarette (90.3 vs. 48.0%), and traditional cigarette (62.2 vs. 21.6%) was higher in participants with sexual risk behaviors compared to participants with no sexual risk behaviors (p<0.0001 for all substances). In regression analysis, anabolic steroid use was associated with the highest odds of sexual risk behaviors (adjusted odds ratio (aOR):4.87, 95%CI: 2.48-9.57; p<0.0001) followed by cocaine (aOR:3.80, 1.80-8.00; p=0.001), marijuana (aOR:3.36, 1.64-6.89; p<0.0001), alcohol (aOR:2.41, 1.05-5.55; p=0.039), electronic vapor products (2.05, 1.004-4.19; p=0.049), and traditional cigarette use (aOR:1.58, 1.10-2.28; p=0.016). We did not find a statistically significant increase in the odds of sexual risk behaviors for the rest of the substances. Conclusion Although the prevalence of sexual risk behaviors is low, the prevalence of substance use is significantly higher in participants with sexual risk behaviors. Among the different types of substances, anabolic steroid use has the highest odds of sexual risk behaviors. Therefore, clinicians should remain vigilant for anabolic steroid use when screening adolescents for substance use. Further large-scale randomized studies are needed to study the effects of anabolic steroids on sexual risk behaviors.
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Affiliation(s)
- Saral Desai
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Nishat Kulkarni
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Sanila Rehmatullah
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, USA
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Reis LF, Valente JY, Sanchez ZM, Surkan PJ. Effects of a School-Based Drug Prevention Program on Sexual Risk Behavior Among Adolescents in Brazilian Schools. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2371-2382. [PMID: 34318392 DOI: 10.1007/s10508-021-01977-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 06/13/2023]
Abstract
Sexual risk behaviors are closely related to the use of alcohol, tobacco, and other illicit drugs as well as teen dating violence. School-based drug prevention programs that teach social and personal skills could potentially also reduce sexual risk behaviors. We examined the effects of the #Tamojunto program on youth sexual risk behaviors. A randomized controlled trial was conducted with 6391 7th and 8th grade students in 72 public schools in six Brazilian cities. Baseline data were collected prior to program implementation. Two waves of follow-up assessments occurred after 9 and 21 months. Analyses were performed taking into account the multilevel structure of the data. We used intention-to-treat to evaluate changes in the prevalence of sexual risk behaviors over time and between groups. Adolescent age ranged from 11 to 15 years, with a mean of 12.6 ± 0.8 years, and 51.0% were female. Among all participants, receipt of #Tamojunto was associated with higher risk of lifetime sex at 21 months follow-up (OR 1.27, 95% CI [1.03, 1.56]). Among girls, at 9 months follow-up, the program was associated with higher likelihood of having engaged in sex in the last month (OR 1.76, 95% CI [1.13, 2.74]). At 21 months follow-up, girls receiving the program were more likely to report engaging in condomless sex in the last month (OR 1.64, 95% CI [1.07, 2.50]). #Tamojunto may be ineffective and possibly harmful for preventing sexual risk behaviors, especially among girls. We suggest further investigation of the possible mediating role of life skills intervention components on girl's sexual behaviors.
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Affiliation(s)
- Larissa F Reis
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Juliana Y Valente
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
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Feltmann K, Elgán TH, Strandberg AK, Kvillemo P, Jayaram-Lindström N, Grabski M, Waldron J, Freeman T, Curran HV, Gripenberg J. Illicit Drug Use and Associated Problems in the Nightlife Scene: A Potential Setting for Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4789. [PMID: 33946164 PMCID: PMC8125188 DOI: 10.3390/ijerph18094789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Illicit drug use is prevalent in the nightlife scene, especially at electronic dance music (EDM) events. The aim of the present study was to investigate illicit drug use patterns and consequences of drug use among frequent visitors of EDM events. Young adults (18-34 years old) who had visited at least six EDM events in Sweden during the past year participated in a web-based survey on drug use patterns and its consequences. Fifty-nine percent of participants had used illicit drugs during the past year, most often cannabis followed by ecstasy, cocaine, and amphetamine. Nightlife venues were identified as the main setting for the use of central stimulants, while cannabis was mostly used at home. Frequent alcohol and tobacco use was associated with illicit drug use. The most prevalent negative consequences of drug use were related to mental health, such as impairments in mood, sleep, and memory problems, but physical manifestations were also reported, such as palpitations and collapsing. These findings confirm that drug use is prevalent and associated with negative health effects among EDM nightlife attendees. The nightlife scene is a setting with promising potential to reach a high-risk target group with illicit drug use prevention interventions.
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Affiliation(s)
- Kristin Feltmann
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Tobias H. Elgán
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Anna K. Strandberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Pia Kvillemo
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Tom Freeman
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Helen Valerie Curran
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Johanna Gripenberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
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Alcohol- and drug-related consequences across latent classes of substance use among American Indian adolescents. Addict Behav 2021; 113:106682. [PMID: 33038678 DOI: 10.1016/j.addbeh.2020.106682] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/30/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Substance use among American Indian (AI) adolescents is a significant public health concern, as they report greater health disparities related to substance use compared to other racial/ethnic groups. The present study examines differences across classes of substance use behaviors regarding alcohol- and drug-related consequences. METHODS The current study was a secondary analysis of the dataset used by Stanley and Swaim (2018). AI adolescents (n = 3498, 47.8% female, Mage = 14.8) completed a survey including substance use and related consequences. Protocols were approved by institutional IRB, tribal authority, school boards, and parental consent/child assent were obtained. RESULTS In line with Stanley and Swaim (2018), we identified four classes of substance use: no past month substance use; marijuana and cigarette use only; alcohol, marijuana, and cigarette use only; and polysubstance use. Cross-class comparisons revealed that adolescents in classes characterized by the use of a greater number of substances also reported experiencing greater alcohol- and drug-related consequences with one exception: the class characterized by marijuana and cigarette use reported greater drug-related consequences compared to the class characterized by alcohol, marijuana, and cigarette use. CONCLUSIONS AI adolescents who engage in the use of multiple substances should be provided with psychoeducation around the increased risk of associated negative consequences. Given the health disparity experienced by AI adolescents, interventions to alleviate the burden of negative consequences are necessary.
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Esser MB, Pickens CM, Guy GP, Evans ME. Binge Drinking, Other Substance Use, and Concurrent Use in the U.S., 2016-2018. Am J Prev Med 2021; 60:169-178. [PMID: 33482979 PMCID: PMC8908897 DOI: 10.1016/j.amepre.2020.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/31/2020] [Accepted: 08/25/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The use of multiple substances heightens the risk of overdose. Multiple substances, including alcohol, are commonly found among people who experience overdose-related mortality. However, the associations between alcohol use and the use of a range of other substances are often not assessed. Therefore, this study examines the associations between drinking patterns (e.g., binge drinking) and other substance use in the U.S., the concurrent use of alcohol and prescription drug misuse, and how other substance use varies by binge-drinking frequency. METHODS Past 30-day alcohol and other substance use data from the 2016-2018 National Survey on Drug Use and Health were analyzed in 2020 among 169,486 U.S. respondents aged ≥12 years. RESULTS The prevalence of other substance use ranged from 6.0% (nondrinkers) to 24.1% (binge drinkers). Among people who used substances, 22.2% of binge drinkers reported using substances in 2 additional substance categories. Binge drinking was associated with 4.2 (95% CI=3.9, 4.4) greater adjusted odds of other substance use than nondrinking. Binge drinkers were twice as likely to report concurrent prescription drug misuse while drinking as nonbinge drinkers. The prevalence of substance use increased with binge-drinking frequency. CONCLUSIONS Binge drinking was associated with other substance use and concurrent prescription drug misuse while drinking. These findings can guide the implementation of a comprehensive approach to prevent binge drinking, substance misuse, and overdoses. This might include population-level strategies recommended by the Community Preventive Services Task Force to prevent binge drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density).
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Affiliation(s)
- Marissa B Esser
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Cassandra M Pickens
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gery P Guy
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E Evans
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Rodzlan Hasani WS, Saminathan TA, Ab Majid NL, Miaw Yn JL, Mat Rifin H, Abd Hamid HA, Robert Lourdes TG, Ahmad A, lsmail H, Rashid RA, Mohd Yusoff MF. Polysubstance use among adolescents in Malaysia: Findings from the National Health and Morbidity Survey 2017. PLoS One 2021; 16:e0245593. [PMID: 33476329 PMCID: PMC7819602 DOI: 10.1371/journal.pone.0245593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/04/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Polysubstance use is defined as the use of more than one non-prescribed licit or illicit substance either concurrently or simultaneously. This study aimed to determine the prevalence of single substance users and polysubstance users and 'their associated factors among adolescents in Malaysia. METHODS This study was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2017, a cross-sectional survey conducted among Malaysian school-going adolescents aged 13 to 17. The NHMS utilised a two-stage stratified cluster sampling. Multivariate Multinomial Logistic Regression analysis was applied. RESULTS The overall prevalence of single substance use and polysubstance use among adolescents were 17.2% and 5.1% respectively. The multinomial model showed a higher likelihood of being single or polysubstance user among male (single user OR = 3.0, poly user OR = 4.6), others Bumiputeras vs Malay (single user OR = 1.7, poly user OR = 5.3), those who live with a single parent (single user OR = 1.2, poly user OR = 1.4), involved in truancy (single user OR = 1.7, poly user OR = 3.6) and being bullied (single user OR = 1.3, poly user OR = 3.4), those who had lack of peer support (single user OR = 1.3, poly user OR = 1.4), poor parental bonding (single user OR = 1.4, poly user OR = 1.8), depression (single user OR = 1.4, poly user OR = 3.2) and those who had no close friend (single user OR = 1.3, poly user OR = 2.7). CONCLUSION Our study highlighted multiple significant associated factors of single and polysubstance use among adolescents in Malaysia. This result can assist in the development of specific intervention and prevention programs targeting high-risk groups.
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Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
- * E-mail:
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Hasimah lsmail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Rusdi Abd Rashid
- Department of Psychological Medicine, Faculty of Medicine, Center for Addiction Science Studies (UMCAS), University of Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
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Whitaker V, Oldham M, Boyd J, Fairbrother H, Curtis P, Meier P, Holmes J. Clustering of health-related behaviours within children aged 11-16: a systematic review. BMC Public Health 2021; 21:137. [PMID: 33446174 PMCID: PMC7807795 DOI: 10.1186/s12889-020-10140-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE We aimed to systematically review and synthesise evidence on the clustering of a broad range of health-related behaviours amongst 11-16 year olds. METHOD A literature search was conducted in September 2019. Studies were included if they used cluster analysis, latent class analysis, prevalence odds ratios, principal component analysis or factor analysis, and considered at least three health-related behaviours of interest among 11-16 year olds in high-income countries. Health-related behaviours of interest were substance use (alcohol, cigarettes and other drug use) and other behavioural risk indicators (diet, physical activity, gambling and sexual activity). RESULTS The review identified 41 studies, which reported 198 clusters of health-related behaviours of interest. The behaviours of interest reported within clusters were used to define eight behavioural archetypes. Some included studies only explored substance use, while others considered substance use and/or other health-related behaviours. Consequently, three archetypes were comprised by clusters reporting substance use behaviours alone. The archetypes were: (1) Poly-Substance Users, (2) Single Substance Users, (3) Substance Abstainers, (4) Substance Users with No/Low Behavioural Risk Indicators, (5) Substance Abstainers with Behavioural Risk Indicators, (6) Complex Configurations, (7) Overall Unhealthy and (8) Overall Healthy. CONCLUSION Studies of youth health behavioural clustering typically find both a 'healthy' cluster and an 'unhealthy' cluster. Unhealthy clusters are often characterised by poly-substance use. Our approach to synthesising cluster analyses may offer a means of navigating the heterogeneity of method, measures and behaviours of interest in this literature.
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Affiliation(s)
| | - Melissa Oldham
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jennifer Boyd
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Penny Curtis
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Petra Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Kowalski AJ, Addo OY, Kramer MR, Martorell R, Norris SA, Waford RN, Richter LM, Stein AD. Initial engagement and persistence of health risk behaviors through adolescence: longitudinal findings from urban South Africa. BMC Pediatr 2021; 21:31. [PMID: 33430827 PMCID: PMC7798218 DOI: 10.1186/s12887-020-02486-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Background Little is known about longitudinal patterns of adolescent health risk behavior initial engagement and persistence in low- and middle-income countries. Methods Birth to Twenty Plus is a longitudinal birth cohort in Soweto-Johannesburg, South Africa. We used reports from Black African participants on cigarette smoking, alcohol, cannabis, illicit drug, and sexual activity initial engagement and adolescent pregnancy collected over 7 study visits between ages 11 and 18 y. We fit Kaplan-Meier curves to estimate behavior engagement or adolescent pregnancy, examined current behavior at age 18 y by age of first engagement, and performed a clustering analysis to identify patterns of initial engagement and their sociodemographic predictors. Results By age 13 y, cumulative incidence of smoking and alcohol engagement were each > 21%, while the cumulative incidence of other behaviors and adolescent pregnancy were < 5%. By age 18 y (15 y for cannabis), smoking, alcohol, and sexual activity engagement estimates were each > 65%, cannabis and illicit drug engagement were each > 16%; adolescent pregnancy was 31%. Rates of engagement were higher among males. Current risk behavior activity at age 18 y was generally unrelated to age of initial engagement. We identified three clusters reflecting low, moderate, and high-risk patterns of initial risk behavior engagement. One-third of males and 17% of females were assigned to the high-risk cluster. Sociodemographic factors were not associated with cluster membership. Conclusions Among urban dwelling Black South Africans, risk behavior engagement across adolescence was common and clustered into distinct patterns of initial engagement which were unrelated to the sociodemographic factors assessed. Patterns of initial risk behavior engagement may inform the timing of primary and secondary public health interventions and support integrated prevention efforts that consider multiple behaviors simultaneously. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-020-02486-y.
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Affiliation(s)
- Alysse J Kowalski
- Laney Graduate School, Emory University, 201 Dowman Dr, Atlanta, GA, 30307, USA.,SAMRC/WITS Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa
| | - O Yaw Addo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE. Room 7007, Atlanta, GA, 30322, USA
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE. Room 7007, Atlanta, GA, 30322, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE. Room 7007, Atlanta, GA, 30322, USA
| | - Shane A Norris
- SAMRC/WITS Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa.,DSI-NRF Centre of Excellence in Child Development, University of the Witwatersrand, Private Bag 3, Wits, Johannesburg, 2050, South Africa
| | - Rachel N Waford
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE. Room 7007, Atlanta, GA, 30322, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 201 Dowman Dr, Atlanta, GA, 30322, USA
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Child Development, University of the Witwatersrand, Private Bag 3, Wits, Johannesburg, 2050, South Africa
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE. Room 7007, Atlanta, GA, 30322, USA.
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30
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Gabrielli G, Paterno A, Strozza S. Sexual behavioural differences and risk-taking differences among born-abroad and native university students in Italy. GENUS 2020. [DOI: 10.1186/s41118-020-00088-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractThere is a substantial lack of information in the literature on affective and sexual behaviours in youths with migratory backgrounds, despite immigrants’ immediate descendants growing in recent years in many destination countries. In order to fill this gap, we use original information, collected by the “Sexual and Emotional Life of Youths (SELFY)” survey carried out in Italy in 2017. We aim to provide a deeper understanding of sexual behaviours by comparing, for the very first time, university students with a migratory background and their native counterparts, stratifying them by gender. Our results show that born-abroad male students have a greater exposure to more liberal attitudes than their native counterparts, while there are no notable differences between born-abroad and native women. Moreover, we analyse, among a number of factors, the association between three sexual behaviours (extra-couple sexual intercourse, occasional sexual intercourse, and numerous sexual partners) and multiple “risk” behaviours. Behaviours defined as “risky” include voluntary attitudes which can be responsible for negative outcomes. Our results show that reckless driving and drug use are directly associated with sexual behaviours, with no differences by gender or migratory status. The association of binge drinking and early sexual debut with the three considered sexual behaviours is largely present only among natives, while having problems with family and school rules have a gender-related role on sex.
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Ssewanyana D, Abubakar A, Newton CRJC, Otiende M, Mochamah G, Nyundo C, Walumbe D, Nyutu G, Amadi D, Doyle AM, Ross DA, Nyaguara A, Williams TN, Bauni E. Clustering of health risk behaviors among adolescents in Kilifi, Kenya, a rural Sub-Saharan African setting. PLoS One 2020; 15:e0242186. [PMID: 33180831 PMCID: PMC7660520 DOI: 10.1371/journal.pone.0242186] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/29/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents tend to experience heightened vulnerability to risky and reckless behavior. Adolescents living in rural settings may often experience poverty and a host of risk factors which can increase their vulnerability to various forms of health risk behavior (HRB). Understanding HRB clustering and its underlying factors among adolescents is important for intervention planning and health promotion. This study examines the co-occurrence of injury and violence, substance use, hygiene, physical activity, and diet-related risk behaviors among adolescents in a rural setting on the Kenyan coast. Specifically, the study objectives were to identify clusters of HRB; based on five categories of health risk behavior, and to identify the factors associated with HRB clustering. METHODS A cross-sectional survey was conducted of a random sample of 1060 adolescents aged 13-19 years living within the area covered by the Kilifi Health and Demographic Surveillance System. Participants completed a questionnaire on health behaviors which was administered via an Audio Computer-Assisted Self-Interview. Latent class analysis on 13 behavioral factors (injury and violence, hygiene, alcohol tobacco and drug use, physical activity, and dietary related behavior) was used to identify clustering and stepwise ordinal logistic regression with nonparametric bootstrapping identified the factors associated with clustering. The variables of age, sex, education level, school attendance, mental health, form of residence and level of parental monitoring were included in the initial stepwise regression model. RESULTS We identified 3 behavioral clusters (Cluster 1: Low-risk takers (22.9%); Cluster 2: Moderate risk-takers (67.8%); Cluster 3: High risk-takers (9.3%)). Relative to the cluster 1, membership of higher risk clusters (i.e. moderate or high risk-takers) was strongly associated with older age (p<0.001), being male (p<0.001), depressive symptoms (p = 0.005), school non-attendance (p = 0.001) and a low level of parental monitoring (p<0.001). CONCLUSION There is clustering of health risk behaviors that underlies communicable and non-communicable diseases among adolescents in rural coastal Kenya. This suggests the urgent need for targeted multi-component health behavior interventions that simultaneously address all aspects of adolescent health and well-being, including the mental health needs of adolescents.
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Affiliation(s)
- Derrick Ssewanyana
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Charles R. J. C. Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Mark Otiende
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - George Mochamah
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Christopher Nyundo
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Walumbe
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Gideon Nyutu
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Amadi
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Aoife M. Doyle
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - David A. Ross
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - Amek Nyaguara
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Thomas N. Williams
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
- Department of Medicine, Imperial College, South Kensington Campus, London, United Kingdom
| | - Evasius Bauni
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
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Wu TL, Ting TT, Chen CY, Su LW, Chen WJ. Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in Taiwan: mediation analysis of preceding-sex use of illicit drugs. BMC Public Health 2020; 20:1647. [PMID: 33143679 PMCID: PMC7641850 DOI: 10.1186/s12889-020-09777-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/26/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs. METHODS Participants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations. RESULTS Around 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%. CONCLUSIONS Early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population's sexual health.
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Affiliation(s)
- Tat Leong Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Te-Tien Ting
- School of Big Data Management, Soochow University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Lien-Wen Su
- Kunming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
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Halladay J, Woock R, El-Khechen H, Munn C, MacKillop J, Amlung M, Ogrodnik M, Favotto L, Aryal K, Noori A, Kiflen M, Georgiades K. Patterns of substance use among adolescents: A systematic review. Drug Alcohol Depend 2020; 216:108222. [PMID: 32971420 DOI: 10.1016/j.drugalcdep.2020.108222] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This review characterizes empirically derived patterns of multiple (multi-) substance use among adolescents. A secondary objective was to examine the extent to which mental health symptomatology was included in the empirical analyses examining substance use patterns. METHODS Eligible studies included those that used cluster-based approaches, included the assessment of at least two different substances, and were based on study samples with mean ages between 11 and 18 years. 4665 records were screened including 461 studies for full-text screening. RESULTS 70 studies were included with common clusters being: low use, single or dual substance use, moderate general multi-use, and high multi-use. The most common patterns of single or multi-substance use were: alcohol only, alcohol with cannabis and/or tobacco, and use of alcohol, tobacco, and cannabis with and without other drugs. Lower socioeconomic status, older age, and male gender were consistent predictors of multi-use clusters. Only 37 % of studies compared differences in levels of mental health across clusters with symptoms consistently associated with a greater likelihood of multi-use. Only 29 % of studies included mental health indicators in cluster-based analyses, with over half identifying distinct mental health and substance use clusters. Fit indices in cluster analyses and measurement properties of substance use were heterogeneous and inconsistently reported across studies. CONCLUSIONS Distinct patterns of substance use were derived but methodological differences prevented direct comparison and reduced capacity to generalize across studies. There is a need to establish standardized methodological approaches to identify robust patterns of substance use to enhance etiological, prognostic, and intervention research.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - R Woock
- Department of Social Sciences, McMaster University, Canada.
| | - H El-Khechen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - C Munn
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - J MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Ogrodnik
- NeuroFit Lab, Department of Kinesiology, McMaster University, Canada.
| | - L Favotto
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - K Aryal
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - A Noori
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - M Kiflen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Population Health Research Institute, Hamilton, ON, Canada.
| | - K Georgiades
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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Drug Use Among Adolescents and Young Adults with Unsuppressed HIV Who Use Alcohol: Identifying Patterns of Comorbid Drug Use and Associations with Mental Health. AIDS Behav 2020; 24:2975-2983. [PMID: 32246358 DOI: 10.1007/s10461-020-02848-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Youth living with HIV (YLWH; aged 16-24) are at elevated risk of alcohol and drug use. Studies in older populations have identified patterns or profiles of multiple substance use differentially associated with mental health and anti-retroviral therapy (ART) adherence. No studies of YLWH have yet examined such patterns. A sample of 179 YLWH, reporting ART non-adherence and alcohol use, were recruited at five Adolescent Trials Network clinics in urban areas of the US between November 2014 and August 2017. Participants completed the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) to assess substance use involvement scores, and the Brief Symptom Inventory. Latent Profile Analysis identified three substance use patterns: minimal illicit drug use (15.1%), cannabis only (56.4%), and global polysubstance use (28.5%). Global polysubstance users experienced more mental health problems compared to the minimal illicit drug use group. The co-occurrence of drug use with alcohol was common among these YLWH-all of whom reported ART adherence problems-indicating the importance of interventions capable of addressing multiple substance use rather than alcohol alone.
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Evans BE, Kim Y, Hagquist C. A latent class analysis of changes in adolescent substance use between 1988 and 2011 in Sweden: associations with sex and psychosomatic problems. Addiction 2020; 115:1932-1941. [PMID: 32149444 DOI: 10.1111/add.15040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/19/2019] [Accepted: 03/02/2020] [Indexed: 11/26/2022]
Abstract
AIMS To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. DESIGN Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). SETTING AND PARTICIPANTS The sample included all 15-16-year-olds in Värmland County, Sweden (n = 20 057). MEASUREMENTS Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems. FINDINGS A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps < 0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps < 0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps < 0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period. CONCLUSIONS Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non-use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period.
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Affiliation(s)
- Brittany E Evans
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
| | - Yunhwan Kim
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
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Prevalence and correlates of youth poly-substance use in the COMPASS study. Addict Behav 2020; 107:106400. [PMID: 32222564 DOI: 10.1016/j.addbeh.2020.106400] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/03/2020] [Accepted: 03/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Youth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming. DESIGN Cross-sectional sample taking part in a cohort study. SETTING Canadian high schools (AB, BC, ON, QC) PARTICIPANTS: 74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019. MEASUREMENTS Self-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures. RESULTS Of the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use. CONCLUSIONS The evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.
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The relationship between early risk-taking behavior and mental health problems among a nationally representative sample of Australian youth. J Affect Disord 2020; 272:239-248. [PMID: 32553364 DOI: 10.1016/j.jad.2020.04.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/02/2020] [Accepted: 04/24/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Earlier engagement in risk-taking behaviors has been associated with more severe mental health problems across development. However, sex differences in risk-outcome relationships remain underexplored and mental health outcomes spanning both ends of the internalizing and externalizing spectra are rarely considered within the same sample. The present study examined associations between age at initiation of alcohol use, illicit drug use, and sexual intercourse, and symptoms of internalizing, externalizing, depression and self-harm, for males and females. METHODS The present study analyzed self-report survey data from a nationally representative sample of Australian adolescents (N=2,950). Logistic regression models were conducted separately for males and females to test the association of early (age 15 or younger) and concurrent (age 16-17) initiation of alcohol use, illicit drug use and sexual behavior with symptoms of internalizing, externalizing, depression and self-harm at age 16-17. RESULTS Risk-taking behaviors were associated with all mental health outcomes. Generally, earlier initiation of risk-taking behaviors demonstrated stronger associations with mental health outcomes than concurrent initiation. Associations between risk-taking behaviors and mental health outcomes varied by participant sex and mental health outcome. LIMITATIONS Mechanisms underlying the relationship between risk-taking behaviors and mental health problems were not tested and the sample had not yet reached early adulthood. CONCLUSIONS Risk-taking behaviors, particularly when initiated early, share links with multiple mental health problems in adolescence. Public health strategies to delay the onset of risk-taking behaviors may therefore incur multiple benefits as might an integrated approach to mental health prevention programs for youth.
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Banks DE, Bello MS, Crichlow Q, Leventhal AM, Barnes-Najor JV, Zapolski TCB. Differential typologies of current substance use among Black and White high-school adolescents: A latent class analysis. Addict Behav 2020; 106:106356. [PMID: 32087473 DOI: 10.1016/j.addbeh.2020.106356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/03/2020] [Accepted: 02/12/2020] [Indexed: 11/27/2022]
Abstract
Black and White adolescents demonstrate different prototypical profiles (i.e., typologies) of substance use, with Blacks demonstrating lower risk for concurrent use of two or more substances. Despite knowledge of these differences, typologies of adolescent substance use identified by person-centered methods, such as latent class analysis, have not characterized profiles by racial group. The current study examined typologies of substance use among Black and White youth separately using person-centered methods to identify common patterns of substance use among subjects. Data were drawn from a 5-year parent study examining adolescent health outcomes. The current study examined high-school aged White (n = 7271, 45.4% male) and Black youth (n = 1301, 40.1% male) who reported past-30-day frequency of cigarette, alcohol, marijuana, inhalant, and other drug use. Latent class analysis was used to examine substance use typologies among each group adjusting for grade and sex. Black and White youth demonstrated different typologies such that four typologies emerged among Blacks: Non-Use (87.8%), Alcohol and Marijuana Use (6.3%), Alcohol, Marijuana, and Cigarette Use (3.8%), and Frequent Polysubstance Use (2.0%). Conversely, five typologies emerged among Whites: Non-Use (73.4%), Predominant Alcohol Use (13.9%), Alcohol, Marijuana, and Cigarette Use (9.4%), Moderate Polysubstance Use (1.6%), and Frequent Polysubstance Use (1.7%). Findings suggest that Black and White youth engage in similar rates of concurrent substance use. Given that Black youth face greater risk for adverse consequences from substance use, prevention efforts are needed to prevent related health disparities related to concurrent substance use.
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Affiliation(s)
- Devin E Banks
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Mariel S Bello
- University of Southern California, Los Angeles, CA, United States
| | - Queenisha Crichlow
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Adam M Leventhal
- University of Southern California, Los Angeles, CA, United States; University of Southern California Keck School of Medicine, Los Angeles, CA, United States
| | | | - Tamika C B Zapolski
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Ünübol H, Sayar GH. Substance use and its risk factors in Turkey: a nationally representative sample study. J Ethn Subst Abuse 2020; 21:476-498. [DOI: 10.1080/15332640.2020.1781731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gottert A, Pulerwitz J, Heck CJ, Cawood C, Mathur S. Creating HIV risk profiles for men in South Africa: a latent class approach using cross-sectional survey data. J Int AIDS Soc 2020; 23 Suppl 2:e25518. [PMID: 32589340 PMCID: PMC7319107 DOI: 10.1002/jia2.25518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/10/2020] [Accepted: 04/22/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Engaging at-risk men in HIV prevention programs and services is a current priority, yet there are few effective ways to identify which men are at highest risk or how to best reach them. In this study we generated multi-factor profiles of HIV acquisition/transmission risk for men in Durban, South Africa, to help inform targeted programming and service delivery. METHODS Data come from surveys with 947 men ages 20 to 40 conducted in two informal settlements from May to September 2017. Using latent class analysis (LCA), which detects a small set of underlying groups based on multiple dimensions, we identified classes based on nine HIV risk factors and socio-demographic characteristics. We then compared HIV service use between the classes. RESULTS We identified four latent classes, with good model fit statistics. The older high-risk class (20% of the sample; mean age 36) were more likely married/cohabiting and employed, with multiple sexual partners, substantial age-disparity with partners (eight years younger on-average), transactional relationships (including more resource-intensive forms like paying for partner's rent), and hazardous drinking. The younger high-risk class (24%; mean age 27) were likely unmarried and employed, with the highest probability of multiple partners in the last year (including 42% with 5+ partners), transactional relationships (less resource-intensive, e.g., clothes/transportation), hazardous drinking, and inequitable gender views. The younger moderate-risk class (36%; mean age 23) were most likely unmarried, unemployed technical college/university students/graduates. They had a relatively high probability of multiple partners and transactional relationships (less resource-intensive), and moderate hazardous drinking. Finally, the older low-risk class (20%; mean age 29) were more likely married/cohabiting, employed, and highly gender-equitable, with few partners and limited transactional relationships. Circumcision (status) was higher among the younger moderate-risk class than either high-risk class (p < 0.001). HIV testing and treatment literacy score were suboptimal and did not differ across classes. CONCLUSIONS Distinct HIV risk profiles among men were identified. Interventions should focus on reaching the highest-risk profiles who, despite their elevated risk, were less or no more likely than the lower-risk to use HIV services. By enabling a more synergistic understanding of subgroups, LCA has potential to enable more strategic, data-driven programming and evaluation.
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Affiliation(s)
| | | | | | - Cherie Cawood
- Epicentre Health ResearchPietermaritzburgSouth Africa
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Jongenelis M, Pettigrew S, Lawrence D, Rikkers W. Factors Associated with Poly Drug Use in Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:695-704. [PMID: 30707340 DOI: 10.1007/s11121-019-00993-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Poly drug use in adolescents represents a significant public health issue, heightening risk for abuse, dependency, and a variety of short- and long-term psychological, psychosocial, and health consequences. However, past studies have typically examined just one or two substances in isolation and there is a lack of research that has comprehensively examined possible predictors of poly drug use in adolescents. To inform the development of comprehensive prevention programs that can simultaneously target multiple substances, the present study sought to identify psychological, environmental, and demographic factors that are most strongly associated with alcohol, tobacco, and cannabis poly drug use. Adolescents aged 15 to 17 years (n = 1661; 50.9% male) completed a survey on their use of alcohol, tobacco, and cannabis over the last 30 days. Various psychological, environmental, and demographic factors were also assessed. Weighted multiple-level logistic regression was conducted to assess the factors associated with poly drug use. In total, 20.3% of respondents had used at least one substance, 6.7% reported using two substances, and 3.3% reported using all three substances. The most common combined pattern of use was alcohol and tobacco, followed by alcohol and cannabis. Several factors emerged as significant, with conduct problems, depression, and the school environment accounting for the most variance. Specific psychological and environmental factors appear to be particularly important domains to target in adolescent substance use prevention programs. Early identification of adolescent depression and conduct problems and the development of programs that address these symptoms in youth may be effective approaches to delaying or preventing poly drug use in this population.
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Affiliation(s)
- Michelle Jongenelis
- School of Psychology, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia.
| | - Simone Pettigrew
- School of Psychology, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia
| | - Wavne Rikkers
- Graduate School of Education, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia
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Dangerfield DT, Carmack CC, Gilreath TD, Duncan DT. Latent classes of partner-seeking venues and sexual risk among men who have sex with men in Paris, France. Int J STD AIDS 2020; 31:502-509. [PMID: 32295477 DOI: 10.1177/0956462419899012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In France, men who have sex with men (MSM) experience the highest HIV incidence. MSM who use multiple venues such as bars and smartphone apps to find sexual partners have greater HIV and sexually transmitted infection risk than those who use a single physical or online venue. To explore the role of venues and sexual behavior on HIV risk, we used latent class analysis to highlight underlying profiles of 580 MSM in Paris, France. Three latent classes emerged: Multi-venue Users (19%), Non-serosorting App Users (49%), and Serosorting App Users (32%). Multi-venue Users had the highest probabilities of condomless receptive anal intercourse (CRAI) and condomless insertive anal intercourse (CIAI), group sex, and meeting partners at venues such as bars or online. Non-serosorting App Users had the lowest probabilities of CRAI, CIAI, and condomless serosorting. Serosorting App Users had an 87% chance of condomless serosorting. MSM reporting a pre-exposure prophylaxis history had 14 and 5 times the odds of being classified as Multi-venue Users and Serosorting App Users than Non-serosorting App Users. MSM were 3% more likely to be Multi-venue Users than Non-serosorting App Users for every one-year increase in age. Interventions addressing sexual risk behaviors among MSM in France should consider tailored risk-reduction and prevention messaging.
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Affiliation(s)
| | - Chakema C Carmack
- Department of Psychological Health and Learning Sciences, University of Houston, Houston, TX, USA
| | - Tamika D Gilreath
- Department of Health and Kinesiology, Texas A&M University, Houston, TX, USA
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
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Abar CC, Koban K, Farnett S, Mendola K, Clark G. Profiles of family routines during adolescence associated with profiles of health behaviors in young adulthood. J Health Psychol 2020; 25:629-639. [DOI: 10.1177/1359105317726149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined associations between profiles of family routines in early adolescence and profiles of health behaviors during young adulthood. In a sample of 4565 individuals, latent transition analysis indicated individuals in a family characterized by low involvement in adolescence were most likely, across classes, to demonstrate a profile characterized by substance use in young adulthood. The high-involvement class during adolescence was least likely to be a substance user but was relatively likely to be in the poor diet and exercise class during young adulthood. Results highlight the utility of examining complex family influences on health using person-centered methods.
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Affiliation(s)
- Caitlin C Abar
- The College at Brockport, State University of New York, USA
| | - Kaitlyn Koban
- The College at Brockport, State University of New York, USA
| | - Sarah Farnett
- The College at Brockport, State University of New York, USA
| | - Kayla Mendola
- The College at Brockport, State University of New York, USA
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Zhang T, Wang Z. The Effects of Family Functioning and Psychological Suzhi Between School Climate and Problem Behaviors. Front Psychol 2020; 11:212. [PMID: 32210862 PMCID: PMC7076191 DOI: 10.3389/fpsyg.2020.00212] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/30/2020] [Indexed: 11/18/2022] Open
Abstract
Problem behaviors have always been a hot topic in the field of adolescent research. It is particularly important to study how problem behaviors are developed. Empirical evidence examining problem behaviors has shared the premise that perceived school climate and family functioning play a role in the development of problem behaviors in adolescents. However, it is less clear whether the interaction of perceived school climate and family functioning can predict problem behaviors in adolescents and which mechanisms within the process it might affect. The present study developed a moderated mediation model to investigate the relationship between perceived school climate, family functioning, psychological suzhi, and problem behaviors in early adolescents. Participants were 1,072 Chinese junior high school students who completed the Perceived School Climate Questionnaire, the Strengths and Difficulties Questionnaire, the Psychological Suzhi Questionnaire for Middle School Students, and the Family APGAR scales. Data were analyzed using IBM SPSS Statistics version 22.0, including descriptive statistics and correlation analysis. The mediating effect and moderating effect were tested by SPSS PROCESS. Results showed that there was a significant negative correlation between perceived school climate and problem behaviors and a partial mediating role of psychological suzhi between perceived school climate and problem behaviors. Moreover, the influence of perceived school climate on psychological suzhi was moderated by family functioning. Indirect effects were significant in participants with high versus low family functioning. There was an interaction between family and school, and psychological suzhi played an important role between environment and adolescent behaviors. This study validates the combined effect of family systems, school systems, and personal systems on problem behaviors and has certain guiding significance for the prevention and intervention of problem behaviors among adolescents.
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Affiliation(s)
| | - Zhi Wang
- Faculty of Psychology, Research Center of Mental Health Education, Southwest University, Chongqing, China
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Miller KM, Briggs HE, Elkins J, Kim I, Mowbray O. Physical Abuse and Adolescent Sexual Behaviors: Moderating Effects of Mental Health Disorders and Substance Use. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:55-62. [PMID: 32318228 PMCID: PMC7163811 DOI: 10.1007/s40653-018-0221-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of the current study was to examine the direct effects of child physical abuse on sexual behaviors and whether mental health problems and substance use moderated the associations between exposure to child physical abuse and sexual behavioral practices among adolescents who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A). The data show statistically significant relationships between physical abuse and risky sexual behaviors for youth who met the clinical criteria for lifetime Posttraumatic Stress Disorder (PTSD) and reported marijuana use. Data from future studies can inform sexual health practice development with adolescents and emerging adults with a history of physical abuse, marijuana use/abuse and PTSD. These findings underscore the importance of exploring presence of symptoms associated with PTSD and marijuana use as part of a comprehensive biopsychosocial assessment for physically abused adolescents and emerging adults to determine if they are engaging in risky sexual behaviors.
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Affiliation(s)
- Keva M. Miller
- School of Social Work, Portland State University, 1800 SW 6th Ave., Portland, OR 97201 USA
| | | | - Jennifer Elkins
- School of Social Work, University of Georgia, Athens, GA USA
| | - Irang Kim
- School of Social Work, University of Georgia, Athens, GA USA
- Department of Social Work, Northwestern State University of Louisiana, Natchitoches, LA USA
| | - Orion Mowbray
- School of Social Work, University of Georgia, Athens, GA USA
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Individual and Neighborhood Factors Associated With Sexual Behavior Classes in an Urban Longitudinal Sample. Sex Transm Dis 2020; 46:98-104. [PMID: 30278028 DOI: 10.1097/olq.0000000000000920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to increase understanding of the clustering of sexual behaviors in an urban sample of emerging adults, and the individual and neighborhood factors associated with sexual behavior patterns to provide insight into reducing the disproportionate burden of poor sexual outcomes among urban African Americans. METHODS We draw on 2 cohorts of urban, predominantly African American youth first assessed at age 6 years and follow-up to emerging adulthood (mean age, 20 years; n = 1618). Latent class analyses by gender identified co-occurrence of sexual behavior. RESULTS We found 3 classes for both males and females: high-risk (13% of males, 15% of females), low-risk (54% of males, 56% of females) and no-risk (33% of males, 29% of females). Membership in the high-risk class was associated with school dropout, a substance use disorder diagnosis, having a criminal arrest, pregnancy, and sexually transmitted diseases for both males and females. High-risk females also had higher rates of depression. Low-risk males and females also had elevated risk of pregnancy and parenthood. Neighborhood factors distinguished the high- and no-risk classes for males and females, including the neighborhood environment scale, which assessed poverty, safety, drug activity, and crime/violence in the neighborhood. Neighborhood religiosity was inversely associated with membership in the high-risk class compared with the no-risk class for females only. Neighborhood racism distinguished those in the high-risk class compared with the no-risk class for males. CONCLUSIONS Future work should take into account the clustering of sexual risk behaviors. Specific neighborhood factors could be addressed to reduce sexual health disparities.
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Hallit S, Sacre H, Salameh P. Effect of waterpipe dependence on risk motives, attitudes and other health-related risky behaviors in Lebanese university students. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:4390-4403. [PMID: 31832948 DOI: 10.1007/s11356-019-06961-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
Explore whether waterpipe dependence in young Lebanese adults would have any effect on modifying the association between risk conception, attitude, and other risky behaviors. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese university students (3384 students). Waterpipe dependence was associated with higher association of alcohol dependence and cigarette dependence by 76.7% and higher excitement for dangerous behaviors by 7.1%. It was significantly associated with increased association of cigarette dependence and alcohol dependence by 66.8%, with the thinking of a behavior of being not dangerous by 239%, with having motives for risky behaviors by 74.1%, with ever having unsafe sex by 111.74%, and between having motives for risky behaviors and ever having unsafe sex by 61.95%. Waterpipe dependence was associated with higher motives, excitement, and perception of risk and risky behaviors, namely cigarette dependence, alcohol dependence, and unsafe sex. Moreover, it was associated with higher risky behavior interdependence.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
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Reis LF, Surkan PJ, Valente JY, Bertolla MHSM, Sanchez ZM. Factors associated with early sexual initiation and unsafe sex in adolescents: Substance use and parenting style. J Adolesc 2020; 79:128-135. [PMID: 31962206 DOI: 10.1016/j.adolescence.2019.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/29/2019] [Accepted: 12/29/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Larissa F Reis
- Department of Preventive Medicine, Universidade Federal de São Paulo, Brazil.
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, USA.
| | - Juliana Y Valente
- Department of Preventive Medicine, Universidade Federal de São Paulo, Brazil.
| | | | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, Brazil.
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Freire GLM, da Silva Paulo JR, da Silva AA, Batista RPR, Alves JFN, do Nascimento Junior JRA. Body dissatisfaction, addiction to exercise and risk behaviour for eating disorders among exercise practitioners. J Eat Disord 2020; 8:23. [PMID: 32528680 PMCID: PMC7285560 DOI: 10.1186/s40337-020-00300-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study investigated the association between body dissatisfaction (BD), addiction to exercise and risk behaviors to eating disorders (EDs) among Brazilian exercise practitioners, besides comparing the variables according to sex, age group and modality. METHODS Participants were 60 exercice practitioners of fitness (n = 44) and crossfit (n = 16), with mean age of 26.58 ± 7.76 years. Data collection was conducted through Eating Attitudes Test-26 (EAT-26), Diagnosis of Orthorexia Questionnaire (ORTO-15), Body Shape Questionnaire (BSQ) and Scale of Dedication to Exercise (SDE). Data analysis was conducted through Kolmogorov-Smirnov and independent t tests, Pearson correlation, and Path Analysis (p < .05). RESULTS Main results showed the association between BD, addiction to exercise and risk behaviour for EDs. Further, individuals dissatisfied with their bodies showed higher level of addiction to exercise and risk behavior for EDs. Furthermore, women showed higher presence of BD than men, and fitness participants reported higher presence of addiction to exercise than crossfit practitioners. CONCLUSIONS This study revealed that BD seems to be a determinant factor for risk behavior for ED's and addiction to exercise among fitness and crossfit particpants.
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Affiliation(s)
- Gabriel Lucas Morais Freire
- postgraduate programme in physical education, University Federal do Vale do São Francisco, Petrolina, Brazil
| | | | - Adson Alves da Silva
- postgraduate programme in physical education, University Federal do Vale do São Francisco, Petrolina, Brazil
| | | | | | - José Roberto Andrade do Nascimento Junior
- postgraduate programme in physical education, University Federal do Vale do São Francisco, Petrolina, Brazil.,postgraduate programme in psychology, University Federal do Vale do São Francisco, Petrolina, Brazil
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King B, Eastman AL, Grinnell-Davis C, Aparicio E. Early Childbirth Among Foster Youth: A Latent Class Analysis to Determine Subgroups at Increased Risk. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2019; 51:229-238. [PMID: 31802630 DOI: 10.1363/psrh.12124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/11/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Research has documented elevated rates of early childbirth among adolescents who have spent time in foster care, and a better understanding is needed of the characteristics of vulnerable individuals and the circumstances of their time in care. METHODS California birth records for 1999-2010 were probabilistically linked to state child welfare service records spanning the same date range to identify females aged 12-19 who had spent time in foster care and had had a first birth before age 20. Latent class analysis was used to identify subgroups based on age at most recent entry into care, length of this stay and three indicators of placement instability. The probability of a first birth being related to class membership was assessed as a distal outcome, and differences across classes were assessed using chi-square tests. RESULTS Four distinct classes of foster youth were identified: Later Entry/High Instability (20% of individuals), Later Entry/Low Instability (43%), Earlier Entry/High Instability (12%) and Earlier Entry/Low Instability (25%). The probability of a first childbirth ranged from 31% (class 1) to 15% (class 4); classes 2 and 3 experienced moderate risk (23% and 24%, respectively). Two groups were further characterized by high rates of reentry into care, with 56% of class 1 and 41% of class 3 individuals experiencing more than one episode in care. CONCLUSIONS Identifiable subgroups of female foster youth are at heightened risk of early childbirth and may benefit from early intervention, enhanced support and access to reliable, ongoing sexual and reproductive health care.
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Affiliation(s)
- Bryn King
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto
- The Children's Data Network
- The Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | | | | | - Elizabeth Aparicio
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park
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