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A Behavioral Decision Model Testing the Association of Marijuana Use and Sexual Risk in Young Adult Women

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Abstract

We created a model conceptualizing sexual risk as a series of discrete event-specific behavioral decisions and tested the hypothesis that marijuana use was associated with increased sexual risk-taking. Three hundred eight marijuana-using women aged 18–24 completed a 90-day time-line-follow-back to assess sexual behaviors and marijuana use. A sequential logit model estimated the effect of marijuana use on the likelihood of being sexually active, partner type when sexually active, and condom nonuse conditional on partner type. Participants had a mean age of 20.4 years, with 67% Caucasian. Marijuana use was associated with an increased likelihood of being sexually active (OR 1.6; 95% CI 1.33, 1.93) and with condom nonuse when sexually active with casual partners (OR 2.58; 95% CI 1.1, 6.09). This behavioral decision model identified where marijuana use affected sexual risk, and suggests where interventions designed to reduce risk may have an impact.

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References

  1. Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36(1):6–10.

    Article  PubMed  Google Scholar 

  2. CDC. Trends in reportable sexually transmitted diseases in the United States, 2004. Atlanta, GA: U.S. Department of Health and Human Services; 2005.

    Google Scholar 

  3. CDC. Trends in reportable sexually transmitted diseases in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human Services; 2009.

    Google Scholar 

  4. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3–17.

    Article  PubMed  CAS  Google Scholar 

  5. Centers for Disease Control and Prevention. HIV and AIDS—United States, 1981–2000. MMWR. 2001;50:430–4.

    Google Scholar 

  6. Turner C, Russell A, Brown W. Prevalence of illicit drug use in young Australian women, patterns of use and associated risk factors. Addiction. 2003;98(10):1419–26.

    Article  PubMed  Google Scholar 

  7. Poulin C, Graham L. The association between substance use, unplanned sexual intercourse and other sexual behaviors among adolescent students. Addiction. 2001;96(4):607–21.

    Article  PubMed  CAS  Google Scholar 

  8. Kingree JB, Betz H. Risky sexual behavior in relation to marijuana and alcohol use among African-American, male adolescent detainees and their female partners. Drug Alcohol Depend. 2003;72(2):197–203.

    Article  PubMed  CAS  Google Scholar 

  9. Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-34, DHHS Publication No. SMA 08-4343): Rockville, MD; 2008.

  10. Lowry R, Holtzman D, Truman BI, Kann L, Collins JL, Kolbe LJ. Substance use and HIV-related sexual behaviors among US high school students: are they related? Am J Public Health. 1994;84(7):1116–20.

    Article  PubMed  CAS  Google Scholar 

  11. Shrier LA, Emans SJ, Woods ER, DuRant RH. The association of sexual risk behaviors and problem drug behaviors in high school students. J Adolesc Health. 1997;20(5):377–83.

    Article  PubMed  CAS  Google Scholar 

  12. Guo J, Chung I-J, Hill KG, Hawkins JD, Catalano RF, Abbott RD. Developmental relationships between adolescent substance use and risky sexual behavior in young adulthood. J Adolesc Health. 2002;31(4):354–62.

    Article  PubMed  Google Scholar 

  13. Kingree JB, Braithwaite R, Woodring T. Unprotected sex as a function of alcohol and marijuana use among adolescent detainees. J Adolesc Health. 2000;27(3):179–85.

    Article  PubMed  CAS  Google Scholar 

  14. De Genna NM, Cornelius MD, Cook RL. Marijuana use and sexually transmitted infections in young women who were teenage mothers. Womens Health Issues. 2007;17(5):300–9.

    Article  PubMed  Google Scholar 

  15. Kingree JB, Phan D. Marijuana use and unprotected sexual intercourse among adolescent detainees: an even analysis. Crim Justice Behav. 2002;29(6):705–17.

    Article  Google Scholar 

  16. Leigh BC, Ames SL, Stacy AW. Alcohol, drugs, and condom use among drug offenders: an event-based analysis. Drug Alcohol Depend. 2008;93(1–2):38–42.

    Article  PubMed  Google Scholar 

  17. Brodbeck J, Matter M, Moggi F. Association between cannabis use and sexual risk behavior among young heterosexual adults. AIDS Behav. 2006;10(5):599–605.

    Article  PubMed  Google Scholar 

  18. Noar SM, Cole C, Carlyle K. Condom use measurement in 56 studies of sexual risk behavior: review and recommendations. Arch Sex Behav. 2006;35(3):327–45.

    Article  PubMed  Google Scholar 

  19. Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Ann Behav Med. 2003;26(2):76–103.

    Article  PubMed  Google Scholar 

  20. Jemmott JB 3rd, Jemmott LS. HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS. 2000;14(Suppl 2):S40–52.

    PubMed  Google Scholar 

  21. Jaccard J, McDonald R, Wan CK, Dittus PJ, Quinlan S. The accuracy of self-reports of condom use and sexual behavior. J Appl Soc Psychol. 2002;32(9):1863–905.

    Article  Google Scholar 

  22. Fishbein M, Pequegnat W. Evaluating AIDS prevention interventions using behavioral and biological outcome measures. Sex Transm Dis. 2000;27(2):101–10.

    Article  PubMed  CAS  Google Scholar 

  23. Halpern-Felsher BL, Millstein SG, Ellen JM. Relationship of alcohol use and risky sexual behavior: a review and analysis of findings. J Adolesc Health. 1996;19(5):331–6.

    Article  PubMed  CAS  Google Scholar 

  24. Leigh BC, Stall R. Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention. Am Psychol. 1993;48(10):1035–45.

    Article  PubMed  CAS  Google Scholar 

  25. Leigh BC. Alcohol and condom use: a meta-analysis of event level studies. Sex Transm Dis. 2002;29(8):476–82.

    Article  PubMed  Google Scholar 

  26. Fortenberry JD, Costa FM, Jessor R, Donovan JE. Contraceptive behavior and adolescent lifestyles: a structural modeling approach. J Res Adolesc. 1997;7(3):307–29.

    Article  PubMed  CAS  Google Scholar 

  27. Leigh BC, Vanslyke JG, Hoppe MJ, Rainey DT, Morrison DM, Gillmore MR. Drinking and condom use: results from an event-based daily diary. AIDS Behav. 2008;12(1):104–12.

    Article  PubMed  Google Scholar 

  28. Carey MP, Carey KB, Maisto SA, Gordon CM, Weinhardt LS. Assessing sexual risk behavior with the timeline followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS. 2001;12(6):365–75.

    Article  PubMed  CAS  Google Scholar 

  29. Stein MD, Anderson BJ, Caviness CM, et al. Relationship of alcohol use and sexual risk-taking among hazardously drinking incarcerated women: an event-level analysis. J Stud Alcohol Drugs. 2009;70(4):508–15.

    PubMed  Google Scholar 

  30. Sobell L, Sobell M. Timeline follow-back: a technique for assessing self-reported alcohol consumption. In: Allen LA, editor. Measuring alcohol consumption. New York: The Humana Press; 1992.

    Google Scholar 

  31. Cherpitel CJ. Substance use, injury, and risk-taking dispositions in the general population. Alcohol Clin Exp Res. 1999;23(1):121–6.

    Article  PubMed  CAS  Google Scholar 

  32. Mare RD. Change and stability in educational stratification. Am Sociol Review. 1981;46(1):72–87.

    Article  Google Scholar 

  33. Buis ML. SEQLOGIT: Stata module to fit a sequential logit model. 2007. http://ideas.repec.org/c/boc/bocode/s456843.html.

  34. Agresti A. Categorical data analysis. 2nd ed. Hoboken, NJ: Wiley-Interscience; 2002.

    Book  Google Scholar 

  35. Maddala GS. Limited dependent and qualitative variables in econometrics. Cambridge: Cambridge University Press; 1983.

    Google Scholar 

  36. Stata Statistical Software: Release 10 [computer program]. College Station, TX: StatCorp LP; 2007.

  37. Clutterbuck DJ, Gorman D, McMillan A, Lewis R, Macintyre CCA. Substance use and unsafe sex among men in Edinburgh. AIDS Care. 2001;13(4):527–35.

    Article  PubMed  CAS  Google Scholar 

  38. Heishman SJ, Arasteh K, Stitzer ML. Comparative effects of alcohol and marijuana on mood, memory, and performance. Pharmacol Biochem Behav. 1997;58(1):93–101.

    Article  PubMed  CAS  Google Scholar 

  39. Ashton CH. Pharmacology and effects of cannabis: a brief review. Br J Psychiatry. 2001;178:101–6.

    Article  PubMed  CAS  Google Scholar 

  40. Vélez-Blasini CJ. Evidence against alcohol as a proximal cause of sexual risk taking among college students. J Sex Res. 2008;45(2):118–28.

    Article  PubMed  Google Scholar 

  41. Staras SA, Cook RL, Clark DB. Sexual partner characteristics and sexually transmitted diseases among adolescents and young adults. Sex Transm Dis. 2009;36:232–8.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by NIDA grant R01DA018954. Dr. Stein is a recipient of a NIDA Mid-Career Award K24-DA000512-08.

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Authors and Affiliations

  1. Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA

    Bradley J. Anderson & Michael D. Stein

  2. Department of Medicine & Community Health, General Medicine Research Unit, Butler Hospital, 345 Blackstone Blvd, Providence, RI, 02906, USA

    Michael D. Stein

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  1. Bradley J. Anderson
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Correspondence to Michael D. Stein.

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Anderson, B.J., Stein, M.D. A Behavioral Decision Model Testing the Association of Marijuana Use and Sexual Risk in Young Adult Women. AIDS Behav 15, 875–884 (2011). https://doi.org/10.1007/s10461-010-9694-z

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