Abstract
The current research assessed the extent to which substance use behaviors (i.e., heavy episodic drinking, marijuana use, and use of illicit drugs other than marijuana) were associated with behaviors that confer risk for HIV infection (i.e., sex with multiple partners, inconsistent condom use, and injection drug use) in a nationally representative sample of young adults. Generalized estimating equations (GEEs) examined patterns in the data from U.S. young adults (N = 7,595), ages 21 to 30, who participated in the Monitoring the Future (MTF) panel study between 2004 and 2009. Fifty-two percent of the participants were female and 70% were White. Time-varying effects indicated that more frequent heavy episodic drinking, marijuana use, and other illicit drug use were associated with a greater number of sex partners. Frequency of marijuana and other illicit drug use was associated with less frequent condom use, and marijuana use was associated with use of injection drugs. Younger individuals (i.e., 21–24 years old versus 25–30 years old) had fewer sexual partners, more frequent condom use, and a stronger association between heavy episodic drinking and number of sexual partners than did older individuals. These effects did not vary across gender. Findings highlight the covariation of substance use with HIV-related risk factors among recent cohorts of young adults in the U. S. and the particularly strong link between heavy episodic drinking and number of sexual partners among individuals aged 21 to 24. Prevention programs should acknowledge the co-occurring risks of substance use and HIV risk behaviors, especially among young adults in their early twenties.
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Notes
A poststratification reweighting procedure was used to adjust for differential retention in the longitudinal panel by demographic variables (gender, race/ethnicity, high school GPA) and drug use variables (level of base-year drug use, initial oversampling of base year drug users) (Johnston et al. 2011).
Given that the data spanned ages 21 to 30 (i.e., largely after the normative years of college attendance), being an attender was used as a fixed predictor measured at ages 19–20 (prior to available data on HIV behaviors), rather than time-varying.
References
Aicken, C. R. H., Anthony, N., & Mercer, C. H. (2011). Alcohol misuse, sexual risk behavior and adverse sexual health outcomes: Evidence from Britain’s national probability sexual behavior surveys. Journal of Public Health, 33, 262–271.
Bachman, J. G., O’Malley, P. M., Schulenberg, J. E., Johnston, L. D., Bryant, A. L., & Merline, A. C. (2002). The decline of substance use in young adulthood: Changes in social activities, roles, and beliefs. Mahwah, NJ: Lawrence Erlbaum.
Bachman, J. G., Johnston, L. D., O’Malley, P. M., & Schulenberg, J. E. (2011). The Monitoring the Future project after thirty-seven years: Design and procedures (Monitoring the Future Occasional Paper No. 76). Ann Arbor, MI: Institute for Social Research.
Bauermeister, J. A., Zimmerman, M. A., Gee, G. C., Caldwell, C., & Yange, X. (2009). Work and sexual trajectories among African American youth. Journal of Sex Research, 46, 290–300. doi:10.1080/00224490802666241.
Brown, N. C., Taylor, E. D., Mulatu, M. S., & Scott, W. (2007). Demographic correlates of HIV testing, high-risk behaviors, and condom/STD consultation among a multi-ethnic sample of women. Women Health, 46, 59–76.
Bryant, A. L., Schulenberg, J., Bachman, J. G., O’Malley, P. M., & Johnston, L. D. (2000). Acting out and lighting up: Understanding the links among school misbehavior, academic achievement, and cigarette use (Monitoring the Future Occasional Paper No. 46). Ann Arbor, MI: Institute for Social Research.
Centers for Disease Control and Prevention. (2006). Cases of HIV infection and AIDS in the United States, by race/ethnicity, 2000–2004. HIV/AIDS Surveillance Supplemental Report, 12(1).
Centers for Disease Control and Prevention. (November 2011a). CDC Fact Sheet: HIV among Latinos. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/pdf/latino.pdf.
Centers for Disease Control and Prevention. (November 2011b). CDC Fact Sheet: HIV in the United States. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/PDF/us.pdf.
Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, S14, 101–107.
Cooper, M. L. (2006). Does drinking promote risky sexual behavior? A complex answer to a simple question. Current Directions in Psychological Science, 15, 19–23.
Dahlberg, L. L., & Krug, E. G. (2002). Violence: A global public health problem. In E. G. Krug, L. L. Dahlberg, J. A. Mercy, A. B. Zwi, & R. Lozano (Eds.), World Report on Violence and Health (pp. 1–56). Geneva: World Health Organization.
Duncan, T. E., Duncan, S. C., Hops, H., & Stoolmiller, M. (1995). An analysis of the relationship between parent and adolescent marijuana use via generalized estimating equation methodology. Multivariate Behavioral Research, 30, 317–339.
Gavin, L., MacKay, A. P., Brown, K., Harrier, S., Ventura, S. J., Kann, L., et al. (2009). Sexual and reproductive health of persons aged 10–24 years – United States, 2002–2007. Morbidity and Mortality Weekly Report, 58, 1–61.
Graves, K. L., & Leigh, B. C. (1995). The relationship of substance use to sexual activity among young adults in the United States. Family Planning Perspectives, 27, 18–22, 33.
Hall, H. E., Song, R., Rhodes, P., Prejean, J., An, Q., Lee, L. M., et al. (2008). Estimation of HIV incidence in the United States. JAMA, 300, 520–529.
Hallfors, D. D., Iritani, B. J., Miller, W. C., & Bauer, D. J. (2007). Sexual and drug behavior patterns and HIV and STD racial disparities: The need for new directions. American Journal of Public Health, 97, 125–132. doi:10.2105/AJPH.2005.075747.
Henry J. Kaiser Family Foundation. (2002). Substance use and risky sexual behavior: Attitudes and practices among adolescents and young adults (Survey Snapshot, February 2002). Menlo Park, CA: Kaiser Family Foundation. Retrieved from http://www.kff.org/youthhivstds/upload/KFF-CASASurveySnapshot.pdf.
Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2010). HIV/AIDS: Risk and protective behaviors among American young adults, 2004–2008 (NIH Publication No.10-7586). Bethesda, MD: National Institute on Drug Abuse.
Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the future national survey results on drug use, 1975–2010: Volume II, College students and adults ages 19–50. Ann Arbor, MI: Institute for Social Research.
Kotchick, B. A., Shaffer, A., Forehand, R., & Miller, K. S. (2001). Adolescent sexual risk behavior: A multi-system perspective. Clinical Psychology Review, 21, 493–519.
Lee, J., Herzog, T. A., Meade, C. D., Webb, M. S., & Brandon, T. H. (2007). The use of GEE for analyzing longitudinal binomial data: A primer using data from a tobacco intervention. Addictive Behaviors, 32, 187–193.
Leonard, K. E., & Homish, G. G. (2005). Changes in marijuana use over the transition into marriage. Journal of Drug Issues, 45, 409–429.
Levy, S., Sherritt, L., Gabrielli, J., Shrier, L. A., & Knight, J. R. (2009). Screening adolescents for substance use—related high-risk sexual behaviors. Journal of Adolescent Health, 45, 473–477.
Neal, D. J., & Fromme, K. (2007). Event-level covariation of alcohol intoxication and behavioral risks during the first year of college. Journal of Consulting and Clinical Psychology, 75, 294–306.
Nkansah-Amankra, S., Diedhiou, A., Agbanu, H. L. K., Harrod, C., & Dhawan, A. (2011). Correlates of sexual risk behaviors among high school students in Colorado: Analysis and implications for school-based HIV/AIDS programs. Maternal Child Health Journal, 15, 730–741.
Patrick, M. E., & Maggs, J. L. (2009). Does drinking lead to sex? Daily alcohol-sex behaviors and expectancies among college students. Psychology of Addictive Behaviors, 23, 472–481.
Prejean, J., Song, R., Hernandez, A., Ziebell, R., Green, T., & Walker, F. (2011). Estimated HIV incidence in the United States, 2006–2009. PLoS ONE, 6, e17502. doi:10.1371/journal.pone.0017502.
Reinisch, J. M., Sanders, S. A., & Ziemba-Davis, M. (1988). The study of sexual behavior in relation to the transmission of Human Immunodeficiency Virus: Caveats and recommendations. American Psychologist, 43, 921–927.
SAS Institute Inc. (2011). SAS/STAT(R) 9.2 user’s guide (2nd ed.). Cary, NC: SAS Institute Inc.
Testa, M., & Collins, R. L. (1997). Alcohol and risky sexual behavior: Event-based analyses among a sample of high-risk women. Psychology of Addictive Behaviors, 11, 190–201.
Townsend, L. (2007). A systematic review of the relationship between high school dropout and substance use. Clinical Child and Family Psychology Review, 10, 295–317.
Williams, M. L., & Snyder, F. R. (1993). Drug use, sexual behaviors, risk of HIV infection, and age differences among injection drug users not in treatment. In B. S. Brown, G. M. Beschner, & The National AIDS Research Consortium (Eds.), Handbook on risk of AIDS: Injection drug users and sexual partners (pp. 297–312). Westport, CT: Greenwood.
Acknowledgements
Research was funded by NIDA Grants R01DA001411 and R01DA016575 to L. Johnston. Funding for manuscript preparation by M. Patrick was also funded by the Survey Research Center, Institute for Social Research, University of Michigan. The content here is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors.
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Patrick, M.E., O’Malley, P.M., Johnston, L.D. et al. HIV/AIDS Risk Behaviors and Substance Use by Young Adults in the United States. Prev Sci 13, 532–538 (2012). https://doi.org/10.1007/s11121-012-0279-0
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DOI: https://doi.org/10.1007/s11121-012-0279-0