Prevention Science

, Volume 10, Issue 4, pp 335–344

Regression Mixture Models of Alcohol Use and Risky Sexual Behavior Among Criminally-Involved Adolescents

  • Sarah J. Schmiege
  • Michael E. Levin
  • Angela D. Bryan
Article

Abstract

Adolescents involved with the criminal justice system engage in high levels of both risky sexual behavior and alcohol use. Yet a strong relationship between the two constructs has not been consistently observed, possibly due to heterogeneity in the data. Regression mixture models were estimated in the current study to address such potential heterogeneity. Criminally-involved adolescents (n = 409) were clustered into latent classes based on patterns of the regression of two measures of risky sexual behavior, condom use and frequency of intercourse, on alcohol use. A three-class solution emerged where alcohol use did not significantly predict either risky sex outcome for approximately 25% of the sample; alcohol use negatively predicted condom use and positively predicted frequency of intercourse for approximately 38% of participants; and alcohol use negatively predicted condom use but not frequency of intercourse for the remaining participants. These classes were then distinguished on the basis of five covariates previously found to influence either alcohol use, risky sexual behavior, or the relationship between the two: self-esteem, gender, participant age, relationship status, and impulsivity/sensation-seeking. High self-esteem, being female, being older, and being in a relationship predicted membership in the class with no observed relationship of alcohol use to risky sex, relative to the other classes. Implications of the present findings are discussed in terms of exploring different risky sex and alcohol use patterns within criminally involved adolescents, as well as understanding the effectiveness of interventions for subgroups of individuals.

Keywords

Alcohol use Risky sexual behavior Condom use Criminally-involved adolescents HIV/AIDS Regression mixture models 

References

  1. Bailey, S. L., Gao, W., & Clark, D. B. (2006). Diary study of substance use and unsafe sex among adolescents with substance use disorders. The Journal of Adolescent Health, 38, 297.e13–297.e20.CrossRefGoogle Scholar
  2. Barthlow, D. J., Horan, P. F., DiClemente, R. J., & Lanier, M. M. (1995). Correlates of condom use among incarcerated adolescents in a rural state. Criminal Justice and Behavior, 22, 295–306. doi:10.1177/0093854895022003007.CrossRefGoogle Scholar
  3. Brook, J. S., Balka, E. B., & Abernathy, T. (1994). Sequence of sexual behavior and its relationship to other problem behaviors in African American and Puerto Rican adolescents. The Journal of Genetic Psychology, 155, 107–114.PubMedGoogle Scholar
  4. Bryan, A., Aiken, L. S., & West, S. G. (2004). HIV/STD risk among incarcerated adolescents: Optimism about the future and self-esteem as predictors of condom use self-efficacy. Journal of Applied Social Psychology, 34, 912–936. doi:10.1111/j.1559-1816.2004.tb02577.x.CrossRefGoogle Scholar
  5. Bryan, A., Rochelau, C. A., Robbins, R. N., & Hutchison, K. E. (2005). Condom use among high-risk adolescents: Testing the influence of alcohol use on the relationship of cognitive correlates of behavior. Health Psychology, 24, 133–142. doi:10.1037/0278-6133.24.2.133.CrossRefPubMedGoogle Scholar
  6. Bryan, A., Ray, L., & Cooper, M. L. (2007). Alcohol use and protective sexual behaviors among high-risk adolescents. Journal of Studies on Alcohol and Drugs, 68, 327–335.PubMedGoogle Scholar
  7. Castrucci, B. C., & Martin, S. L. (2002). The association between substance use and risky sexual behaviors among incarcerated adolescents. Maternal and Child Health Journal, 3, 43–47. doi:10.1023/A:1014316200584.CrossRefGoogle Scholar
  8. Centers for Disease Control and Prevention. (2005). HIV/AIDS among youth. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/pubs/facts/youth.pdf. Retrieved 25 April 2006.
  9. Centers for Disease Control and Prevention. (2006). National Youth Risk Behavior Survey: 1991–2003: Trends in the prevalence of sexual behaviors. http://www.cdc.gov/HealthyYouth/yrbs/pdfs/trends-sex.pdf. Retrieved 25 April 2006.
  10. Clark, R. D., & Hatfield, E. (1989). Gender differences in receptivity to sexual offers. Journal of Psychology & Human Sexuality, 2, 39–55. doi:10.1300/J056v02n01_04.CrossRefGoogle Scholar
  11. Conigrave, K. M., Hall, W. D., & Saunders, J. B. (1995). The AUDIT questionnaire: Choosing a cut-off score. Addiction (Abingdon, England), 90, 1349–1356. doi:10.1111/j.1360-0443.1995.tb03552.x.Google Scholar
  12. Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, 14, 101–117.Google Scholar
  13. 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. doi:10.1111/j.0963-7214.2006.00385.x.CrossRefGoogle Scholar
  14. Cooper, M. L., & Orcutt, H. K. (1997). Drinking and sexual experience on first dates among adolescents. Journal of Abnormal Psychology, 106, 191–202. doi:10.1037/0021-843X.106.2.191.CrossRefPubMedGoogle Scholar
  15. Cooper, M. L., Wood, P. K., Orcutt, H. K., & Albino, A. (2003). Personality and the predisposition to engage in risky or problem behaviors during adolescence. Journal of Personality and Social Psychology, 84, 390–410. doi:10.1037/0022-3514.84.2.390.CrossRefPubMedGoogle Scholar
  16. Ding, C. S. (2006). Using regression mixture analysis in educational research. Practical Assessment. Research Evaluation, 11, 1–11.Google Scholar
  17. Ethier, K. A., Kershaw, T. S., Lewis, J. B., Milan, S., Niccolai, L. M., & Ickovics, J. R. (2006). Self-esteem, emotional distress and sexual behaviour among adolescent females: Inter-relationships and temporal effects. The Journal of Adolescent Health, 38, 268–274. doi:10.1016/j.jadohealth.2004.12.010.CrossRefPubMedGoogle Scholar
  18. Flisher, A. J., & Chalton, D. O. (2001). Adolescent contraceptive non-use and covariation among risk behaviors. The Journal of Adolescent Health, 28, 235–241. doi:10.1016/S1054-139X(00)00157-9.CrossRefPubMedGoogle Scholar
  19. Fortenberry, J. D., Orr, D. P., Katz, B. P., Brizendine, E. J., & Blythe, M. J. (1997). Sex under the influence: A diary self-report study of substance use and sexual behavior among adolescent women. Sexually Transmitted Diseases, 24, 313–319. doi:10.1097/00007435-199707000-00001.CrossRefPubMedGoogle Scholar
  20. Gold, R. S., Karmiloff-Smith, A., Skinner, M. J., & Morton, J. (1992). Situational factors and thought processes associated with unprotected intercourse in heterosexual students. AIDS Care, 4, 305–323. doi:10.1080/09540129208253101.CrossRefPubMedGoogle Scholar
  21. Guilamo-Ramos, V., Litardo, H. A., & Jaccard, J. (2005). Prevention programs for reducing adolescent problem behaviors: Implications of the co-occurrence of problem behaviors in adolescence. Journal of Adolescent Health, 36, 82–86.CrossRefPubMedGoogle Scholar
  22. Halpern-Felsher, B. L., Millstein, S. G., & Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: A review and analysis of findings. Journal of Adolescent Health, 19, 331–336.CrossRefPubMedGoogle Scholar
  23. Holmbeck, G. N., Crossman, R. E., Wandrei, M. L., & Gasiewiski, E. (1994). Cognitive development, egocentrism, self-esteem, and adolescent contraceptive knowledge, attitudes and behaviour. Journal of Youth and Adolescence, 23, 169–193.CrossRefPubMedGoogle Scholar
  24. Huba, G. J., Tenner, A., Panter, A. T., Remafedi, G., Melchior, L. A., Greenberg, B., et al. (2003). Modeling HIV risk in highly vulnerable youth. Structural Equation Modeling, 10, 583–608.CrossRefGoogle Scholar
  25. Hull, J. G., & Bond, C. F. (1986). Social and behavioral consequences of alcohol consumption and expectancy: A meta-analysis. Psychological Bulletin, 99, 347–360.CrossRefPubMedGoogle Scholar
  26. Jessor, R., Turbin, M. S., & Costa, F. M. (1998). Protective factors in adolescent health behavior. Journal of Personality and Social Psychology, 75, 788–800.CrossRefPubMedGoogle Scholar
  27. Justus, A. N., Finn, P. R., & Steinmetz, J. E. (2000). The influence of traits of disinhibition on the association between alcohol use and risky sexual behavior. Alcoholism: Clinical and Experimental Research, 24, 1028–1035.CrossRefGoogle Scholar
  28. Kalichman, S. C., & Cain, D. (2004). A prospective study of sensation seeking and alcohol use as predictors of sexual risk behaviors among men and women receiving sexually transmitted infection clinic services. Psychology of Addictive Behaviors, 18, 367–373.CrossRefPubMedGoogle Scholar
  29. Kalichman, S. C., Cain, D., Zweben, A., & Swain, G. (2003). Sensation seeking, alcohol use and sexual risk behaviors among men receiving services at a clinic for sexually transmitted infections. Journal of Studies on Alcohol, 64, 564–569.PubMedGoogle Scholar
  30. Kalichman, S. C., Heckman, T., & Kelly, J. A. (1996). Sensation seeking, substance use, and, HIV–AIDS risk behavior: Tests of directional relationships among gay men. Archives of Sexual Behavior, 25, 141–154.CrossRefPubMedGoogle Scholar
  31. Kingree, J. B., & Phan, D. L. (2001). Marijuana use and HIV risk among adolescent offenders: The moderating effect of age. Journal of Substance Abuse, 13, 59–71.CrossRefPubMedGoogle Scholar
  32. Kingree, J. B., & Phan, D. (2002). Marijuana use and unprotected sexual intercourse among adolescent detainees: An event analysis. Criminal Justice and Behavior, 29, 705–717.CrossRefGoogle Scholar
  33. Ku, L., Sonenstein, F. L., & Pleck, J. H. (1993). Young men’s risk behaviors for HIV infection and sexually transmitted diseases, 1988 through 1991. American Journal of Public Health, 83, 1609–1615.CrossRefPubMedGoogle Scholar
  34. LaBrie, J. W., Earleywine, M., Schiffman, J., Pederson, E., & Marriot, C. (2005). Effect of alcohol, expectancies, and partner type on condom use in college males: Event-level analyses. Journal of Sex Research, 42, 259–266.PubMedCrossRefGoogle Scholar
  35. Leigh, B. C. (2002). Alcohol and condom use: A meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.CrossRefPubMedGoogle Scholar
  36. Leigh, B. C., & Stall, R. (1993). Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation, and prevention. American Psychologist, 48, 1035–1045.CrossRefPubMedGoogle Scholar
  37. Lo, Y., Mendell, N. R., & Rubin, D. B. (2001). Testing the number of components in a normal mixture. Biometrika, 88, 767–778.CrossRefGoogle Scholar
  38. Lowry, R., Holtzman, D., Truman, B. I., Kann, L., Collins, J. L., & Kolbe, L. J. (1994). Substance use and HIV-related sexual behaviors among US high school students: Are they related? American Journal of Public Health, 84, 1116–1120.CrossRefPubMedGoogle Scholar
  39. Macaluso, M., Demand, M. J., Artz, L. M., & Hook III., E. W. (2000). Partner type and condom use. AIDS, 14, 537–546.CrossRefPubMedGoogle Scholar
  40. McLachlan, G. J., & Peel, D. (2000). Finite mixture models. New York: Wiley.CrossRefGoogle Scholar
  41. Morris, R. E., Harrison, E. A., Knox, G. W., Tromanhauser, E., & Marquis, D. K. (1995). Health risk behavioral survey from 39 juvenile correctional facilities in the United States. Journal of Adolescent Health, 17, 334–344.CrossRefPubMedGoogle Scholar
  42. Morris, R. E., Baker, C. J., Valentine, M., & Pennisi, A. J. (1998). Variations in HIV risk behaviors of incarcerated juveniles during a four-year period: 1989–1992. Journal of Adolescent Health, 23, 39–48.CrossRefPubMedGoogle Scholar
  43. Muthén, B. O. (2002). Beyond SEM: General latent variable modeling. Behaviormetrika, 29, 81–117.CrossRefGoogle Scholar
  44. Muthén, B. O., & Muthén, L. K. (2000). Integrating person-centered and variable-centered analysis: Growth mixture modeling with latent trajectory classes. Alcoholism: Clinical and Experimental Research, 24, 882–891.CrossRefGoogle Scholar
  45. Muthén, L. K., & Muthén, B. O. (1998–2008). Mplus user’s guide (5th ed.). Los Angeles, CA: Author.Google Scholar
  46. Noar, S. M., Zimmerman, R. S., Palmgreen, P., Lustria, M., & Horosewski, M. L. (2006). Integrating personality and psychosocial theoretical approaches to understanding safer sexual behavior: Implications for message design. Health Communication, 19, 165–174.CrossRefPubMedGoogle Scholar
  47. Nylund, K. L., Asparouhov, T., & Muthén, B. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling. A Monte Carlo simulation study. Structural Equation Modeling, 14, 535–569.Google Scholar
  48. Otto-Salaj, L. L., Gore-Felton, C., McGarvey, E., & Canterbury II, R. J. (2002). Psychiatric functioning and substance use: Factors associated with HIV risk among incarcerated adolescents. Child Psychiatry & Human Development, 33, 91–106.CrossRefGoogle Scholar
  49. Rees, V., Saitz, R., Horton, N. J., & Samet, J. (2001). Association of alcohol consumption with HIV sex- and drug-risk behaviors among drug users. Journal of Substance Abuse Treatment, 21, 129–134.CrossRefPubMedGoogle Scholar
  50. Reisen, C. A., & Poppen, P. J. (1995). College women and condom use: Importance of partner relationship. Journal of Applied Social Psychology, 25, 1485–1498.CrossRefGoogle Scholar
  51. Robbins, R. N., & Bryan, A. (2004). Relationships between future orientation, impulsive sensation seeking, and risk behavior among adjudicated adolescents. Journal of Adolescent Research, 19, 428–445.CrossRefPubMedGoogle Scholar
  52. Romero, E. G., Teplin, L. A., McClelland, G. M., Abram, K. M., Welty, L. J., & Washburn, J. J. (2007). A longitudinal study of the prevalence, development, and persistence of HIV/sexually transmitted infection risk behaviors in delinquent youth: Implications for health care in the community. Pediatrics, 119, 1126–1141.CrossRefGoogle Scholar
  53. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Google Scholar
  54. Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, R. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection or persons with harmful alcohol consumption: II. Addiction, 88, 791–804.CrossRefPubMedGoogle Scholar
  55. Schmiege, S. J., Broaddus, M. R., Levin, M., & Bryan, A. (2009). Randomized trial of group interventions to reduce HIV/STD risk and change theoretical mediators among detained adolescents. Journal of Consulting and Clinical Psychology, 77, 38–50.CrossRefPubMedGoogle Scholar
  56. Steele, C. M., & Josephs, R. A. (1990). Alcohol myopia: Its prized and dangerous effects. American Psychologist, 45, 921–933.CrossRefPubMedGoogle Scholar
  57. Teplin, L. A., Mericle, A. A., McClelland, G. M., & Abram, K. M. (2003). HIV and AIDS risky behaviors in juvenile detainees: Implications for public health policy. American Journal of Public Health, 93, 906–912.CrossRefPubMedGoogle Scholar
  58. Tubman, J. G., & Langer, L. M. (1995). “About last night”: The social ecology of sexual behavior relative to alcohol use among adolescents and young adults in substance abuse treatment. Journal of Substance Abuse, 7, 449–461.CrossRefPubMedGoogle Scholar
  59. Unger, J. B., Kipke, M. D., Simon, T. R., Montgomery, S. B., & Johnson, C. J. (1997). Homeless youths and young adults in Los Angeles: Prevalence of mental health problems and the relationship between mental health and substance abuse disorders. American Journal of Community Psychology, 25, 371–394.CrossRefPubMedGoogle Scholar
  60. Vermunt, J. K., & Magidson, J. (2002). Latent class cluster analysis. In J. A. Hagenaars & A. L. McCutcheon (Eds.), Applied latent class analysis (pp. 89–106). New York: Cambridge University Press.Google Scholar
  61. Weinhardt, L. S., & Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research, 11, 125–157.PubMedGoogle Scholar
  62. Whaley, A. L. (1999). Preventing the high-risk sexual behavior of adolescents: Focus on HIV/AIDS transmission, unintended pregnancy, or both? Journal of Adolescent Health, 24, 376–382.CrossRefPubMedGoogle Scholar
  63. Williams, M. L., Freeman, R. C., Bowen, A. M., Zhao, Z., Elwood, W. N., Gordon, C., et al. (2000). A comparison of the reliability of self-reported drug use and sexual behaviors using computer-assisted versus face-to-face interviewing. AIDS Education and Prevention, 12, 199–213.PubMedGoogle Scholar
  64. Zuckerman, M. (1994). Impulsive unsocialized sensation seeking: The biological foundations of a basic dimension of personality. In J. E. Bates, & T. D. Wachs (Eds.), Temperament: Individual differences at the interface of biology and behavior (pp. 219–255). Washington, DC: American Psychological Association.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2009

Authors and Affiliations

  • Sarah J. Schmiege
    • 1
  • Michael E. Levin
    • 2
  • Angela D. Bryan
    • 3
  1. 1.Department of Psychology, 345 UCBUniversity of ColoradoBoulderUSA
  2. 2.Department of Psychology, MS 296University of Nevada, RenoRenoUSA
  3. 3.Department of Psychology and Center on Alcoholism, Substance Abuse, and AddictionsUniversity of New MexicoAlbuquerqueUSA

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