A cross-sectional study of the relationship between substance use and sexual risk behaviors among high school students

Objectives: Sexual risk behaviors among adolescents lead to 10 million new STIs in the United States each year and have resulted in 194,377 infants born to women aged 15-19 years in 2017. The present study aims to examine the relationship between substance use and HIV/STI-related sexual risk behaviors among a national sample of adolescents in the United States. Methods: Participants included 9th - 12th grade adolescents (N=14,765) who completed the 2017 National Youth Risk Behavior Survey. The independent variables were alcohol, marijuana, heroin, and prescription pain medicine use. The dependent variables were ever had sexual intercourse, condom use at time of last sexual intercourse, and ever been tested for HIV. Unadjusted and adjusted logistic regression models were examined. Results: Lifetime use of alcohol (OR= 0.72, CI= 0.69, 0.74; OR= 0.93, CI= 0.89, 0.98) and marijuana (OR= 0.71, CI= 0.69, 0.74; OR= 0.83, CI= 0.80, 0.86) was associated with ever had sex and ever been tested for HIV. Lifetime use of marijuana (OR= 1.11, CI= 1.08, 1.15) and prescription pain medicine (OR= 1.15, CI= 1.08, 1.23) was associated with decreased use of condoms at time of last sexual intercourse. Conclusions: Adolescents who reported ever using alcohol were more likely to have had sex and to have ever gotten tested for HIV. Adolescents who reported ever using marijuana were more likely to have ever had sex and to have ever been tested for HIV; among sexually experienced marijuana users, they were less likely to have used a condom the last time they had sexual intercourse. The study highlighted the need to provide youth with increased STI/HIV knowledge, including the influence of substance use on sexual risk behaviors