Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2007 Dec;99(12):1386–1394.

STD-/HIV-related sexual risk behaviors and substance use among U.S. rural adolescents.

Alice F Yan 1, Yu-Wen Chiu 1, Carolyn A Stoesen 1, Min Qi Wang 1
PMCID: PMC2575928  PMID: 18229775

Abstract

OBJECTIVES: The present study aims to examine the relationship between substance use and HIV/sexually transmitted disease (STD)-related sexual risk behaviors among a national sample of sexually active adolescents in rural settings. METHODS: Participants included 9th-12th grade rural adolescents (N=5,745) who completed the 2003 national Youth Risk Behavior Survey. The independent variables were six substance use behaviors, including alcohol, marijuana, tobacco and cocaine use. The dependent variables were unprotected sex and the number of recent sexual partners. Univariate and multivariate logistic regression models were examined. RESULTS: Smoking > or =3 days during the past 30 days was associated with unprotected sex. Alcohol or drug use before last sexual intercourse, having ever used marijuana, having ever used cocaine and drinking alcohol during the past 30 days were associated with having multiple sexual partners. CONCLUSIONS: Results from the current study highlighted the need to provide youth with increased STD/HIV prevention knowledge in rural areas. Our finding confirmed that in order to achieve more effective STD/HIV prevention among high-risk substance-abusing youth, more intensive and better-tailored efforts will be needed to promote sexual risk reduction.

Full text

PDF
1386

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. E., Wilson R., Doll L., Jones T. S., Barker P. Condom use and HIV risk behaviors among U.S. adults: data from a national survey. Fam Plann Perspect. 1999 Jan-Feb;31(1):24–28. [PubMed] [Google Scholar]
  2. Bachanas Pamela J., Morris Mary K., Lewis-Gess Jennifer K., Sarett-Cuasay Eileen J., Sirl Kimberly, Ries Julie K., Sawyer Mary K. Predictors of risky sexual behavior in African American adolescent girls: implications for prevention interventions. J Pediatr Psychol. 2002 Sep;27(6):519–530. doi: 10.1093/jpepsy/27.6.519. [DOI] [PubMed] [Google Scholar]
  3. Binson D., Dolcini M. M., Pollack L. M., Catania J. A. Data from the National AIDS Behavioral Surveys. IV. Multiple sexual partners among young adults in high-risk cities. Fam Plann Perspect. 1993 Nov-Dec;25(6):268–272. [PubMed] [Google Scholar]
  4. Botvin G. J., Malgady R. G., Griffin K. W., Scheier L. M., Epstein J. A. Alcohol and marijuana use among rural youth: interaction of social and intrapersonal influences. Addict Behav. 1998 May-Jun;23(3):379–387. doi: 10.1016/s0306-4603(98)00006-9. [DOI] [PubMed] [Google Scholar]
  5. Centers for Disease Control and Prevention (CDC) Cluster of HIV-infected adolescents and young adults--Mississippi, 1999. MMWR Morb Mortal Wkly Rep. 2000 Sep 29;49(38):861–864. [PubMed] [Google Scholar]
  6. Centers for Disease Control and Prevention (CDC) Cluster of HIV-positive young women--New York, 1997-1998. MMWR Morb Mortal Wkly Rep. 1999 May 28;48(20):413–416. [PubMed] [Google Scholar]
  7. Centers for Disease Control and Prevention (CDC) HIV and AIDS--United States, 1981-2000. MMWR Morb Mortal Wkly Rep. 2001 Jun 1;50(21):430–434. [PubMed] [Google Scholar]
  8. Centers for Disease Control and Prevention (CDC) Trends in HIV-related risk behaviors among high school students--United States, 1991-2005. MMWR Morb Mortal Wkly Rep. 2006 Aug 11;55(31):851–854. [PubMed] [Google Scholar]
  9. Crosby R. A., Yarber W. L. Perceived versus actual knowledge about correct condom use among U.S. adolescents: results from a national study. J Adolesc Health. 2001 May;28(5):415–420. doi: 10.1016/s1054-139x(00)00213-5. [DOI] [PubMed] [Google Scholar]
  10. Eisenberg Marla, Wechsler Henry. Substance use behaviors among college students with same-sex and opposite-sex experience: results from a national study. Addict Behav. 2003 Jul;28(5):899–913. doi: 10.1016/s0306-4603(01)00286-6. [DOI] [PubMed] [Google Scholar]
  11. Guo Jiantong, Stanton Bonita, Cottrell Lesley, Clemens Rebecca L., Li Xiaoming, Harris Carole, Marshall Sharon, Gibson Catherine. Substance use among rural adolescent virgins as a predictor of sexual initiation. J Adolesc Health. 2005 Sep;37(3):252–255. doi: 10.1016/j.jadohealth.2004.11.124. [DOI] [PubMed] [Google Scholar]
  12. Howard Donna E., Wang Min Qi. Multiple sexual-partner behavior among sexually active US adolescent girls. Am J Health Behav. 2004 Jan-Feb;28(1):3–12. doi: 10.5993/ajhb.28.1.1. [DOI] [PubMed] [Google Scholar]
  13. Howard Donna E., Wang Min Qi. Multiple sexual-partner behavior among sexually active US adolescent girls. Am J Health Behav. 2004 Jan-Feb;28(1):3–12. doi: 10.5993/ajhb.28.1.1. [DOI] [PubMed] [Google Scholar]
  14. Kaplan D. W., Feinstein R. A., Fisher M. M., Klein J. D., Olmedo L. F., Rome E. S., Yancy W. S., Adams Hillard P. J., Sacks D., Pearson G. Condom use by adolescents. Pediatrics. 2001 Jun;107(6):1463–1469. doi: 10.1542/peds.107.6.1463. [DOI] [PubMed] [Google Scholar]
  15. Kelley Stephanie S., Borawski Elaine A., Flocke Susan A., Keen Kevin J. The role of sequential and concurrent sexual relationships in the risk of sexually transmitted diseases among adolescents. J Adolesc Health. 2003 Apr;32(4):296–305. doi: 10.1016/s1054-139x(02)00710-3. [DOI] [PubMed] [Google Scholar]
  16. Kingree J. B., Braithwaite R., Woodring T. Unprotected sex as a function of alcohol and marijuana use among adolescent detainees. J Adolesc Health. 2000 Sep;27(3):179–185. doi: 10.1016/s1054-139x(00)00101-4. [DOI] [PubMed] [Google Scholar]
  17. Kirby D., Barth R. P., Leland N., Fetro J. V. Reducing the risk: impact of a new curriculum on sexual risk-taking. Fam Plann Perspect. 1991 Nov-Dec;23(6):253–263. [PubMed] [Google Scholar]
  18. Licanin Ifeta, Redzić Amira. Alcohol abuse and risk behavior among adolescents in larger cities in Bosnia and Herzegovina. Med Arh. 2005;59(3):164–167. [PubMed] [Google Scholar]
  19. Milhausen Robin R., Crosby Richard, Yarber William L., DiClemente Ralph J., Wingood Gina M., Ding Kele. Rural and nonrural African American high school students and STD/HIV sexual-risk behaviors. Am J Health Behav. 2003 Jul-Aug;27(4):373–379. doi: 10.5993/ajhb.27.4.9. [DOI] [PubMed] [Google Scholar]
  20. Palepu Anita, Raj Anita, Horton Nicholas J., Tibbetts Nicole, Meli Seville, Samet Jeffrey H. Substance abuse treatment and risk behaviors among HIV-infected persons with alcohol problems. J Subst Abuse Treat. 2005 Jan;28(1):3–9. doi: 10.1016/j.jsat.2004.09.002. [DOI] [PubMed] [Google Scholar]
  21. Raj Anita, Saitz Richard, Cheng Debbie M., Winter Michael, Samet Jeffrey H. Associations between alcohol, heroin, and cocaine use and high risk sexual behaviors among detoxification patients. Am J Drug Alcohol Abuse. 2007;33(1):169–178. doi: 10.1080/00952990601091176. [DOI] [PubMed] [Google Scholar]
  22. Ramirez-Valles J., Zimmerman M. A., Newcomb M. D. Sexual risk behavior among youth: modeling the influence of prosocial activities and socioeconomic factors. J Health Soc Behav. 1998 Sep;39(3):237–253. [PubMed] [Google Scholar]
  23. Riehman Kara S., Wechsberg Wendee M., Francis Shelley A., Moore Melvin, Morgan-Lopez Antonio. Discordance in monogamy beliefs, sexual concurrency, and condom use among young adult substance-involved couples: implications for risk of sexually transmitted infections. Sex Transm Dis. 2006 Nov;33(11):677–682. doi: 10.1097/01.olq.0000218882.05426.ef. [DOI] [PubMed] [Google Scholar]
  24. Ross M. W., Williams M. L. Sexual behavior and illicit drug use. Annu Rev Sex Res. 2001;12:290–310. [PubMed] [Google Scholar]
  25. Sanders Stephanie A., Graham Cynthia A., Yarber William L., Crosby Richard A. Condom use errors and problems among young women who put condoms on their male partners. J Am Med Womens Assoc. 2003 Spring;58(2):95–98. [PubMed] [Google Scholar]
  26. Santelli J. S., Brener N. D., Lowry R., Bhatt A., Zabin L. S. Multiple sexual partners among U.S. adolescents and young adults. Fam Plann Perspect. 1998 Nov-Dec;30(6):271–275. [PubMed] [Google Scholar]
  27. Simbayi Leickness C., Kalichman Seth C., Cain Demetria, Cherry Charsey, Jooste Sean, Mathiti Vuyisile. Alcohol and risks for HIV/AIDS among sexually transmitted infection clinic patients in Cape Town, South Africa. Subst Abus. 2006 Dec;27(4):37–43. doi: 10.1300/j465v27n04_05. [DOI] [PubMed] [Google Scholar]
  28. Smith C. A. Factors associated with early sexual activity among urban adolescents. Soc Work. 1997 Jul;42(4):334–346. doi: 10.1093/sw/42.4.334. [DOI] [PubMed] [Google Scholar]
  29. Stevens M. M., Mott L. A., Youells F. Rural adolescent drinking behavior: three year follow-up in the New Hampshire substance abuse prevention study. Adolescence. 1996 Spring;31(121):159–166. [PubMed] [Google Scholar]
  30. Sánchez J., Comerford M., Chitwood D. D., Fernandez M. I., McCoy C. B. High risk sexual behaviours among heroin sniffers who have no history of injection drug use: implications for HIV risk reduction. AIDS Care. 2002 Jun;14(3):391–398. doi: 10.1080/09540120220123793. [DOI] [PubMed] [Google Scholar]
  31. Tapert S. F., Aarons G. A., Sedlar G. R., Brown S. A. Adolescent substance use and sexual risk-taking behavior. J Adolesc Health. 2001 Mar;28(3):181–189. doi: 10.1016/s1054-139x(00)00169-5. [DOI] [PubMed] [Google Scholar]
  32. Taylor J., Fulop N., Green J. Drink, illicit drugs and unsafe sex in women. Addiction. 1999 Aug;94(8):1209–1218. doi: 10.1046/j.1360-0443.1999.948120911.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES