Adolescent substance use and sexual risk-taking behavior

Purpose: To examine the relationship of adolescent substance use and depend ence to sexual risk-taking behavior in late adolescence and young adulthood . Methods: We prospectively examined self-reported sexual behaviors and subst ance involvement questionnaires in a sample of youth in substance abuse tre atment programs and a comparison sample of sociodemographically similar com munity youths without histories of substance use disorders recruited from m edia ads. Assessments of sexual behaviors and substance involvement (78% wh ite, 51% female) were collected at 2, 4, and 6 years after initial assessme nts, as they transitioned from middle adolescence to young adulthood (from age 15.5 to age 21.5 years, on average). The two samples were compared using Chi-square, analysis of variance, and m ultivariate analysis of variance approaches. Continuous indicators of high- risk sexual behaviors and substance involvement were analyzed with multiple regression. Results: Earlier age of onset to sexual activity, more sexual partners, les s consistent use of condoms, more sexually transmitted diseases (STDs), and greater prevalence of human immunodeficiency Virus testing were reported b y youth in the clinical treatment sample relative to sociodemographically c omparable nonabusing community youth. High rates of STDs were found among f emales, and more substance-abusing females reported pregnancies than commun ity females. Substance involvement continued to be associated with high-ris k sexual behavior throughout the transition into young adulthood. Conclusions: Youth identified with substance problems are more likely to en gage in risky sexual behaviors during adolescence and to continue risky sex ual behaviors to the extent that substance problems persist. Risk reduction education should be included with adolescent substance abuse treatment. (C ) Society for Adolescent Medicine, 2001.