Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults

Context: Although alcohol and drug use by young people has been associated with sexual risk behavior in some research, detailed data are lacking on th e timing of substance use in relationship to sexual risk-taking. Methodology: Cross-sectional data on 7,441 unmarried young people aged 14-2 2 from the 1992 Youth Risk Behavior Survey (household supplement) were used in the analysis. Alcohol and other drug use at last sexual intercourse, su bstance use in the past 30 days (recent use), the number of different subst ances ever used (lifetime use) and age at initiation of alcohol use are exa mined here. The outcome variables assessed through multivariate regression analyses were condom use at last intercourse and more than one sexual partn er in the past three months. Results: Failure to use a condom was strongly associated with the lifetime substance-use scale or, alternatively, with age at initiation of alcohol. O nce the number of substances ever used was controlled for, neither substanc e use at last sexual intercourse nor recent use was associated with the lik elihood of using a condom at last coitus. Among young men and women, recent substance use and use of either alcohol or drugs at last intercourse were both strongly associated with having had more than one sexual partner in th e past three months. For females only, lifetime use also increased the prob ability of recent multiple partners. Conclusions: The relationships between alcohol and other drug use and two s exual behaviors-condom use and multiple partners-suggest distinct mechanism s of influence and the need for different prevention strategies.