Sex Under the Influence: A Diary Self-Report Study of Substance Use and Sexual Behavior Among Adolescent Women

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Objective:To evaluate the potential causal relationship between alcohol and drug use and behavior that increases the risk of sexually transmitted diseases.Study Design:Longitudinal study conducted at a sexually transmitted diseases clinic and four community-based primary care clinics for adolescents. The participants were 82 female adolescents (age 16–19 years) who agreed to complete diaries recording each coital event. Subjects were participants in a larger study of prevention of reinfections by sexually transmitted organisms. The main outcome measure was condom use at each coital event. Predictor variables were usual pattern of condom use (when substances were not involved) and two event-specific measures: sex partner change and use of alcohol or drugs before intercourse.Results:Average time span of the diaries was 9.2 weeks. Subjects recorded 1,265 coital events. Ninety-three substance-associated coital events were recorded by 22 subjects. Event-specific condom use was associated with usual pattern of condom use, but not with event-specific variables of partner change or substance use before intercourse.Conclusions:These data do not support the hypothesis that substance use causes alteration of adolescent women's behavior in a manner that increases risk of sexually transmitted diseases.

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