Sexual Behavior and Substance Use in Adolescence and Young Adulthood: Non-specific Associations Between a Range of Sexual Behaviors and Alcohol, Nicotine, and Marijuana Use

Sexual behaviors and substance use exhibit high rates of co-occurrence and similar patterns of age-related change, with typical initiation in middle adolescence followed by large increases in late adolescence and emerging adulthood. Because adolescent sexual behaviors are associated with negative health consequences including sexually-transmitted infections and substance use, adolescent sexual behaviors are often conceptualized within a health-risk framework. Sexual development, however, is a normative process important for healthy psychosocial adjustment, with the timing (early vs later initiation) and context (casual vs romantic partner) of sexual behaviors influencing their association with health risks. We tested whether seven common sexual behaviors could be conceptualized as markers along a continuum of sexual development (e.g., from kissing and making out to oral, vaginal, and anal sex) and then examined their associations with various measures of substance use in a sample of adolescents and young adults (N = 626; ages 13-22 years old). We found a 2-parameter logistic item response theory model provided a good fit to the prevalence and covariance among the sexual behaviors, with each behavior holding a different location on a trait representing the progression of sexual development. Each sexual behavior was associated with greater substance use even after adjusting for an early initiation of sexual behavior, current age, biological sex, and socioeconomic status. The results indicate that even normative sexual behaviors have strong and non-specific associations with substance use in adolescence and emerging adulthood.

Adolescent Sexual Behavior Patterns in a British Birth Cohort: A Latent Class Analysis

This study examined adolescent sexual behaviors patterns, and the consistency between sexual behavior and sexual orientation, in a prospective birth cohort. We used data on 5150 young people from the Avon Longitudinal Study of Parents and Children. Sexual orientation was assessed using a 5-point scale of sexual attraction at 15.5 years. Fourteen sexual activities were assessed using the Adolescent Sexual Activities Index at 13.5 and 15.5 years. Latent class analysis suggested four subgroups of adolescent sexual behaviors at 13.5: a “high-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (3.87%); a “moderate-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (16.57%); a “low-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (34.21%); and a “no sexual behavior” group (45.35%). There were five subgroups at 15.5 where four of them (23.42%, 18.37%, 28.12%, and 24.52%, respectively) were interpreted the same as at 13.5 years and a new “high-intensity sexual behaviors, some same-sex intimacy” subgroup (5.57%). Latent transition analysis showed approximately half the adolescents moved toward greater engagement in higher intensity sexual activities with other-sex at 15.5. Boys and girls who were in groups without same-sex intimacy were predominantly attracted to the other-sex, whereas there were moderate consistencies between same-sex intimacy and same-sex attraction for boys and low consistency for girls. Findings suggest that it may be important to include low-intensity sexual behaviors when assigning adolescents to sexual orientation groupings (via sexual behaviors) in order to reduce selection biases and increase statistical power via the increase in sample size.

Beliefs and misconceptions about contraception and condom use among adolescents in south-east Nigeria

Background: Misconceptions about the usefulness of condoms and other contraceptives in preventing unwanted teenage pregnancies and sexually-transmitted infections (STIs) among unmarried adolescents, still expose many adolescents to the risk of both conditions due to certain misconceptions. This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. Method: A qualitative study was undertaken in six local government areas in Ebonyi state, southeast Nigeria. Data was collected within a period of one month from in and out-of-school adolescents aged 13 to 18 years using twelve focus group discussions (FGD). The data was analyzed using the thematic framework approach. Result: Majority of the adolescents were knowledgeable about methods of contraception, how they are used and their modes of action. They were also knowledgeable about the dual effects of condoms for prevention of pregnancy and STIs. However, some misconceptions that were expressed by some adolescents were that pregnancy could be prevented by the use of i) hard drugs, ii) laxatives, iii) white chlorine, and iv) boiled alcoholic beverages. Condoms were described by some adolescent boys as reusable. Condoms were also perceived by some adolescents to reduce sexual pleasure, and this opinion was mostly held by boys. Coitus interruptus (withdrawal method) was therefore considered more preferable than condoms for prevention of pregnancy. Conclusion: Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behavior change interventions in schools and within communities to debunk persisting misconceptions about contraception, and properly educate adolescents on safe sex practices. Keywords: Misconceptions, Contraceptives, Condom, Adolescent, Sexual behaviors