Tapert S F, Aarons G A, Sedlar G R, Brown S A
Department of Psychiatry, University of California, San Diego, USA.
J Adolesc Health. 2001 Mar;28(3):181-9. doi: 10.1016/s1054-139x(00)00169-5.
To examine the relationship of adolescent substance use and dependence to sexual risk-taking behavior in late adolescence and young adulthood.
We prospectively examined self-reported sexual behaviors and substance involvement questionnaires in a sample of youth in substance abuse treatment programs and a comparison sample of sociodemographically similar community youths without histories of substance use disorders recruited from media ads. Assessments of sexual behaviors and substance involvement (78% white, 51% female) were collected at 2, 4, and 6 years after initial assessments, 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 multivariate analysis of variance approaches. Continuous indicators of high-risk sexual behaviors and substance involvement were analyzed with multiple regression.
Earlier age of onset to sexual activity, more sexual partners, less consistent use of condoms, more sexually transmitted diseases (STDs), and greater prevalence of human immunodeficiency virus testing were reported by youth in the clinical treatment sample relative to sociodemographically comparable nonabusing community youth. High rates of STDs were found among females, and more substance-abusing females reported pregnancies than community females. Substance involvement continued to be associated with high-risk sexual behavior throughout the transition into young adulthood.
Youth identified with substance problems are more likely to engage in risky sexual behaviors during adolescence and to continue risky sexual behaviors to the extent that substance problems persist. Risk reduction education should be included with adolescent substance abuse treatment.
探讨青少年药物使用及依赖与青春期后期及青年期性冒险行为之间的关系。
我们前瞻性地研究了药物滥用治疗项目中的青少年样本以及通过媒体广告招募的无药物使用障碍病史、社会人口统计学特征相似的社区青少年对照样本的自我报告性行为和药物使用情况问卷。在他们从青春期中期过渡到青年期（平均年龄从15.5岁到21.5岁）后的第2年、第4年和第6年收集性行为和药物使用情况评估（78%为白人，51%为女性）。使用卡方检验、方差分析和多变量方差分析方法对两个样本进行比较。对高风险性行为和药物使用的连续指标进行多元回归分析。
与社会人口统计学特征相当的未滥用药物的社区青少年相比，临床治疗样本中的青少年报告性活动开始年龄更早、性伴侣更多、避孕套使用一致性更低、性传播疾病（STD）更多以及进行人类免疫缺陷病毒检测的比例更高。女性中STD发生率较高，且滥用药物的女性报告的怀孕情况多于社区女性。在向青年期过渡的整个过程中，药物使用情况继续与高风险性行为相关。
有药物问题的青少年在青春期更有可能从事危险性行为，并且只要药物问题持续存在，就会继续进行危险性行为。青少年药物滥用治疗应包括降低风险教育。
