Bonar Erin E, Cunningham Rebecca M, Chermack Stephen T, Blow Frederic C, Barry Kristen L, Booth Brenda M, Walton Maureen A
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Injury Center, University of Michigan, Ann Arbor, Michigan, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, School of Public Health, University of Michigan, Ann Arbor, Michigan.
J Stud Alcohol Drugs. 2014 Mar;75(2):259-68. doi: 10.15288/jsad.2014.75.259.
The purpose of this study was to evaluate associations between prescription drug misuse (PDM) and sexual risk behaviors (SRBs) among adolescents and emerging adults.
In a hospital emergency department, 2,127 sexually active 14- to 20-year-olds (61% female) reported on past-year alcohol use severity (using the Alcohol Use Disorders Identification Test-consumption [AUDIT-C]), cannabis use, PDM (n = 422), and SRBs (inconsistent condom use, multiple partners, intercourse following alcohol/other drug use).
Bivariately, AUDIT-C score, cannabis use, and PDM of stimulants, opioids, and sedatives were positively associated with each SRB. Because many participants reported PDM for multiple drug classes (i.e., sedatives, stimulants, opioids), participants were categorized as (a) no PDM (n = 1,705), (b) PDM of one class (n = 251), (c) PDM of two classes (n = 90), or (d) PDM of three classes (n = 81). Three hierarchical logistic regression models evaluated the associations of number of classes of PDM with SRBs separately, after accounting for demographics (age, gender, race), AUDIT-C score, and cannabis use. Adding PDM statistically improved each model beyond what was accounted for by demographics, alcohol, and cannabis use. For inconsistent condom use and substance use before sex, PDM of one, two, or three classes was significantly associated with increased odds of these SRBs. PDM of two or three classes was associated with increased odds of reporting multiple partners.
Findings suggest that PDM, especially poly-PDM, may be a pertinent risk factor for SRBs among youth. Event-based research could further evaluate how PDM, as well as other substance use, is related to SRBs at the event level in order to inform interventions.
本研究旨在评估青少年和刚成年者中处方药滥用（PDM）与性风险行为（SRB）之间的关联。
在一家医院急诊科，2127名14至20岁有性活动的青少年（61%为女性）报告了过去一年的酒精使用严重程度（使用酒精使用障碍识别测试-消费量[AUDIT-C]）、大麻使用情况、处方药滥用（n = 422）以及性风险行为（避孕套使用不一致、多个性伴侣、饮酒/使用其他药物后发生性行为）。
双变量分析显示，AUDIT-C评分、大麻使用以及兴奋剂、阿片类药物和镇静剂的处方药滥用与每种性风险行为均呈正相关。由于许多参与者报告了多种药物类别的处方药滥用情况（即镇静剂、兴奋剂、阿片类药物），参与者被分为以下几类：（a）无处方药滥用（n = 1705），（b）一种药物类别的处方药滥用（n = 251），（c）两种药物类别的处方药滥用（n = 90），或（d）三种药物类别的处方药滥用（n = 81）。在考虑了人口统计学因素（年龄、性别、种族）、AUDIT-C评分和大麻使用情况后，三个层次逻辑回归模型分别评估了处方药滥用的药物类别数量与性风险行为之间的关联。加入处方药滥用因素后，每个模型在统计学上都有显著改善，超出了人口统计学、酒精和大麻使用所解释的范围。对于避孕套使用不一致和性行为前使用药物的情况，一种、两种或三种药物类别的处方药滥用与这些性风险行为的发生几率增加显著相关。两种或三种药物类别的处方药滥用与报告有多个性伴侣的几率增加相关。
研究结果表明，处方药滥用，尤其是多种药物类别的处方药滥用，可能是青少年中性风险行为的一个相关风险因素。基于事件的研究可以进一步评估处方药滥用以及其他物质使用在事件层面与性风险行为的关系，以便为干预措施提供依据。
