Min Meeyoung O, Minnes Sonia, Lang Adelaide, Albert Jeffrey M, Kim June-Yung, Singer Lynn T
Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
Drug Alcohol Depend. 2016 Apr 1;161:284-91. doi: 10.1016/j.drugalcdep.2016.02.013. Epub 2016 Feb 16.
To assess the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors. Externalizing behavior, teen substance use, and early sexual intercourse were examined as pathways mediating the effects of PCE on sexual risk behaviors.
Adolescents (N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Risky sexual behaviors were assessed at ages 15 and 17. Externalizing behavior at 12 years was assessed with the Youth Self-Report. Substance use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. Path analyses with the weighted least squares estimator with mean and variance adjustments were performed.
The final structural equation model-based path model, χ(2)=31.97 (df=27), p=.23, CFI=.99, TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk behavior (β=.16, p=.02). Although PCE was related to greater externalizing behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse (β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001), bootstrapping indicated a non-significant indirect effect (β=.01, p>.10). Substance use was correlated with early sexual intercourse (r=.60, p<.001) and predicted sexual risk behavior by age 17 (β=.31, p=.01).
Prenatal cocaine exposure was related to more engagement in sexual risk behaviors, suggesting the importance of reducing substance use among pregnant women as a means of prevention of offspring substance use and sexual risk behavior.
评估产前可卡因暴露（PCE）对青少年性风险行为的影响。将外化行为、青少年物质使用和过早性交作为介导PCE对性风险行为影响的途径进行研究。
前瞻性纳入了出生时的一项纵向研究中的青少年（N = 364；185名有PCE，179名无可卡因暴露（NCE）；205名女孩，159名男孩），主要为非裔美国人且社会经济地位较低。在15岁和17岁时评估危险性行为。12岁时用青少年自评量表评估外化行为。15岁时通过自评和生物学检测评估物质使用情况，并评估过早（15岁之前）性交情况。采用加权最小二乘估计器并进行均值和方差调整的路径分析。
最终基于结构方程模型的路径模型，χ(2)=31.97（自由度 = 27），p = 0.23，CFI = 0.99，TLI = 0.99，RMSEA = 0.021，WRMR = 0.695，表明PCE对性风险行为有直接影响（β = 0.16，p = 0.02）。虽然PCE与更多的外化行为相关（β = 0.14，p = 0.009），而外化行为反过来又预测过早性交（β = 0.16，p = 0.03），进而导致性风险行为（β = 0.44，p < 0.001），但自抽样法表明间接效应不显著（β = 0.01，p > 0.10）。物质使用与过早性交相关（r = 0.60，p < 0.001），并预测到17岁时的性风险行为（β = 0.31，p = 0.01）。
产前可卡因暴露与更多参与性风险行为有关，这表明减少孕妇物质使用作为预防后代物质使用和性风险行为手段的重要性。
