调查英国年轻人物质使用与性行为之间的关系：一项全国概率调查的结果
Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey.
作者信息
Khadr S N, Jones K G, Mann S, Hale D R, Johnson A M, Viner R M, Mercer C H, Wellings K
机构信息
Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK.
Research Department of Infection and Population Health, University College London, London, UK.
出版信息
BMJ Open. 2016 Jun 30;6(6):e011961. doi: 10.1136/bmjopen-2016-011961.
BACKGROUND
Health risk behaviours are prominent in late adolescence and young adulthood, yet UK population-level research examining the relationship between drug or alcohol use and sexual health and behaviour among young people is scarce, despite public health calls for an integrated approach to health improvement. Our objective was to further our understanding of the scale of and nature of any such relationship, using contemporary data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).
METHODS
Analyses of data from Natsal-3, a stratified probability survey of 15 162 men and women (3869 aged 16-24 years), undertaken in 2010-2012, using computer-assisted personal interviewing, were carried out. Logistic regression was used to explore associations between reporting (1) frequent binge drinking (≥weekly), (2) recent drug use (within past 4 weeks) or (3) multiple (both types of) substance use, and key sexual risk behaviours and adverse sexual health outcomes. We then examined the sociodemographic profile, health behaviours and attitudes reported by 'risky' young people, defined as those reporting ≥1 type of substance use plus non-condom use at first sex with ≥1 new partner(s), last year.
RESULTS
Men and women reporting frequent binge drinking or recent drug use were more likely to report: unprotected first sex with ≥1 new partner(s), last year; first sex with their last partner after only recently meeting; emergency contraception use (last year) and sexually transmitted infection diagnosis/es (past 5 years). Associations with sexual risk were frequently stronger for those reporting multiple substance use, particularly among men. The profile of 'risky' young people differed from that of other 16-24 years old.
CONCLUSIONS
In this nationally representative study, substance use was strongly associated with sexual risk and adverse sexual health outcomes among young people. Qualitative or event-level research is needed to examine the context and motivations behind these associations to inform joined-up interventions to address these inter-related behaviours.
背景
健康风险行为在青春期后期和青年期较为突出，然而，尽管公共卫生领域呼吁采取综合方法促进健康改善，但英国针对年轻人中药物或酒精使用与性健康及性行为之间关系的人群层面研究却很匮乏。我们的目标是利用英国第三次全国性态度和生活方式调查（Natsal - 3）的当代数据，进一步了解这种关系的规模和性质。
方法
对2010 - 2012年进行的Natsal - 3数据进行分析，这是一项对15162名男性和女性（3869名年龄在16 - 24岁之间）的分层概率调查，采用计算机辅助个人访谈。逻辑回归用于探讨报告（1）频繁暴饮（每周≥1次）、（2）近期药物使用（过去4周内）或（3）多种（两种类型）物质使用与关键性风险行为和不良性健康结果之间的关联。然后，我们研究了被定义为去年报告≥1种物质使用且与≥1名新伴侣首次性行为时未使用避孕套的“高风险”年轻人报告的社会人口学特征、健康行为和态度。
结果
报告频繁暴饮或近期药物使用的男性和女性更有可能报告：去年与≥1名新伴侣首次性行为时未采取保护措施；与最后一名伴侣在最近才相识后发生首次性行为；去年使用紧急避孕药以及过去5年被诊断患有性传播感染。对于报告多种物质使用的人，尤其是男性，与性风险的关联通常更强。“高风险”年轻人的特征与其他16 - 24岁的人不同。
结论
在这项具有全国代表性的研究中，物质使用与年轻人的性风险和不良性健康结果密切相关。需要进行定性或事件层面的研究，以考察这些关联背后的背景和动机，为解决这些相互关联行为的联合干预措施提供信息。
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