Divison of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, USA.
Oakridge Associated Universities, 1299 Bethel Valley Rd, Oak Ridge, TN 37830, USA.
Addict Behav. 2019 Jun;93:122-128. doi: 10.1016/j.addbeh.2019.01.018. Epub 2019 Jan 17.
Limited information exists on whether associations between substance use behaviors (SUBs) and sexual risk behaviors (SRBs) vary by sexual identity.
Data from the 2015 national Youth Risk Behavior Survey (n = 15,624), were analyzed to assess associations between SUBs (cigarette smoking, alcohol use, binge drinking, marijuana use, prescription drug misuse, injection drug use, illicit drug use) and SRBs (sexual activity, number of partners, condom use). Logistic regression models calculated adjusted prevalence ratios (aPR), stratified by sexual identity, and interaction effects for sexual identity were introduced to models to determine if associations varied by sexual identity.
All SUBs had significant associations with current sexual activity and 4+ sexual partners for both heterosexual and LGB students. No condom use during last sexual intercourse was significantly associated with all SUBs except alcohol use among heterosexual students, while no condom use was only significantly associated with injection drug use among LGB students. Associations between current sexual activity and SUBs were significantly stronger among heterosexual compared to LGB students for smoking (aPR = 2.39;95% CI:2.15,2.65 vs aPR = 1.49;95% CI:1.14,1.95), marijuana use (2.41;2.15,2.71 vs 1.86;1.58,2.19) and prescription drug misuse (2.10;1.93,2.28 vs 1.60;1.28,2.00). Associations between no condom use and SUBs were significantly stronger for heterosexual compared to LGB students only for smoking (1.32;1.16,1.50 vs 0.96;0.73,1.25) and marijuana use (1.22;1.07,1.38 vs 0.90;0.72,1.12).
The relationship between most SUBs and SRBs did not vary significantly by sexual identity. These findings underscore the importance coordinating school-based programs to prevent substance use and promote sexual health.
关于物质使用行为 (SUBs) 和性风险行为 (SRBs) 之间的关联是否因性身份而异，目前信息有限。
对 2015 年全国青少年风险行为调查（n=15624）的数据进行了分析，以评估 SUBs（吸烟、饮酒、狂饮、大麻使用、滥用处方药物、注射药物使用、非法药物使用）与 SRBs（性活动、性伴侣数量、避孕套使用）之间的关联。使用 logistic 回归模型计算了调整后的患病率比 (aPR)，并按性身份分层，并在模型中引入了性身份的交互作用效应，以确定关联是否因性身份而异。
所有 SUBs 均与异性恋和 LGB 学生的当前性活动和 4+性伴侣有显著关联。除了异性恋学生的饮酒外，没有使用避孕套与所有 SUBs 都有显著关联，而 LGB 学生仅与注射药物使用有显著关联。与异性恋学生相比，当前性活动与 SUBs 之间的关联在吸烟（aPR=2.39；95%CI：2.15，2.65 vs aPR=1.49；95%CI：1.14，1.95）、大麻使用（2.41；2.15，2.71 vs 1.86；1.58，2.19）和滥用处方药物（2.10；1.93，2.28 vs 1.60；1.28，2.00）方面，在 LGB 学生中显著更强。与异性恋学生相比，没有使用避孕套与 SUBs 之间的关联仅在吸烟（1.32；1.16，1.50 vs 0.96；0.73，1.25）和大麻使用（1.22；1.07，1.38 vs 0.90；0.72，1.12）方面显著更强。
大多数 SUBs 和 SRBs 之间的关系不因性身份而异。这些发现强调了协调以学校为基础的计划以预防物质使用和促进性健康的重要性。
