Department of Preventive Medicine, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China.
Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, No.1 Xincheng Road, Dongguan, 523808, Guangdong, China.
BMC Public Health. 2024 Sep 11;24(1):2474. doi: 10.1186/s12889-024-19939-z.
Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide.
Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12-17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1-2, 3-5, 6-9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors.
Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47-2.81] to 3.98[2.63-6.03]; risky: 2.43[1.75-3.38] to 4.21[3.26-5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12-14 years (vs. aged 15-17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas).
Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.
性行为，特别是高危性行为，已成为全球青少年面临的严重公共卫生问题，对包括人类免疫缺陷病毒（HIV）在内的性传播感染的预防构成了重大障碍。然而，利用一致和标准化的方法来研究青少年中烟草和酒精使用频率与总性行为和高危性行为之间的关联的研究有限。我们旨在研究全球青少年中烟草和/或酒精使用与总性行为和高危性行为之间的关联。
数据来自全球学校学生健康调查，该调查包括来自 59 个国家的 211847 名 12-17 岁的青少年。过去 30 天内烟草或酒精的使用频率分为 0、1-2、3-5、6-9 或≥10 天。烟草和酒精的使用也分为不使用、单独使用烟草、单独使用酒精和同时使用。多变量逻辑回归分析用于检查烟草和酒精使用与总性行为和高危性行为的独立和联合关联。
与不使用烟草相比，随着烟草使用频率从 1 到 2 天到≥10 天（总：2.03[95%置信区间 1.47-2.81]至 3.98[2.63-6.03]；高危：2.43[1.75-3.38]至 4.21[3.26-5.42]），以及随着酒精使用频率的增加，发生性行为的可能性增加。总体而言，与单独使用烟草、单独使用酒精和不使用者相比，同时使用烟草和酒精的人更有可能发生总性行为和高危性行为。同样，在青少年女孩中，与单独使用烟草相关的高危性行为的关联比在青少年男孩中更为明显（与青少年男孩相比），而在年龄较小的 12-14 岁青少年中，与单独使用酒精相关的高危性行为的关联比在年龄较大的 15-17 岁青少年中更为明显，在西太平洋地区（与非洲和美洲地区相比），与烟草和/或酒精使用相关的高危性行为的关联比在其他地区更为明显。
我们的研究结果表明，青少年中烟草和/或酒精使用与性行为之间存在独立和联合关联，且这种关联在年龄、性别和世卫组织区域之间存在差异。
