Profiles of Young Women's Alcohol and Cannabis use Linked to Risk for Sexually Transmitted Infection Highlight the Importance of Multi-Level Targeted Interventions: Findings from the Pittsburgh Girls Study

Abstract

Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n ¼ 2,138; 58% Black, 42% White) at ages 18-20. Profile indicators included: women's and partner's alcohol and cannabis use, women's sexual risk behavior, and selfreported STI. Profile predictors included racial background, structural-, community-, and individuallevel risk factors. Results: Two of the five identified profiles had low STI likelihood: "Low Use" of alcohol and cannabis (25.5%; overrepresented by Black women), and "Alcohol Only" (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: "Co-Use: Increasing Alcohol and Occasional Cannabis use" (16.5%; overrepresented by White women), "Co-Use: Occasional Alcohol and Cannabis use" (26.1%; overrepresented by Black women), and "Co-Use: Frequent Cannabis and Occasional Alcohol use" (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with "Low Use" and "Co-Use: Frequent Cannabis and Occasional Alcohol use" profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the "Co-Use: Frequent Cannabis and Occasional Alcohol use" profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural-and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.

Adolescent sibling associations among alcohol, cannabis, and sexual risk behavior: A test of interdependence

“…In a study of juvenile justiceinvolved adolescents, researchers found adolescents who were heavy users of both cannabis and alcohol reported more risky sex than those who used only cannabis (Gillman, Yeater, Feldstein Ewing, Kong, & Bryan, 2018). In late-adolescent women, the highest STI risk was among those who used alcohol and cannabis (Chung et al, 2021). Furthermore, in another study, using both cannabis and alcohol at high rates in adolescence was significantly associated with greater likelihood of teen pregnancy, compared to moderate alcohol use (Green et al, 2017).…”

“…Adolescent substance use is associated with negative consequences, including risky sexual behaviors, which increases the likelihood adolescents experience sexually transmitted infections (STIs) and sexual assault (Chung, Hipwell, Stepp, Miller, & Sartor, 2021;Espelage, Davis, Basile, Rostad, & Leemis, 2018;Green et al, 2017). Although siblings are a main source of social influence during adolescence, few studies have considered how sibling substance use behaviors are related to risky sexual behaviors.…”

Adolescent Sibling Associations among Alcohol, Cannabis, and Sexual Risk Behavior: A Test of Interdependence

“…In a study of justice-involved adolescents, researchers found adolescents who were heavy users of both cannabis and alcohol reported a higher frequency of unprotected sex than those who used only cannabis (Gillman et al, 2018). In late-adolescent women, the highest STI risk was among those who used alcohol and cannabis (Chung et al, 2021). Furthermore, in another study, using both cannabis and alcohol at high rates in adolescence was significantly associated with greater likelihood of teen pregnancy, compared to moderate alcohol use (Green et al, 2017).…”

“…Adolescent substance use is associated with negative consequences, including risky sexual behaviors, which increases the likelihood adolescents experience sexually transmitted infections (STIs) and sexual assault (Chung et al, 2021;Espelage et al, 2018;Green et al, 2017). Although siblings are a main source of social influence during adolescence, few studies have considered how sibling substance use behaviors are related to risky sexual behaviors.…”