Adolescent substance use and sexually transmitted diseases at risk: A review.
Abstract
The behavioral antecedents and correlates of sexually transmitted diseases (STD) a m o n g adolescents are issues of clear relevance to the prevention of STD (1). Substance use particularly of alcohol and other mood-altering d r u g s - - i s often identified as an important causal link with risky sexual behavior (2). This assumption of causal relationships between abuse of substances and high-risk sexual behavior is derived from cultural lore (3), and patterns of increasing involvement in both types of behavior during adolescence (4,5). H e a v y alcohol use is associated with increased STD rates for some adolescent groups (6,7), and "sex u n d e r the influence" as a risk for adolescent STD appears to be an assumption held b y both researchers and policy makers (8). M a n y STD prevention programs n o w target substance use as a preventable antecedent of risky sexual behavior. Some studies, however, raise questions about a causal role for substance use in STD-risk, and point toward more complex relationships of these behaviors (9-12).