PURPOSE Common polymorphisms in the N-acetyltransferase-2 (NAT2) metabolic enzyme determine slow or rapid acetylator phenotypes. We investigated the effects of alcohol, smoking, and caffeine on fecundability, and determined whether the effects were modified by NAT2. METHODS Three NAT2 polymorphisms were genotyped in 319 women office workers participating in a prospective pregnancy study (1990–1994). Women were ages 20–41 and at risk for pregnancy. Discrete-time survival analysis was used to determine the effects of alcohol, smoking, and caffeine on fecundability and evaluate effect modification by NAT2. RESULTS 319 women (161 slow acetylators, 158 rapid) were followed for an average of 8 menstrual cycles, resulting in 124 pregnancies. There was no effect of caffeine on fecundability. Drinking 1+ alcoholic drink/day and current smoking were significantly associated with reduced fecundability, but only among slow acetylators (adjusted fecundability odds ratio (FOR) for smoking= 0.34: 95% CI, 0.22, 0.90; adjusted FOR for 1+ drink/day = 0.20: 0.05, 0.92). There was no effect among rapid acetylators. CONCLUSIONS NAT2 status significantly modified the effects of alcohol and smoking on fecundability, emphasizing the importance of incorporating genetic and metabolic information in studies of reproductive health. Replication of this study is warranted.

The Bronx Teens Connection Clinic Linkage Model is an explicit framework for clinical and youth-serving organizations seeking to establish formal linkage relationships that may be useful for other municipalities or organizations.

Few sexual health studies have examined subgroup differences in youth risk behaviors that sufficiently account for sexual orientation and gender identity. This study used 2017 New York City Youth Risk Behavior Survey data (N ¼ 10,191), a stratified cluster-sampled survey, to examine descriptive differences in the prevalence of risky sexual behaviors, such as failing to use contraception and engaging in sexual activity while intoxicated, among others. Weighted logistic regression analyses revealed that LGBTQ youth were more likely to engage in risky sexual behaviors than non-LGBTQ youth, placing them at increased risk of pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV). Results suggest the need for prevention and intervention programs, and more fundamentally, basic health education and care for these adolescents whose risk for sexual and reproductive health concerns outweighs their non-LGBTQ peers.

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