Increased Partner Risk Characteristic Among Adolescents Using Alcohol In the Moment

Abstract

Background Alcohol is a recognized risk factor for sexually transmitted diseases (STD) acquisition, but the mechanism is unclear. Potentially, adolescents using alcohol in the two hours before sex (in-the-moment use) have riskier sexual partners. Methods We used multivariable logistic regression to examine the association between in-the-moment alcohol use and partner risk characteristics reported for the most recent sex among primarily 17-18 year old adolescents originally recruited from a representative sample of Chicago public elementary schools. We created three composite partner risk profiles: partner familiarity risk (casual and unexpected), partner context risk (age discordance and met in public), and overall risk using all measures except partner alcohol use. Results Teens who reported any in-the-moment alcohol use were more likely than non-drinking teens to report casual [Adjusted Odds Ratio (AOR)=3.2, 95% CI = 2.1 to 4.9)], unexpected (AOR=1.6, 95% CI = 1.0 to 2.5), age discordant (AOR=3.0, 95% CI=2.0 to 4.6), or met in public partners (AOR=1.4, 95% CI = 1.0 to 2.1). For each composite measure, the number of partner risk characteristics reported increased linearly with the percent of teens drinking in-the-moment (Cochran-Armitage trend P<0.0001). Compared to zero characteristics, in-the-moment alcohol use was associated with increased odds of reporting one (AOR=2.8, 95% CI=1.7, 4.5), two (AOR=4.6, 95% CI=2.7, 7.6), or three to four characteristics (AOR=7.1, 95% CI=3.3, 15.3). Conclusions Our findings expand the link between in-the-moment alcohol use and partner risk reported in prior studies to encompass adolescents’ general sexual experiences and additional partner characteristics including the highly associated composite characteristics. For primarily 17-18 year olds’ most recent sexual encounter, adolescents using any alcohol in-the-moment were two to three times more likely than non-users to have a risky sex partner.