Examining differential relationships of substance use and risky sexual behavior among African American and white adolescents

Abstract

Adolescents are at disproportionate risk for health consequences associated with risky sexual behavior (RSB), including sexually transmitted infections and unintended pregnancy. Racial disparities have also been observed with African American adolescents experiencing higher rates of such negative health outcomes than their White peers. Substance use, particularly alcohol and marijuana use, has been shown to predict RSB among adolescents of both racial groups. However, research suggests that alcohol use is more predictive of RSB in White adolescents than African American adolescents, perhaps due to significantly higher rates of alcohol use among White adolescents. Given recent trends indicating higher rates of marijuana use among African American adolescents than their White peers and a strong association between marijuana use and RSB among African American adolescents, marijuana use may better explain the relationship between substance use and risky sexual behavior among African Americans than alcohol use. Thus, the current study examined whether alcohol and marijuana use have differential effects on adolescent RSB by race at the event- and global-level of analysis. To that end, 113 adolescents ages 14-18 (African American = 93, White=20) completed self-report measures of substance use and RSB. Contrary to hypotheses, results revealed no racial differences in the relationship between substance use and RSB. However, post-hoc analyses revealed that marijuana use significantly predicted frequency of sex among African American adolescents above the effects of alcohol. These findings indicate that previously documented racial differences in the relationship between substance use and RSB may not be accounted for by marijuana use, but suggest that future studies continue to examine the unique impact of marijuana use on RSB, particularly among African American adolescents.