Risk-Takers: Alcohol, Drugs, Sex and Youth - AbeBooks - Moira Plant:
Current as of: September 25, Home About MyHealth. Include Images Large Print. Set limits. Consequently, amongst those who did not use drugs under 16, boys were much more likely than girls to have had sex under Alcohol shows a similar relationship, with use under 16 increasing the odds of sex under 16 by only 2.
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The increase in early sex associated with early alcohol use was not significant in Venice, Ljubljana or Berlin Table 2. Participants reported if and how substances were utilised for sexual purposes Table 3. Overall, alcohol was most likely to be used to facilitate a sexual encounter while cocaine and cannabis were more likely to be utilised to enhance sensations and arousal Table 3.
Comparing between sexes, males were more likely to use alcohol to facilitate a sexual encounter although nearly a quarter of female alcohol users also used it for the same purpose. While a high proportion of both sexes used cocaine to prolong sex, males generally differed from females in their greater utilisation of alcohol and ecstasy for this purpose. Interestingly, a greater proportion of female than male users of cannabis took the drug to enhance sexual sensations and arousal; although this failed to reach statistical significance.
Although overall only There were few differences between individuals depending on whether they were single or with a partner although predictably more single people used cannabis and alcohol to facilitate sexual encounters. Finally gay and bisexual users of alcohol or cannabis were more likely to use such drugs to facilitate sexual encounters and heterosexual users were less likely to use cocaine to enhance sensations and arousal Table 3.
While such results identify the sexual benefits users seek from different substances, additional analyses examined the sexual risks associated with their use.
Alcohol and young people
Thus, participants who had been drunk in the past four weeks were more likely to have had five or more partners, sex without a condom and to have regretted sex after drink or drugs in the past 12 months Table 4. Cannabis, cocaine or ecstasy use was associated with having had five or more sexual partners in the previous 12 months, sex with no contraceptive protection and regretted sex after alcohol or drug use.
Exchange of sex for drugs was strongly linked to regular cocaine and ecstasy use with more than one in seven regular ecstasy users having done so in the past year.
To control for confounding relationships between behaviours, logistic regression was used to identify predictors for six key markers of sexual risk taking Table 5. Here, younger study participants were more likely to regret having sex after alcohol or drug use, but were less likely to seek an STI test, compared with older 26—35 years persons Table 5.
Regular cocaine use was also associated with having had sex without contraception, payment for sex, and having had an STI test. Any cannabis use was associated with sex without a condom or other form of contraception. Both cannabis and ecstasy use were associated with having had regretted sex after substance use.
Most sexual risk behaviours also varied significantly between city samples; except having exchanged sex for drugs and having had regretted sex. Participants from Vienna were most likely to have had an STI test, and five or more partners in the past 12 months.
Together with those from Athens, they were also substantially more likely to have paid for sex. Participants from the two former eastern block countries Czech Republic and Slovenia were most likely to have had sex without a condom and were least likely to have had an STI test. We used RDS, an established methodology validated for the purpose of sampling recreational drug users while minimising selection bias [ 23 ]. Here, in each location seeds were recruited according to a prescribed age sex profile in order to provide a broad initial sample as well as improve comparability between sites.
Although these techniques help facilitate wider distribution of the survey tool, our methodology did not allow an overall measure of response rates. Thus, our sample should not be considered representative of youths and young adults in any of the study cities but instead was a diverse opportunistic sample of individuals who routinely engaged in European nightlife and within which relationships between sexual and substance use behaviour could be examined. In addition, sample sizes precluded substantial examination of country-specific relationships with various substances and their sexual repercussions.
Nevertheless, our limited geographical analyses provide inferences that may be followed up in more depth by the individual countries concerned. Data collected also relied on recollection of levels of substance use, sexual behaviour and time of initiation into such behaviours. Such data are prone to recall bias and, where anonymity is not guaranteed, even deliberate misreporting. However, by guaranteeing anonymity, time and privacy to complete questionnaires, we attempted to maximise study participants' opportunity for recollection and honesty in their responses.
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Finally, like all cross-sectional surveys results cannot typically be used to establish cause and effect [ 24 ]. However, by directly questioning individuals about why they used particular substances we were able to establish the sexual effects users believed would result from drug use even within a cross sectional design.
Across a European sample, our findings indicate strong associations between sex and substance use in all cities studied from the point of initiation into alcohol consumption, drug use and sexual behaviour up to and including current social behaviour. Thus, alcohol, cannabis, cocaine and ecstasy use before the age of 16 were associated with sexual initiation before that age across all countries Table 2. Moreover, the relationship between initiation into sex and substance use appears especially strong in females Table 2.
Thus, taking substances early is associated with an increase in the odds of early sexual initiation in girls far greater than that in boys Table 2. Although at least in part the relationship between early sex and substance use may be related to the direct effects of substances on making sexual decisions, it is also likely to relate to a predisposition towards risk-taking in certain individuals, meaning some indulge in both behaviours [ 25 ].
However, regardless of whether one behaviour causes another, sexual activity accompanied by substance use is still likely to result in less informed decisions, more unprotected sex and more sex that is later regretted. Importantly however, the association between sex and substance use is not just incidental but frequently strategic. Thus, a third of male and nearly a quarter of female alcohol users reported using it specifically to facilitate a sexual encounter Table 3.
The use of alcohol to increase opportunities for sexual activity is not new. However, its use by both sexes in this fashion can reduce consideration of contraception and STI prevention and raise issues regarding whether consensual sex actually took place if one or more parties were drunk [ 26 ]. Thus, here frequent alcohol use was associated with having sex that was later regretted Table 4. Cocaine users are also using it to facilitate sexual encounters; in similar proportions in both sexes Table 3. While such practices may date back even centuries, many European countries have seen increases in cocaine use e.
Norway, Spain, UK [ 27 ] ; magnifying the potential contribution of cocaine to sexual risk-taking. In this study, being a cocaine user was significantly linked to having more sexual partners per year, having sex with no form of contraception and even having paid for sex Table 5. Other drugs are also being used strategically but for different sexual effects.
Cannabis, the most widely used recreational drug in Europe, is being used to enhance sexual sensations and arousal Table 3. Europe has an estimated Individual users of both sexes were using cocaine for this purpose and males cf. The use of cocaine during sex can mean length of sexual acts exceed natural lubrications, increasing risks of abrasions and subsequently STIs [ 1 , 28 ].
In fact our results suggest that, of the most commonly used drugs, cocaine has the strongest links amongst users with not just prolonged sex but also exploring exciting and unusual sex and enhancing sensations during sex. To a large extent it is the modern aphrodisiac. However, strategies and interventions addressing sexual health are often developed, managed and implemented independently from those addressing substance use, and vice versa [ 29 ].
As a result, information addressing the sexual effects of drugs is often absent from drug prevention leaflets, websites and campaign materials. Further, the role substance use plays in sexual activity can be a strong incentive to continue drug use; especially when it is routinely part of an individual's method of finding a partner, undertaking a sexual act and in some cases a psychological necessity for sex [ 30 ]. Despite this, those dealing with, for instance, recreational drug problems are often unaware of the role a drug's sexual effects play in continued use or, if necessary, how to bridge treatment between disciplines.
Thus, unlinked responses to sexual health and substance use will hamper drug prevention and cessation efforts [ 1 ]. Equally however, those tackling STIs should consider the key role that drug use can play.
Risk-takers: Alcohol, Drugs, Sex And Youth
However, those working in sexual health are often poorly informed about the sexual and other effects of drugs and rarely able to provide a one stop service to address both issues. A broader public health response which incorporates sex and substance use would provide new opportunities for substance use prevention and improvements in sexual health. In tobacco, for instance, the relationship between consumption and impotence has been used as a powerful message to reduce smoking prevalence by directly attacking a once positive association between sexuality and cigarettes [ 31 ].
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Despite attitudes that cannabis, ecstasy and cocaine can all be used to enhance sensations and arousal, use of such drugs can increase the likelihood of impotence in males and long-term use can permanently damage erectile function [ 32 ]. Using analyses presented here, such interventions could be designed for and targeted at the appropriate demographics.