Methamphetamine Use Is Independently Associated with Recent Risky Sexual Behaviors and Adolescent Pregnancy

Article excerpt

INTRODUCTION

Methamphetamine, a schedule II stimulant drug, is chemically related to amphetamine and has a high potential for abuse and addiction. (1) Methamphetamine can be smoked, taken orally, taken intranasally, or administered via intravenous injection. Central nervous system and psychological effects of methamphetamine use include increased alertness, decreased appetite, euphoria, insomnia, increased self-confidence, hypersexuality, and decreased sexual inhibitions. (2-4)

In the United States, methamphetamine use is reaching epidemic proportions and receiving widespread popular media attention including a 2005 Newsweek cover story entitled "America's most dangerous drug." (5) Treatment admission rates for primary methamphetamine or amphetamine abuse (most of which was methamphetamine abuse) increased 331% between 1993 and 2003, from 13 to 56 admissions per 100,000 persons aged 12 years and older. (6) Data from the 2004 National Survey on Drug Use and Health found that 11.7 million (4.9%) Americans aged 12 years or older had ever used methamphetamine in their lifetime and 1.4 million (0.6 %) had used methamphetamine during the past year. (7) Among adolescents, school-based surveys have estimated the prevalence of lifetime methamphetamine use to be between 5% and 10%. (8,9)

Youth substance use in general, including use of cigarettes, alcohol, marijuana, and other illicit drags, has been associated with initiation of sexual activity, having 4 or more lifetime sexual partners, and nonuse of contraception during last intercourse. (10) These risky sexual behaviors may lead to sexually transmitted infections (STIs), human immunodefidency virus (HIV) infection, and unintended pregnancy. Each year in the United States, 1 in 4 teens contracts an STI, (11) costing an estimated $6.5 billion per year. (12) In addition, nearly half of incident HIV infections in the Unites States occur in people younger than 25 years, with the majority being infected through sexual behavior. (11) Adolescent pregnancy is a serious public health concern given its association with material high school dropout rates and receipt of late or no prenatal care, infant prematurity and low birth weight, and child abuse and neglect, (13) costing between $7 and $15 billion per year in direct costs in the United States. (11)

Although several studies have documented an association between methamphetamine use and risky, (14-19) sexual behaviors among gay and bisexual men, fewer studies have examined the association among heterosexuals (20,21) and only 1 has been reported among US youth. (22) Notwithstanding this latter study, the independent effect of methamphetamine use on recent risky sexual behaviors has received little attention. The purpose of this analysis was to investigate the association between ever using methamphetamine (ie, lifetime methamphetamine use) and recent high-risk sexual behaviors and lifetime adolescent pregnancy in a national sample of US youth, adjusting for other substance use behaviors.

METHODS

Subjects

We analyzed data from the 2003 national Youth Risk Behavior Survey (YRBS), a school-based paper-and-pencil survey assessing risky health behaviors among US high school students. (23) This survey, which was administered to whole classrooms, used a 3-stage duster design to draw a nationally representative sample of 15,214 students in grades 9-12. Parental permission was obtained for all participating youth. Black and Hispanic students were oversampled. Additional details on the sampling strategy and procedures employed by the YRBS have been described elsewhere. (23) The YRB S was reviewed and approved by an institutional review board at the Centers for Disease Control and Prevention, Atlanta, GA.

Instrument

Methamphetamine use was measured by the question "During your life, how many times have you used methamphetamines (also called speed, crystal, crank, or ice)? …