Risky Sex Behavior and Susbtance Use among Young Adults
Staton, Michele, Leukefeld, Carl, Logan, Tk, Zimmerman, Rick, Lynam, Donald, Milich, Richard, Martin, Catherine, McClanahan, Karen, Clayton, Richard, Health and Social Work
Adolescent experimentation with alcohol and drugs has been well documented in the literature (Kandel, 1975; Kandel & Faust, 1980; Yamaguchi & Kandel, 1984a, 1984b). Although some people consider experimentation with substance use normative, earlier research has examined the hypothesis that experimental substance use during adolescence may predict the continued use of such substances into young adulthood (Kandel, Davies, Karus, & Yamaguchi, 1986). This hypothesis is supported by Bachman et al. (1997), who documented a significant increase in cigarette, alcohol, and other drug use among adults who developed patterns of substance use during high school. Increases in substance use resulted in part from increased freedom as adolescents became adults. Leaving social control agents, such as parents and high school, promotes the making of autonomous decisions regarding drug and alcohol use. Bachman et al. also found that people who were not users in high school were more likely to continue not to use in subsequent years.
Substance use among teenagers and college students also has been related to risky sexual behavior. For example, in a sample of college students ages 17 to 24, 47 percent of men and 57 percent of women indicated that they had sexual intercourse one to five times while under the influence of alcohol (Butcher, Thompson, & O'Neal, 1991). Heavy use of alcohol also has been correlated with increased casual sex without condoms and with increased numbers of sex partners among 18-to-21-year-olds (McEwan, McCallum, Bhopal, & Madhok, 1992). In a younger teenage sample of 13-to-19-year-olds, respondents admitted engaging in riskier behaviors during sexual encounters when they used alcohol or other substances compared with encounters when they did not use substances (Cooper, Peirce, & Huselid, 1994).
One of the consequences of risky sexual behavior for this age group is the increased number of sexually transmitted diseases (STDs). Estimates show that nearly two-thirds of people who acquire STDs in the United States are under age 25 (Institute of Medicine, 1997). The most common bacterial STD in the United States is chlamydia, with two of the highest rates of chlamydia occurring among adolescents in general and young adult women (Institute of Medicine, 1997; Centers for Disease Control and Prevention [CDC], 1997b). Cases of genital herpes among white adolescents have increased five times, and cases among white people in their twenties have doubled over the past few years (Flemming, 1997). Among college-age women in one study, cases of human papillomavirus (HPV) infections increased from 26 percent to 43 percent over a three-year period (Ho, Bierman, Beardley, Chang, & Burk, 1998).
Studies have indicated that contracting STDs may increase the risk of being infected with HIV (Melnick et al., 1997). The Centers for Disease Control and Prevention (CDC) estimated that as many as half of new H IV infect ions may be among people under age 25 (CDC, 1997c). Because college students have more opportunities to have different sex partners and may use drugs and alcohol more often before sex (Butcher et al., 1991), it is likely that college students are at greater risk. Risky sex behavior is an important factor to consider for young adults, because the documented cases of HIV among 13-to-24-year-olds reported in 1995 showed that 6 percent of young men and 51 percent of young women were infected heterosexually (CDC, 1997a).
In summary, the literature suggests that many adolescents increasingly use alcohol and other substances as they progress into young adulthood. Using these substances also may lead to risky sex behaviors, which place young adults at increased risk of STDs, including HIV. Most of the research with the young adult population has focused on college students. The research described in this article studied young men and young women ages 19 to 21 with some college experience as well as young men and young women ages 19 to 21 with no college experience. …