Skip to main content

Advertisement

SpringerLink
Log in

Heterogeneity in the Relationship of Substance Use to Risky Sexual Behavior Among Justice-Involved Youth: A Regression Mixture Modeling Approach

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Justice-involved adolescents engage in high levels of risky sexual behavior and substance use, and understanding potential relationships among these constructs is important for effective HIV/STI prevention. A regression mixture modeling approach was used to determine whether subgroups could be identified based on the regression of two indicators of sexual risk (condom use and frequency of intercourse) on three measures of substance use (alcohol, marijuana and hard drugs). Three classes were observed among n = 596 adolescents on probation: none of the substances predicted outcomes for approximately 18 % of the sample; alcohol and marijuana use were predictive for approximately 59 % of the sample, and marijuana use and hard drug use were predictive in approximately 23 % of the sample. Demographic, individual difference, and additional sexual and substance use risk variables were examined in relation to class membership. Findings are discussed in terms of understanding profiles of risk behavior among at-risk youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2008. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2009. http://www.cdc.gov/std/stats08/main.htm.

  2. Wilson CM, Wright PF, Safrit JT, Rudy B. Epidemiology of HIV infection and risk in adolescents and youth. J Acquir Immune Defic Syndr. 2010;54(Suppl 1):S5–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Elkington KS, Teplin LA, Mericle AA, Welty LJ, Romero EG, Abram KM. HIV/sexually transmitted infection risk behaviors in delinquent youth with psychiatric disorders: a longitudinal study. J Am Acad Child Adolesc Psychiatry. 2008;47(8):901–11.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Montanaro E, Ewing SW, Bryan AD. What works? An empirical perspective on how to retain youth in longitudinal HIV and substance risk reduction studies. Subst Abus. 2014.

  5. Teplin LA, Mericle AA, McClelland GM, et al. HIV and AIDS risky behaviors in juvenile detainees: implications for public health policy. Am J Public Health. 2003;93(6):906–12.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Teplin LA, Elkington KS, Mcclelland GM, Abram KM, Mericle AA, Washburn JJ. Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees. Psychiatr Serv. 2005;56(7):823–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tolou-Shams M, Steward A, Fasciano J, Brown LK. A review of HIV prevention interventions for juvenile offenders. J Pediatr Psychol. 2010;35(3):250–61.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Latham TP, Sales JM, Renfro TL, et al. Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women. Health Educ Res. 2012;27(5):895–903.

    Article  PubMed  Google Scholar 

  9. Lebeau-Craven R, Stein L, Barnett N, Colby SM, Smith JL, Canto AL. Prevalence of alcohol and drug use in an adolescent training facility. Subst Use Misuse. 2003;38(7):825–34.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Valera P, Epperson M, Daniels J, Ramaswamy M, Freudenberg N. Substance use and HIV-risk behaviors among young men involved in the criminal justice system. Am J Drug Alcohol Abuse. 2009;35(1):43–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. National Institute of Justice. ADAM (Arrestee Drug Abuse Monitoring Program): Annual report on drug use among adult and juvenile arrestees, 1999. Washington, DC: National Institute of Justice, NCJ; 2000. p. 181426.

    Google Scholar 

  12. Cooper LM. Does drinking promote risky sexual behavior? A complex answer to a simple question. Curr Dir Psychol Sci. 2006;15:19–23.

    Article  Google Scholar 

  13. LaBrie J, Earleywine M, Schiffman J, Pedersen E, Marriot C. Effects of alcohol, expectancies, and partner type on condom use in college males: event-level analyses. J Sex Res. 2005;42(3):259–66.

    Article  PubMed  Google Scholar 

  14. Leigh BC. Alcohol and condom use: a meta-analysis of event-level studies. Sex Transm Dis. 2002;29(8):476–82.

    Article  PubMed  Google Scholar 

  15. Tubman JG, Langer LM. ”About last night”: the social ecology of sexual behavior relative to alcohol use among adolescents and young adults in substance abuse treatment. J Subst Abuse. 1995;7(4):449–61.

    Article  CAS  PubMed  Google Scholar 

  16. Anderson BJ, Stein MD. A behavioral decision model testing the association of marijuana use and sexual risk in young adult women. AIDS Behav. 2011;15(4):875–84.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Andrade LF, Carroll KM, Petry NM. Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers. Am J Drug Alcohol Abuse. 2013;39(4):266–71.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Bellis MA, Hughes K, Calafat A, et al. Sexual uses of alcohol and drugs and the associated health risks: a cross sectional study of young people in nine European cities. BMC Public Health. 2008;8:155.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hensel DJ, Stupiansky NW, Orr DP, Fortenberry JD. Event-level marijuana use, alcohol use, and condom use among adolescent women. Sex Transm Dis. 2011;38(3):239–43.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Koopman C, Rosario M, Rotheram-borus MJ. Alcohol and drug use and sexual behaviors placing runaways at risk for HIV infection. Addict Behav. 1994;19(1):95–103.

    Article  CAS  PubMed  Google Scholar 

  21. Mackellar DA, Valleroy LA, Hoffmann JP, et al. Gender differences in sexual behaviors and factors associated with nonuse of condoms among homeless and runaway youths. AIDS Educ Prev. 2000;12(6):477–91.

    CAS  PubMed  Google Scholar 

  22. Walsh JL, Fielder RL, Carey KB, Carey MP. Do alcohol and marijuana use decrease the probability of condom use for college women? J Sex Res. 2014;51(2):145–58.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bryan A, Ray L, Cooper ML. Alcohol use and protective sexual behaviors among high-risk adolescents. J Stud Alcohol Drugs. 2007;68(3):327–35.

    Article  PubMed  Google Scholar 

  24. Bryan AD, Schmiege SJ, Magnan RE. Marijuana use and risky sexual behavior among high-risk adolescents: trajectories, risk factors, and event-level relationships. Dev Psychol. 2012;48(5):1429–42.

    Article  PubMed  Google Scholar 

  25. Kingree JB, Betz H. Risky sexual behavior in relation to marijuana and alcohol use among African-American, male adolescent detainees and their female partners. Drug Alcohol Depend. 2003;72(2):197–203.

    Article  CAS  PubMed  Google Scholar 

  26. Kingree JB, Braithwaite R, Woodring T. Unprotected sex as a function of alcohol and marijuana use among adolescent detainees. J Adolesc Health. 2000;27(3):179–85.

    Article  CAS  PubMed  Google Scholar 

  27. Liau A, Diclemente RJ, Wingood GM, et al. Associations between biologically confirmed marijuana use and laboratory-confirmed sexually transmitted diseases among African American adolescent females. Sex Transm Dis. 2002;29(7):387–90.

    Article  PubMed  Google Scholar 

  28. Rosengard C, Stein LA, Barnett NP, Monti PM, Golembeske C, Lebeau-craven R. Co-occurring sexual risk and substance use behaviors among incarcerated adolescents. J Correct Health Care. 2006;12(4):279–87.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Cooper ML. Alcohol use and risky sexual behavior among college students and youth: evaluating the evidence. J Stud Alcohol Suppl. 2002;14:101–17.

    Article  PubMed  Google Scholar 

  30. CDC (2015). Monitoring the Future Study: Trends in Prevalence of Various Drugs. http://www.drugabuse.gov/trends-statistics/monitoring-future/monitoring-future-study-trends-in-prevalence-various-drugs. Accessed 21 May 2015.

  31. Theodore PS, Duran RE, Antoni MH. Drug use and sexual risk among gay and bisexual men who frequent party venues. AIDS Behav. 2014;18:2178–86.

    Article  PubMed  Google Scholar 

  32. Pappas MK, Halkitis PN. Sexual risk taking and club drug use across three age cohorts of HIV-positive gay and bisexual men in New York city. AIDS Care. 2011;23:1410–6.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Duff P, Tyndall M, Buxton J, Zhang R, Kerr T, Shannon K. Sex for crack exchanges: associations with risky sexual and drug use niches in an urban Canadian city. Harm Reduct J. 2013;10:29.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Noor SW, Ross MW, Lai D, Risser JM. Use of latent class analysis approach to describe drug and sexual HIV risk patterns among injection drug users in Houston, Texas. AIDS Behav. 2014;18(Suppl 3):276–83.

    Article  PubMed  Google Scholar 

  35. Pagano ME, Maietti CM, Levine AD. Risk factors of repeated infectious disease incidence among substance-dependent girls and boys court-referred to treatment. Am J Drug Alcohol Abuse. 2015;41(3):230–6.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Jackson JM, Seth P, Diclemente RJ, Lin A. Association of depressive symptoms and substance use with risky sexual behavior and sexually transmitted infections among African American female adolescents seeking sexual health care. Am J Public Health. 2015;105(10):2137–42.

    Article  PubMed  Google Scholar 

  37. Steinberg JK, Grella CE, Boudov MR, Kerndt PR, Kadrnka CM. Methamphetamine use and high-risk sexual behaviors among incarcerated female adolescents with a diagnosed STD. J Urban Health. 2011;88(2):352–64.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Klein H, Elifson KW, Sterk CE. Self-esteem and HIV risk practices among young adult ecstasy users. J Psychoactive Drugs. 2010;42:447–56.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Steele CM, Josephs RA. Alcohol myopia: its prized and dangerous effects. Am Psychol. 1990;45(8):921–33.

    Article  CAS  PubMed  Google Scholar 

  40. Jessor R, Turbin MS, Costa FM. Protective factors in adolescent health behavior. J Pers Soc Psychol. 1998;75(3):788–800.

    Article  CAS  PubMed  Google Scholar 

  41. Schmiege SJ, Levin ME, Bryan AD. Regression mixture models of alcohol use and risky sexual behavior among criminally-involved adolescents. Prev Sci. 2009;10(4):335–44.

    Article  PubMed  Google Scholar 

  42. Van Horn ML, Smith J, Fagan AA, et al. Not quite normal: consequences of violating the assumption of normality in regression mixture models. Struct Equ Modeling. 2012;19:227–49.

    Article  Google Scholar 

  43. George MRW, Yang N, Jaki T, et al. Finite mixtures for simultaneously modeling differential effects and non-normal distributions. Multivariate Behav Res. 2013;48:816–44.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Ding CS. Using regression mixture analysis in educational research. Practic Assess Res Eval. 2006;11:1–11.

    Google Scholar 

  45. McLachlan GJ, Peel D. Finite mixture models. New York: Wiley; 2000.

    Book  Google Scholar 

  46. Cooper ML, Wood PK, Orcutt HK, Albino A. Personality and the predisposition to engage in risky or problem behaviors during adolescence. J Pers Soc Psychol. 2003;84(2):390–410.

    Article  PubMed  Google Scholar 

  47. Ethier KA, Kershaw TS, Lewis JB, Milan S, Niccolai LM, Ickovics JR. Self-esteem, emotional distress and sexual behaviour among adolescent females: inter-relationships and temporal effects. J Adoloesc Health. 2006;38:268–74.

    Article  Google Scholar 

  48. Huba GJ, Tenner A, Panter AT, Remafedi G, Melchior LA, Greenberg B, et al. Modeling HIV risk in highly vulnerable youth. Struct Equ Modeling. 2003;10:583–608.

    Article  Google Scholar 

  49. Kingree JB, Phan DL. Marijuana use and HIV risk among adolescent offenders: the moderating effect of age. J Subst Abuse. 2001;13(1–2):59–71.

    Article  CAS  PubMed  Google Scholar 

  50. Sarver DE, Mccart MR, Sheidow AJ, Letourneau EJ. ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk. J Child Psychol Psychiatry. 2014;55(12):1345–53.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Wu J, Witkiewitz K, Mcmahon RJ, Dodge KA. A parallel process growth mixture model of conduct problems and substance use with risky sexual behavior. Drug Alcohol Depend. 2010;111(3):207–14.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Mustanski B, Byck GR, Newcomb ME, Henry D, Bolland J, Dick D. HIV information and behavioral skills moderate the effects of relationship type and substance use on HIV risk behaviors among African American youth. AIDS Patient Care STDS. 2013;27(6):342–51.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Vasilenko SA, Kugler KC, Butera NM, Lanza ST. Patterns of adolescent sexual behavior predicting young adult sexually transmitted infections: a latent class analysis approach. Arch Sex Behav. 2014;44:705.

    Article  PubMed  Google Scholar 

  54. Andrade LF, Carroll KM, Petry NM. Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers. Am J Drug Alcohol Abuse. 2013;39(4):266–71.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Bryan A, Aiken LS, West SG. HIV/STD risk among incarcerated adolescents: optimism about the future and self-esteem as predictors of condom use self-efficacy. J Appl Soc Psychol. 2004;34:912–36.

    Article  Google Scholar 

  56. Schmiege SJ, Broaddus MR, Levin M, Bryan AD. Randomized trial of group interventions to reduce HIV/STD risk and change theoretical mediators among detained adolescents. J Consult Clin Psychol. 2009;77:38–50.

    Article  PubMed  Google Scholar 

  57. Murphy DA, Durako S, Muenz LR, Wilson CM. Marijuana use among HIV-positive and high-risk adolescents: a comparison of self-report through audio computer-assisted self-administered interviewing and urinalysis. Am J Epidemiol. 2000;152(9):805–13.

    Article  CAS  PubMed  Google Scholar 

  58. White HR, Labouvie EW. Towards the assessment of adolescent problem drinking. J Stud Alcohol. 1989;50(1):30–7.

    Article  CAS  PubMed  Google Scholar 

  59. Robbins R, Bryan A. Relationships between future orientation, impulsive sensation seeking, and the risk behavior of adjudicated adolescents. J Adolosec Res. 2004;19:428–45.

    Article  Google Scholar 

  60. Donohew L, Zimmerman R, Cupp PS, Novak S, Colon S, Abell R. Sensation seeking, impulsive decision-making, and risky sex: implications for risk-taking and design of interventions. Pers Individ Dif. 2000;28:1079–91.

    Article  Google Scholar 

  61. Hoyle RH, Stephenson MT, Palmgreen P, Lorch EP, Donohew RL. Reliability and validity of a brief measure of sensation seeking. Pers Individ Dif. 2002;31:401–14.

    Article  Google Scholar 

  62. Achenbach TM. Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington: University of Vermont, Department of Psychiatry; 1991.

    Google Scholar 

  63. Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965.

    Google Scholar 

  64. Bryan A, Rocheleau CA, Robbins RN, Hutchinson KE. Condom use among high-risk adolescents: testing the influence of alcohol use on the relationship of cognitive correlates of behavior. Health Psychol. 2005;24(2):133–42.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Schmiege SJ, Feldstein Ewing SW, Hendershot CS, Bryan AD. Positive outlook as a moderator of the effectiveness of an HIV/STI intervention with adolescents in detention. Health Educ Res. 2011;26(3):432–42.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Muthén LK, Muthén BO. Mplus User’s Guide. 7 ed. Los Angeles, CA: Muthén & Muthén; 1998-2014.

  67. Vermunt JK, Magidson J. Latent class cluster analysis. In: Hagenaars JA, McCutcheon AL, editors. Applied Latent Class Analysis. New York: Cambridge University Press; 2002. p. 89–106.

    Chapter  Google Scholar 

  68. Muthén BO. Beyond SEM: general latent variable modeling. Behaviormetrika. 2002;29:81–117.

    Article  Google Scholar 

  69. Muthén BO, Muthén LK. Integrating person-centered and variable-centered analysis: Growth mixture modeling with latent trajectory classes. Alcohol Clin Exp Res. 2000;24:882–91.

    Article  PubMed  Google Scholar 

  70. Lo Y, Mendell NR, Rubin DB. Testing the number of components in a normal mixture. Biometrika. 2001;88:767–78.

    Article  Google Scholar 

  71. Nylund KL, Asparouhov T, Muthén B. Deciding on the number of classes in latent class analysis and growth mixture modeling. A Monte Carlo simulation study. Struct Equ Modeling. 2007;14:535–69.

    Article  Google Scholar 

  72. Feingold A, Tiberio SS, Capaldi DM. New approaches for examining associations with latent categorical variables: applications to substance abuse and aggression. Psychol Addict Behav. 2014;28(1):257–67.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Simons JS, Maisto SA, Wray TB. Sexual risk taking among young adult dual alcohol and marijuana users. Addict Behav. 2010;35(5):533–6.

    Article  PubMed  Google Scholar 

  74. Bryan A, Fisher JD, Fisher WA. Tests of the mediational role of preparatory safer sexual behavior in the context of the theory of planned behavior. Health Psychol. 2002;21(1):71–80.

    Article  PubMed  Google Scholar 

  75. Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1:72–107.

    Article  Google Scholar 

  76. Netting NS, Burnett ML. Twenty years of student sexual behavior: subcultural adaptations to a changing health environment. Adolescence. 2004;39(153):19–38.

    PubMed  Google Scholar 

  77. Bryan AD, Schmiege SJ, Broaddus MR. HIV risk reduction among detained adolescents: a randomized, controlled trial. Pediatrics. 2009;124(6):1180–8.

    Article  Google Scholar 

  78. Rosengard C, Stein LA, Barnett NP, et al. Randomized clinical trial of motivational enhancement of substance use treatment among incarcerated adolescents: post-release condom non-use. J HIV AIDS Prev Child Youth. 2008;8(2):45–64.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Bauer DJ, Curran PJ. Distributional assumptions of growth mixture models: implications for overexraction of latent trajectory classes. Psychol Methods. 2003;8:338–63.

    Article  PubMed  Google Scholar 

  80. Williams RJ, Nowatzki N. Validity of adolescent self-report of substance use. Subst Use Misuse. 2005;40(3):299–311.

    Article  PubMed  Google Scholar 

  81. Donohue B, Hill HH, Azrin NH, Cross C, Strada MJ. Psychometric support for contemporaneous and retrospective youth and parent reports of adolescent marijuana use frequency in an adolescent outpatient treatment population. Addict Behav. 2007;32(9):1787–97.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by a Grant from the National Institute on Drug Abuse awarded to the second author (R01 DA019139) and by NIH/NCATS Colorado CTSI Grant Number UL1 TR001082, which provided support to the first author’s time in developing the manuscript. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

Author information

Authors and Affiliations

  1. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13120 E. 19th Ave, Mail Stop C288-04, Aurora, CO, 80045, USA

    Sarah J. Schmiege

  2. Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, USA

    Angela D. Bryan

Authors
  1. Sarah J. Schmiege
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Angela D. Bryan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah J. Schmiege.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schmiege, S.J., Bryan, A.D. Heterogeneity in the Relationship of Substance Use to Risky Sexual Behavior Among Justice-Involved Youth: A Regression Mixture Modeling Approach. AIDS Behav 20, 821–832 (2016). https://doi.org/10.1007/s10461-015-1219-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-015-1219-3

Keywords

Search

Navigation