Abstract
Background: While The Bahamas have significantly reduced poor reproductive health outcomes among adolescents and emerging adults, data indicate that youth are engaged in sexual risk behaviors. Substance use has been linked to increased risk for HIV and sexually transmitted infections in other contexts. There are limited data on Bahamian youth in relation to consumption of alcohol and marijuana use and engagement in sexual behaviors.
Objective: This study aimed to assess potential relationships between alcohol and marijuana use and engagement in sexual behavior among government secondary school students in New Providence, The Bahamas.
Materials and methods: Total sample size was 2572, and about 56% of respondents were female. Mean age was 14.2 (SD 2.7 years). Cross-sectional data came from a baseline survey conducted as part of a longitudinal randomized controlled evaluation of a school-based HIV prevention and reproductive health program in New Providence.
Results: Overall, 46.5% (519) males and 44.8% (652) females reported alcohol consumption; 7.3% (82) males and 1.7% (25) females reported use of marijuana in the last 6 months. About 43% (477) male respondents and 16% (231) female respondents reported ever having vaginal sex. Logistic regression analysis indicates that increased likelihood of engaging in sex during the past 6 months is associated with being older, male, and consuming alcohol and marijuana.
Conclusion: These data provide a ‘global correlation’ between substance use and engagement in sexual behaviors among Bahamian adolescents. Longitudinal research is needed to assess event specific risks and identify mediating and moderating factors. These findings indicate the importance of integrating reproductive health and substance use education.
Acknowledgments
The research is funded through the U.S. National Institute of Mental Health, Grant Number R01 MH069229. We would like to thank the Bahamian Ministry of Health and Ministry of Education as well as the students, parents, teachers, principals, and guidance counselors who made this research possible.
References
1. Dinkelman J. Working towards an AIDS-free generation. The Nassau Guardian, December 2, 2011. Available at: http://www.thenassauguardian.com/index.php?option=com_content&view=article&id=17952:working-towards-an-aids-free-generation&catid=49:op-ed&Itemid=86.Search in Google Scholar
2. Gomez MP, Kimball AM, Orlander H, Bain RM, Fisher LD, et al. Epidemic crack cocaine use linked with epidemics of genital ulcer disease and heterosexual HIV infection in the Bahamas: evidence of impact of prevention and control measures. Sex Transm Dis 2002;29:259–64.10.1097/00007435-200205000-00002Search in Google Scholar PubMed
3. Ministry of Health, The Bahamas. Vital Statistics 2014. Nassau: The Bahamas.Search in Google Scholar
4. UNAIDS/Ministry of Health, Bahamas/PEPFAR. The Commonwealth of the Bahamas: Global AIDS Response Progress Reporting, Monitoring the 2011 Political Declaration on HIV/AIDS, Country Report 2012. Available at: http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/progressreports/2012countries/ce_BS_Narrative_Report[1].pdf.Search in Google Scholar
5. PAHO/WHO. Caribbean Epidemiology Centre. (2012) Morbidity Review of Communicable Diseases in CAREC Member Countries: Syphillis. Available at: http://new.paho.org/carec/dmdocuments/27.%20Syphilis.pdf.Search in Google Scholar
6. Department of Statistics of the Bahamas. Birth Report: 1970–2010. Reports of Surveys. Available at: www.statistics.bahamas.gov.bs/reports.php.Search in Google Scholar
7. Gong J, Stanton B, Lunn S, Deveaux L, Li X, et al. Effects through 24 months of an HIV/AIDS prevention intervention based on Protection Motivation Theory among preadolescents in The Bahamas. Pediatrics 2009;123:917–28.10.1542/peds.2008-2363Search in Google Scholar PubMed PubMed Central
8. PAHO/WHO. Health situation in the Americas: Basic Health Indicators (2012). Available at: http://new.paho.org/hq/index.php?option=com_content&view=article&id=2470&Itemid=2003&lang=en.Search in Google Scholar
9. Coleman LM. Young people, ‘risk’, and sexual behavior: a literature review. Report prepared for the Health Development Agency and the Teenage Pregnancy Unit. Brighton: Trust for the Study of Adolescence, 2005.Search in Google Scholar
10. Dermen KH, Cooper ML, Agocha VB. Sex-related alcohol expectancies as moderators of the relationship between alcohol use and risky sex in adolescents. J Stud Alcohol 1998;59:71–7.10.15288/jsa.1998.59.71Search in Google Scholar PubMed
11. Guilette DL, Lyons MA. Sensation seeking, self-esteem, and unprotected sex in college students. J Assoc Nurses AIDS Care 2006;7:23–31.10.1016/j.jana.2006.07.001Search in Google Scholar PubMed
12. Thompson JC, Kao TC, Thomas RJ. The relationship between alcohol use and risk-taking sexual behaviors in a large behavioral study. Prev Med 2005;41:247–52.10.1016/j.ypmed.2004.11.008Search in Google Scholar PubMed
13. Baliunas D, Rehm J, Irving H, Shuper P. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. Int J Public Health 2010;55:159–66.10.1007/s00038-009-0095-xSearch in Google Scholar PubMed
14. Boner EE, Whiteside LK, Walton MA, Zimmerman MA, Booth BM, et al. Prevalence and correlates of HIV risk among adolescents and young adults reporting drug use: data from an urban Emergency Department in the U.S. J HIV AIDS Soc Serv 2014;28:625–30.10.1080/15381501.2013.775685Search in Google Scholar
15. Chersich MF, Rees HV, Scorrgie F, Martin G. Enhancing global control of alcohol to reduce unsafe sex and HIV in sub-Saharan Africa. Global Health 2009;5:16.10.1186/1744-8603-5-16Search in Google Scholar PubMed PubMed Central
16. Li Q, Li X, Stanton B. Alcohol use and sexual risk behavior and outcomes in China: a literature review. AIDS Behav 2010;14:1227–36.10.1007/s10461-009-9648-5Search in Google Scholar PubMed PubMed Central
17. Thato S, Charron-Prochownik D, Dorn LD, Albrecht SA, Stone CA. Predictors of condom use among adolescent Thai vocational students. J Nurs Scholarsh 2003;35:157–63.10.1111/j.1547-5069.2003.00157.xSearch in Google Scholar PubMed
18. Kaljee L, Genberg B, Minh TT, Tho LH, Thoa LTK, et al. Alcohol use and risk behaviors among rural adolescents in Khanh Hoa Province Viet Nam. Health Educ Res 2004;20:71–80.10.1093/her/cyg096Search in Google Scholar
19. Kaljee L, Green M, Zhan M, Riel R, Lerdboon P, et al. Gender, alcohol consumption patterns and engagement in sexually intimate behaviors among adolescents and young adults in Nha Trang, Viet Nam. Youth Soc 2009;43:118–41.10.1177/0044118X09351285Search in Google Scholar
20. Terry Fountain, 2012 Bahamas Secondary School Drug Prevalence Survey, National Anti-Drug Secretariat, Ministry of National Security, Nassau, Bahamas.Search in Google Scholar
21. Liu H, Yu S, Cottrell L, Lunn S, Deveaux L, et al. Personal values and involvement in problem behaviors among Bahamian early adolescents: a cross-cultural study. BMC Public Health 2007;7:135–44.10.1186/1471-2458-7-135Search in Google Scholar
22. Padilla MB, Guilamo-Ramos V, Godbole R. A syndemic analysis of alcohol use and sexual risk behavior among tourism employees in Sosua, Dominican Republic. Qual Health Res 2012;22: 89–102.10.1177/1049732311419865Search in Google Scholar
23. Reid SD, Malow RM, Rosenberg R. Alcohol, drugs, sexual behavior and HIV in Trinidad and Tobago-the way forward. J Int Assoc Physicians AIDS Care 2012;11:66–82.10.1177/1545109711416245Search in Google Scholar
24. Andreuccetti G, Carvatho HB, Korcha R, Ye Y, Bond J, et al. A review of emergency room studies on alcohol and injuries conducted in Latin America and Caribbean region. Drug Alcohol Rev 2012;31:737–46.10.1111/j.1465-3362.2012.00419.xSearch in Google Scholar
25. Knowles V, Kaljee L, Deveaux L, Lunn S, Rolle G, et al. National implementation of an evidence-based HIV prevention and reproductive health program for Bahamian youth. Int Electron J Health Educ 2012;15:173–90.Search in Google Scholar
26. Stanton B, Chen X, Koci V, Deveaux L, Lunn S, et al. Effect of a grade 6 HIV risk reduction intervention four years later among students who were and were not enrolled in the study trial. J Adolesc Health 2012;50:243–9.10.1016/j.jadohealth.2011.06.012Search in Google Scholar
27. Stanton B, Black M, Feigelman S, Ricardo I, Galbraith J, et al. Development of a culturally, theoretically and developmentally based survey instrument for assessing risk behaviors among African American early adolescents living in urban low-income neighborhoods. AIDS Educ Prev 1995;7:160–77.Search in Google Scholar
28. Ohene SA. The clustering of risk behaviors among Caribbean youth. Matern Child Health J 2005;9:91–100.10.1007/s10995-005-2452-6Search in Google Scholar
29. Botvin GJ. Preventing drug abuse in schools: aocial and competence enhancement approaches targeting individual-level etiologic factors. Addict Behav 2000;25:887–97.10.1016/S0306-4603(00)00119-2Search in Google Scholar
30. Gibbons FX, Helweg-Larson M, Gerrard M. Prevalence estimates and adolescent risk behavior: Cross-sectional differences in social influences. J Appl Psychol 1995;80:107–21.10.1037/0021-9010.80.1.107Search in Google Scholar PubMed
31. Lewis MA, Lee CM, Patrick ME, Fossos N. Gender-specific normative misperceptions of risky sexual behavior and alcohol-related risky sexual behavior. Sex Roles 2007; 57:81–90.10.1007/s11199-007-9218-0Search in Google Scholar
32. Martens MP, Page JC, Mowry ES, Damann KM, Taylor KK, et al. Differences between actual and perceived student norms: An examination of alcohol use, drug use, and sexual behavior. J Am Coll Health 2006;54:295–300.10.3200/JACH.54.5.295-300Search in Google Scholar PubMed
33. Scholly K, Katz A, Gascoigne J, Hoick P. Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: An exploratory study. J Am Coll Health 2005;53:159–66.10.3200/JACH.53.4.159-166Search in Google Scholar PubMed
34. Beauclair R, Kassanjee R, Temmerman M, Welte A, Delva W. Age-disparate relationships and implications for STI transmission among young adults in Cape Town, South Africa. Eur J Contracep Reprod Health Care 2012;17:30–9.10.3109/13625187.2011.644841Search in Google Scholar PubMed
35. Volpe EM, Hardie TL, Cerulli C, Sommers MS, Morrison-Beedy D. What’s age got to do with it? Partner age difference, power, intimate partner violence, and sexual risk in urban adolescents. J Interpers Violence 2013;28:2068–87.10.1177/0886260512471082Search in Google Scholar PubMed PubMed Central
36. Wood EB, Hutchinson MK, Kague E, Hewitt H, Waldron N. Jamaican adolescent girls with older male sexual partners. J Nurs Scholarsh 2011;43:396–404.10.1111/j.1547-5069.2011.01418.xSearch in Google Scholar PubMed
37. Wood EB. HIV related sexual risk behaviors among late-adolescent Jamaican girls with older male partners. West Indian Med J 2010;59:403–8.Search in Google Scholar
38. Kaljee L, Lostutter T, Tho LH, Minh TT. Alcohol consumption, coping, and sexual behaviors among university men in Viet Nam: Implications for interventions. San Francisco, CA: Research Society for Alcoholism, 2012.Search in Google Scholar
©2016 by De Gruyter
