Frequency of Alcohol Use in Adolescence as a Marker for Subsequent Sexual Risk Behavior in Adulthood



      Although a number of studies have demonstrated an association between alcohol use frequency and sexual risk behavior, few have used longitudinal data. This study examined alcohol use frequency in adolescence as a predictor of HIV sexual risk behavior in adulthood.


      We collected data among 1,368 participants in Colorado. During adolescence (time 1), respondents were asked about the frequency of using alcohol during the previous 12 months. In adulthood (time 2), the same respondents were asked about their sexual risk behavior during the previous 12 months. Sexual risk behavior items were used to construct an index, which was categorized to indicate low-, medium-, and high-risk study participants. The relationship between alcohol use patterns and risky sexual behavior was modeled using ordinal regression.


      Compared with individuals who drank no alcohol in the past 12 months at time 1, the odds of being in a higher risk group of sexual behavior as opposed to a lower one at time 2 were 1.56 (95% CI, 1.04–2.35) among those who drank 6–19 times. Similarly, the odds of being in a higher risk group relative to a lower one among those who drank ≥20 times or were 1.78 (95% CI, 1.05–3.02).


      Alcohol use patterns in adolescence may be useful markers for programs that aim to prevent risky sexual behavior. Based on alcohol intake patterns, it may be possible to identify frequent alcohol users that need to be targeted with appropriate alcohol use and HIV risk reduction messages.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Adolescent Health
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Prejean J.
        • Song R.
        • Hernandez A.
        • et al.
        Estimated HIV incidence in the United States, 2006–2009.
        PLoS One. 2011; 6: e17502
        • CDC
        Increases in unsafe sex and rectal gonorrhea among men who have sex with men–San Francisco, California, 1994–1997.
        MMWR Morb Mortal Wkly Rep. 2010; 48: 45-48
      1. United Nations Children's Fund & Joint United Nations Programme on HIV/AIDS and World Health Organisation: Young People and HIV/AIDS. Opportunity in Crisis: United Nations Children's Fund (UNICEF). 2002. Available at: Accessed January 26, 2012.

        • Shelton J.D.
        • Halperin D.T.
        • Nantulya V.
        • et al.
        Partner reduction is crucial for balanced “ABC” approach to HIV prevention.
        BMJ. 2004; 328: 891-893
        • Ericksen K.P.
        • Trocki K.F.
        Behavioral risk factors for sexually transmitted diseases in American households.
        Soc Sci Med. 1992; 34: 843-853
        • Gregson S.
        • Garnett G.P.
        • Nyamukapa C.A.
        • et al.
        HIV decline associated with behavior change in Eastern Zimbabwe.
        Science. 2006; 311: 664-666
        • Kral A.H.
        • Bluthenthal R.N.
        • Booth R.E.
        • et al.
        HIV seroprevalence among street-recruited injection drug and crack cocaine users in 16 US municipalities.
        Am J Public Health. 1998; 88: 108-113
        • Graves K.L.
        • Leigh B.C.
        The relationship of substance use to sexual activity among young adults in the United States.
        Fam Plann Perspect. 1995; 27: 18-22
        • Cooper M.L.
        Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence.
        J Stud Alcohol Suppl. 2002; : 101-117
        • Leigh B.C.
        • Stall R.
        Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention.
        Am Psychol. 1993; 48: 1035-1045
        • Zimmer-Gembeck M.J.
        • Helfand A.
        Ten years of longitudinal research on U.S. adolescent sexual behavior: Developmental correlates of sexual intercourse, and the importance of age, gender and ethnic background.
        Dev Rev. 2008; 28: 153-224
        • Floyd L.J.
        • Latimer W.
        Adolescent sexual behaviors at varying levels of substance use frequency.
        J Child Adolesc Substance Abuse. 2010; 19: 66-77
        • Morrison T.C.
        • DiClemente R.J.
        • Wingood G.M.
        • Collins C.
        Frequency of alcohol use and its association with STD/HIV-related risk practices, attitudes and knowledge among an African-American community-recruited sample.
        Int J STD AIDS. 1998; 9: 608-612
        • Stein M.
        • Herman D.S.
        • Trisvan E.
        • et al.
        Alcohol use and sexual risk behavior among human immunodeficiency virus-positive persons.
        Alcoholi Clin Exp Res. 2005; 29: 837-843
        • Kapiga S.H.
        • Sam N.E.
        • Shao J.F.
        • et al.
        HIV-1 epidemic among female bar and hotel workers in northern Tanzania: Risk factors and opportunities for prevention.
        J Acquir Immune Defic Syndr. 2002; 29: 409-417
        • Mnyika K.S.
        • Klepp K.I.
        • Kvale G.
        • OleKingori N.
        Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania.
        Intl J STD AIDS. 1997; 8: 176-183
        • Dogan S.J.
        • Stockdale G.D.
        • Widaman K.F.
        • Conger R.D.
        Developmental relations and patterns of change between alcohol use and number of sexual partners from adolescence through adulthood.
        Dev Psychol. 2010; 46: 1747-1759
        • Rhea S.A.
        • Gross A.A.
        • Haberstick B.C.
        • Corley R.P.
        Colorado Twin Registry.
        Twin Res Human Genet. 2006; 9: 941-949
      2. Petrill SA, Plomin R, DeFries JC, Hewitt JK, editors. Nature, nurture, and the transition to early adolescence. Adolescence 2005;40:870.

        • Stallings M.C.
        • Corley R.P.
        • Dennehey B.
        • et al.
        A genome-wide search for quantitative trait Loci that influence antisocial drug dependence in adolescence.
        Arch Gen Psychiatry. 2005; 62: 1042-1051
        • Johnston L.D.
        • O'Mally P.M.
        • Bachman J.G.
        National survey results on drug use from the Monitoring the Future Study, 1975–1998.
        Secondary school students. Vol. I. National Institute on Drug Abuse, Rockville, MD1999 (Available at:) (Accessed March 6, 2012)
        • Booth R.E.
        • Mikulich-Gilbertson S.K.
        • Brewster J.T.
        • et al.
        Predictors of self-reported HIV infection among drug injectors in Ukraine.
        J Acquir Immune Defic Syndr. 2004; 35: 82-88
        • Cottler L.B.
        • Robins L.N.
        • Helzer J.E.
        The reliability of the CIDI-SAM: A comprehensive substance abuse interview.
        Br J Addict. 1989; 84: 801-814
        • Allen D.R.
        • Finlayson T.
        • Abdul-Quader A.
        • Lansky A.
        The role of formative research in the National HIV Behavioral Surveillance System.
        Public Health Rep. 2009; 124: 26-33
        • Kutner M.H.
        • Nachtsheim C.
        • Neter J.
        Applied linear regression models.
        McGraw–Hill/Irwin, New York2004
        • O'Brien R.M.
        A caution regarding rules of thumb for variance inflation factors.
        Qual Quant. 2007; 41: 673-690
        • Seth P.
        • Wingood G.M.
        • DiClemente R.J.
        • Robinson L.S.
        Alcohol use as a marker for risky sexual behaviors and biologically confirmed sexually transmitted infections among young adult African-American women.
        Womens Health Issues. 2011; 21: 130-135
        • Avins A.L.
        • Woods W.J.
        • Lindan C.P.
        • et al.
        HIV infection and risk behaviors among heterosexuals in alcohol treatment programs.
        JAMA. 1994; 271: 515-518
      3. United Nations Population Fund. Adolescents and young people. State of World Population 2004. Available at: Accessed November 12, 2012.

        • Kalmuss D.
        • Davidson A.
        • Cohall A.
        • et al.
        Preventing sexual risk behaviors and pregnancy among teenagers: Linking research and programs.
        Perspect Sex Reprod Health. 2003; 35: 87-93
        • Hall P.A.
        • Holmqvist M.
        • Sherry S.B.
        Risky adolescent sexual behavior: A psychological perspective for primary care clinicians.
        Top Adv Pract Nurs eJournal. 2004; 4 (Available at:) (Accessed November 12, 2012)
        • Sieving R.E.
        • Eisenberg M.E.
        • Pettingell S.
        • Skay C.
        Friends' influence on adolescents' first sexual intercourse.
        Perspect Sex Reprod Health. 2006; 38: 13-19
        • Simons-Morton B.
        • Chen R.
        Latent growth curve analyses of parent influences on drinking progression among early adolescents.
        J Stud Alcohol. 2005; 66: 5-13
        • Ellickson P.L.
        • Hays R.D.
        Antecedents of drinking among young adolescents with different alcohol-use histories.
        J Stud Alcohol. 1991; 52: 398-408
        • Wood M.D.
        • Read J.P.
        • Mitchell R.E.
        • Brand N.H.
        Do parents still matter? Parent and peer influences on alcohol involvement among recent high school graduates.
        Psychol Addict Behav. 2004; 18: 19-30
        • Ryan S.M.
        • Jorm A.F.
        • Lubman D.I.
        Parenting factors associated with reduced adolescent alcohol use: A systematic review of longitudinal studies.
        Aust NZ J Psychiatry. 2010; 44: 774-783
        • Young S.E.
        • Friedman N.P.
        • Miyake A.
        • et al.
        Behavioral disinhibition: Liability for externalizing spectrum disorders and its genetic and environmental relation to response inhibition across adolescence.
        Jo Abnorm Psychol. 2009; 118: 117-130
        • Hoyle R.H.
        • Fejfar M.C.
        • Miller J.D.
        Personality and sexual risk taking: A quantitative review.
        J Pers. 2000; 68: 1203-1231