The Global Burden of Disease Study 2016 has ranked unsafe sex as the 13th risk factors. Early sexual initiation (< 16 years) has been associated with various risky sexual practices, such as multiple sexual partners, sex with non regular partners, sex under the influence of alcohol or drugs, and condom nonuse. While risky sexual behavior has been correlated with use of a variety of substances among young people, illicit drug use among adolescents would increase the odds of risky sexual behavior further than alcohol or tobacco use. As early sexual initiation has become increasingly common in East Asia, Dr. Wei J. Chen from the Center for Neuropsychiatric Research and his collaborators examined whether preceding-sex use of illicit drugs acted as a mediator between early sexual initiation and risky sexual practices.
Dr. Chen and team utilized a sample of alcohol- and tobacco-using young adults recruited using respondent-driven sampling (RDS) in the Taipei metropolitan area from 2007 to 2010. Of the 1,115 participants recruited, 916 participants had had sexual experience. Causal mediation analyses were then conducted to examine whether illicit drug use preceding sex mediated these associations. The team found that 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%. Dr. Chen and team concluded that early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, and proposed to call for more attention to this population’s sexual health. These findings have been published in BMC Public Health.
Citation: Wu, TL; Ting, TT; Chen, CY; Su, LW; Chen, WJ. Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in Taiwan: Mediation analysis of preceding-sex use of illicit drugs. BMC Public Health. 2020 Nov 3;20:Article number 1647