Substance Use, Sexual Intercourse, and Condom Nonuse Among Depressed Adolescents and Young Adults

The current study sought to "examine daily- and event-level associations of substance use with occurrence of sex and condom nonuse" among depressed, sexually active outpatients ages 15-22.

For two weeks, participants reported alcohol use, marijuana use and sexual activity on a personal digital assistant. If sex was reported, participants indicated partner type and condom use. Generalized estimating equations were used to analyze data for those who reported both substance use and sex events (N=39). Daily-level models compared the likelihood of sex and of condom nonuse between days on which participants did or did not use substances. Event-level models examined the likelihood of sex in the two, six and 12 hours following substance use and the likelihood of condom nonuse if substances were used in the preceding two, six and 12 hours.

A total of 307 sex events (180 unprotected) and 391 substance use events were reported on 572 days. Substance use was associated with increased odds of same-day sex, but not after adjusting for weekends. Depressed youths were less likely to have sex within two hours after substance use and more likely to report sex within 12 hours following marijuana use. No main effect of substance use on condom nonuse was seen, though there was a significant interaction such that on weekdays condom nonuse was less likely when substances were used within six hours prior to sex.

"The findings from this small, predominantly female sample suggest that contextual factors, not intoxication, influence associations of substance use with sexual behavior in depressed youth," the researchers concluded.

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