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Co-occurrence of intoxication during sex and sexually transmissible infections among young African American women: does partner intoxication matter?

Richard A. Crosby A B G , Ralph J. DiClemente C D E F , Gina M. Wingood C D , Laura F. Salazar C D , Delia Lang C , Eve Rose C and Jessica McDermott-Sales C

A College of Public Health, University of Kentucky, 121 Washington Avenue, Lexington, KY 40506, USA.

B Rural Center for AIDS/STD Prevention, Indiana University, 801 East 7th Street, Bloomington, IN 47405, USA.

C Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, 1516 Clifton Avenue, Atlanta, GA 30322, USA.

D Emory Center for AIDS Research, 1518 Clifton Avenue, Atlanta, GA 30322, USA.

E Emory University School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Epidemiology, and Immunology, 2015 Uppergate Drive, Atlanta, GA 30322, USA.

F Emory University School of Medicine, Department of Medicine (Infectious Diseases), 1440 Clifton Avenue, Atlanta, GA 30322, USA.

G Corresponding author. Email:

Sexual Health 5(3) 285-289
Submitted: 15 December 2007  Accepted: 1 May 2008   Published: 6 August 2008


Background: The co-occurrence of a behaviour (being intoxicated on alcohol/drugs during sex) with a disease outcome [laboratory-confirmed sexually transmissible infection (STI) prevalence] among young African American women and their male sex partners was studied. Methods: A cross-sectional study was conducted. Recruitment and data collection occurred in three clinics located in a metropolitan city of the Southern USA. A total of 715 African American adolescent females (15–21 years old) were enrolled (82% participation rate). The primary outcome measure was the analysis of self-collected vaginal swabs using nucleic acid amplification assays for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Results: After controlling for age and self-efficacy to negotiate condom use, young women’s alcohol/drug use while having sex was not significantly associated with STI prevalence [adjusted odds ratios (AOR) = 1.29, 95% confidence interval (CI) = 0.90–1.83]. However, using the same covariates, the association between male partners’ alcohol/drug use and sexually transmitted disease prevalence was significant (AOR = 1.44, 95% CI = 1.03–2.02). Young women reporting that their sex partners had been drunk or high while having sex (at least once in the past 60 days) were ~1.4 times more likely to test positive for at least one of the three assessed STIs. Conclusion: Young African American women reporting a male sex partner had been intoxicated during sex were significantly more likely to have an STI. The nature of this phenomenon could be a consequence of women’s selection of risky partners and lack of condom use possibly stemming from their intoxication or their partners’ intoxication.

Additional keywords: adolescent females, condom use, sexual behaviour.


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