Factors associated with alcohol and/or drug use at sexual debut among sexually active university students: cross-sectional findings from Lebanon

• Published in: BMC public health 2014-07, Vol.14 (1), p.671-671, Article 671
• Main Authors: Ghandour, Lilian A, Mouhanna, Farah, Yasmine, Rola, El Kak, Faysal
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol Drinking - epidemiology; Analysis; College students; Confidence Intervals; Cross-Sectional Studies; Female; Humans; Lebanon - epidemiology; Male; Odds Ratio; Risk Factors; Sexual behavior; Sexual Behavior - psychology; Sexual Behavior - statistics & numerical data; Social aspects; Students; Studies; Substance-Related Disorders; Surveys; Surveys and Questionnaires; Teenagers; Universities; Women; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-14-671

Sexual activity accompanied by substance use can impair youth decision-making and enhance risk-taking behaviors. Less is known, however, about the sexual values, perceptions and subsequent sexual practices of youth whose sexual debut occurs while using alcohol/drugs. A cross-sectional anonymous online survey was conducted in April-August 2012 among undergraduate and graduate university students (aged 18 to 30) attending the 4th largest private university in Beirut. Pearson's Chi-square and regression models were run using Stata/IC 10.0. 940 university students had engaged in oral, anal and/or vaginal sex, of whom 10% admitted to having had consumed alcohol or taken drugs at sexual debut, a behavior that was more common in the males, less religious, non-Arabs, students living alone or who had lived abroad. Students who used alcohol/drugs at sexual debut were twice as likely to have: their first oral and vaginal sex with an unfamiliar partner [odds ratio (OR) = 2.6, 95% confidence interval (CI): (1.6, 4.2) and OR = 2.1 (1.2, 3.5), respectively], controlling for sex, nationality, current relationship status, living abroad after the age of 12, and spirituality. Students who had sex the first time while using alcohol/drugs were three times as likely to report having had 11 or more subsequent sexual partners versus one or two [OR = 3.0 (1.5-6.0)]; and almost twice as likely to ever engage in something sexual they did not want to do [OR = 1.7 (1.1, 2.8)]. Perceived peer pressure to have sex by a certain age [OR = 1.8 (1.1, 2.9)], and perceived peer norms to consume alcohol/drugs before sex [OR = 4.8 (2.3, 9.9)] were also strong correlates of having sex for the first time while using alcohol and/or drugs. Findings stress the importance of sexuality education for youth, and the need to begin understanding the true interplay--beyond association--between youth sexual practices and substance use behaviors from a broader public health perspective.