Profiles of young women’s alcohol and cannabis use linked to risk for sexually transmitted infection highlight the importance of multi-level targeted interventions: Findings from the Pittsburgh girls study

Abstract

Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18–20. Profile indicators included: women’s and partner’s alcohol and cannabis use, women’s sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors. Results: Two of the five identified profiles had low STI likelihood: “Low Use” of alcohol and cannabis (25.5%; overrepresented by Black women), and “Alcohol Only” (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: “Co-Use: Increasing Alcohol and Occasional Cannabis use” (16.5%; overrepresented by White women), “Co-Use: Occasional Alcohol and Cannabis use” (26.1%; overrepresented by Black women), and “Co-Use: Frequent Cannabis and Occasional Alcohol use” (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with “Low Use” and “Co-Use: Frequent Cannabis and Occasional Alcohol use” profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the “Co-Use: Frequent Cannabis and Occasional Alcohol use” profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural- and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.

Keywords:

• Alcohol
• cannabis
• sexually transmitted infection
• racial disparities

Disclosure statement

The authors have no disclosures to report.

Author contributions

TC developed the idea for the manuscript, conducted the analyses, and took the lead in writing this manuscript. AH and SS managed the operation of the Pittsburgh Girls Study. All authors, TC, AH, SS, LM, and CS provided critical feedback and contributed to the writing of the manuscript.

Additional information

Funding

R01 DA012237; MH056630 The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.