Pathways to Adolescent Sexual Risk Behaviors: Effects of Prenatal Cocaine Exposure
Highlights
- Prenatal cocaine exposure (PCE) was related to adolescent
sexual risk.
- PCE is related to externalizing behavior, which increased
early sexual intercourse.
- Substance use was related to early sexual intercourse and
sexual risk behaviors.
- Reducing maternal drug use may mitigate offspring sexual
risk behavior.
BACKGROUND:
To assess
the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors.
Externalizing behavior, teen substance use, and early sexual intercourse were
examined as pathways mediating the effects of PCE on sexual risk behaviors.
METHODS:
Adolescents
(N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily
African-American and of low socioeconomic status, were prospectively enrolled
in a longitudinal study at birth. Risky sexual behaviors were assessed at ages
15 and 17. Externalizing behavior at 12 years was assessed with the Youth
Self-Report. Substance use, via self-report and biologic assays, and early
(before age 15) sexual intercourse were assessed at age 15. Path analyses with
the weighted least squares estimator with mean and variance adjustments were
performed.
RESULTS:
The final
structural equation model-based path model, χ(2)=31.97 (df=27), p=.23, CFI=.99,
TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk
behavior (β=.16, p=.02). Although PCE was related to greater externalizing
behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse
(β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001),
bootstrapping indicated a non-significant indirect effect (β=.01, p>.10).
Substance use was correlated with early sexual intercourse (r=.60, p<.001)
and predicted sexual risk behavior by age 17 (β=.31, p=.01).
CONCLUSIONS:
Prenatal
cocaine exposure was related to more engagement in sexual risk behaviors,
suggesting the importance of reducing substance use among pregnant women as a
means of prevention of offspring substance use and sexual risk behavior.
- 1Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States. Electronic address: meeyoung.min@case.edu.
- 2Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
- 3School of Medicine, Department of Epidemiology and Biostatistics, Cleveland, OH, United States.
- 4Departments of Environmental Health Sciences, Psychiatry & Pediatrics, Cleveland, OH, United States.
- Drug Alcohol Depend. 2016 Apr 1;161:284-91. doi: 10.1016/j.drugalcdep.2016.02.013. Epub 2016 Feb 16.
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