Substance Use and Risky Sexual Behavior Among Adolescents: A Cross-National Clustered Analysis of 35 European and North American Countries
Bibliographic record
Abstract
Background: Adolescents, comprising about 16% of the global population, experience unique challenges during their transition to adulthood, which can be marked by substance use and risky sexual behaviors. Two key gaps exist in previous studies investigating substance use and sexual behaviors among adolescents including: (1) lack of stratified analysis based on sex; and (2) the use of broader or composite term/variable 'substance use'. This study sought to address these gaps by investigating the association between specific substances, including alcohol, cigarette, and cannabis and risky sexual behavior for adolescent boys and girls in 35 countries across Europe and North America. Methods: Data were obtained from the 2017/2018 Health Behavior in School-aged Children (HBSC) survey, involving 10,060 adolescents aged 15 years, stratified by gender 5574 boys and 4486 girls, from 35 countries. Clustered binary logit models using the Generalized Estimating Equation approach were employed to assess the association between the use of alcohol, cigarette, and cannabis and adolescent risky sexual behavior status. Results: Our results showed that alcohol use was statistically significantly associated with higher odds of risky sexual behavior for boys (AOR = 1.31; 95% CI = 1.16, 1.47) and not for girls (AOR = 1.07; 95% CI = 0.92,1.24). Cigarette smoking, however, was statistically significantly associated with higher odds of risky sexual behavior for girls (AOR = 1.58; 95% CI = 1.26,1.97) and not for boys (AOR = 1.26; 95% CI = 0.86, 1.84). Cannabis was not significantly associated with risky sexual behavior for both boys and girls. Conclusion: Findings from this study underscore the complex link between substance use and risky sexual behavior among adolescents. The results highlight the importance of understanding gender-specific differences in risk-taking behaviors, especially concerning substance use and its influence on risky sexual behaviors. These insights are crucial for designing effective interventions and promoting healthier behaviors among adolescents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".