Meta-analysis of the association between ecstasy use and risky sexual behavior
Highlights
► Meta-analyzed the association between ecstasy use and risky sexual behavior. ► Results indicated a small to moderate sized, statistically significant effect (weighted mean r = 0.211, 95% CI: 0.085–0.336, weighted median r = 0.161). ► Random-effects homogeneity testing was non-significant, thus formal moderator analyses were not performed. ► Numerical and visual diagnostics suggested that publication bias was not a concern.
Section snippets
Literature search and study descriptives
Two strategies were employed to obtain relevant empirical research articles published through April, 2011. First, keyword searches were conducted using electronic databases, such as PsycINFO, PubMed, and Conference Papers Index. Second, the reference lists of key articles were examined for additional relevant studies. Electronic search terms included MDMA, ecstasy, sexual risk, HIV/AIDS, STDs, and high-risk behavior. All empirical articles examining the association between MDMA/ecstasy use and
Results
Across the 17 studies, the pooled weighted mean r was 0.211 (95% CI: 0.085–0.336), and the median r was 0.161. Because the 95% CI for the pooled mean r excluded zero, the overall effect size was statistically significant at p < 0.05. The effect sizes and 95% confidence intervals for all studies are arrayed by ascending sample size in the forest plot presented in Fig. 1. Although the forest plot indicates variability in effect size estimates, the confidence intervals are overlapping in most cases.
Discussion
The primary objective of this meta-analysis was to ascertain the overall mean (and median) effect size between ecstasy use and risky sexual behavior. As regards to the overall strength of association, the mean weighted effect size between ecstasy use and risky sexual behavior was statistically significant and small to moderate in magnitude (mean weighted r = 0.211, 95% CI: 0.085–0.336, median r = 0.161). Such a positive association between ecstasy use and risky sexual behavior is consistent with
Role of funding sources
The authors declare they did not receive any external funding for the present study.
Contributors
JH conceptualized the project, ES conducted the literature review and coded the articles, JH developed the data analysis plan and performed all analyses, JH and ES interpreted the results, and JH and ES wrote the manuscript. Both authors have read and approved the final manuscript.
Conflict of interest
The authors have no financial disclosures and no conflicts of interest.
Acknowledgments
This research was supported in part by a 2011 Summer Undergraduate Research Grant awarded by the College of Charleston to James B. Hittner and Elana R. Schachne.
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References marked with an asterisk indicate studies included in the meta-analysis.