Elsevier

Women's Health Issues

Volume 17, Issue 5, September–October 2007, Pages 300-309
Women's Health Issues

Article
Marijuana Use and Sexually Transmitted Infections in Young Women Who Were Teenage Mothers

https://doi.org/10.1016/j.whi.2007.07.002Get rights and content

Purpose

Teenage pregnancy and marijuana use are associated with higher risk of contracting sexually transmitted infections (STIs). In this study, we examined the role of early and current marijuana use as it related to STI risk in a sample of young women who were pregnant teenagers, using a variety of statistical models.

Methods

We recruited 279 pregnant adolescents, ages 12–18, from an urban prenatal clinic as part of a study that was developed to evaluate the long-term effects of prenatal substance exposure. Six years later, they were asked about their substance use and sexual history. The association of early and late marijuana use to lifetime sexual partners and STIs was examined, and then structural equation modeling (SEM) was used to illustrate the associations among marijuana use, number of sexual partners, and STIs.

Results

Bivariate analyses revealed a dose–response effect of early and current marijuana use on STIs in young adulthood. Early and current marijuana use also predicted a higher number of lifetime sexual partners. However, the effect of early marijuana use on STIs was mediated by lifetime number of sexual partners in the SEM, whereas African-American race, more externalizing problems, and a greater number of sexual partners were directly related to more STIs.

Conclusions

Adolescent pregnancy, early marijuana use, mental health problems, and African-American race were significant risk factors for STIs in young adult women who had become mothers during adolescence. Pregnant teenage girls should be screened for early drug use and mental health problems, because they may benefit the most from the implementation of STI screening and skill-based prevention programs.

Section snippets

Study Sample

Participants in this study were part of a larger, ongoing cohort study that sought to determine the long-term effects of prenatal substance use in the offspring of pregnant teenagers. Detailed methods of the study have been published previously (Cornelius, Goldschmidt, Day, & Larkby, 2002). Pregnant adolescents (12–18 years old) were recruited from an outpatient prenatal clinic (Time 1) at an inner-city teaching hospital associated with the University of Pittsburgh. All pregnant girls under age

Bivariate Results

Consistent with national surveillance data (CDC, 2005; Weinstock et al., 2004), African-Americans in this sample were significantly more likely to report having been infected with gonorrhea (18% vs. 3%), chlamydia (42% vs. 16%), pubic lice (13% vs. 3%) and trichomonas (24% vs. 7%) than Caucasians. The zero-order correlation between lifetime number of sex partners and number of STIs reported by Time 2 was r = .315 (p < .001). The results of cross-tabulations on marijuana usage at both time

Discussion

To our knowledge, this is the first longitudinal study that examines the associations between early and current marijuana use and risk for reported STIs in an urban community sample of teenage mothers while controlling for several demographic and psychosocial factors. Bivariate analyses suggested a dose–response effect of current marijuana use on STIs, and subsequent multivariate analyses were generally consistent with our other hypotheses. Adolescent mothers who had initiated marijuana at a

Conclusions

One of the most valuable contributions of this study is the use of both cross-sectional and longitudinal models, which were crucial in distinguishing which variables were associated with multiple partners and infections at both time points, and highlight the value of prospective cohort studies. Early marijuana use was associated with more sexual partners by young adulthood, suggesting that early substance users are at especially high risk for STIs, even within this vulnerable subgroup of girls.

Acknowledgments

Young Shim Jhon, Lidush Goldschmidt, and Sharon Leech provided invaluable assistance with data management and statistical analyses. The authors also thank the young women who made this study possible by contributing their time and candidly sharing their experiences with our interviewers and field staff.

Natacha M. De Genna is a developmental psychologist and postdoctoral fellow in substance use epidemiology at the University of Pittsburgh Medical School. Her primary research interest is the association among health-risk behaviors, especially substance use and sexual risk. She is also interested in psychosocial correlates of health-risk behavior such as aggression, and biosocial developmental transitions such as puberty and pregnancy.

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  • Cited by (0)

    Natacha M. De Genna is a developmental psychologist and postdoctoral fellow in substance use epidemiology at the University of Pittsburgh Medical School. Her primary research interest is the association among health-risk behaviors, especially substance use and sexual risk. She is also interested in psychosocial correlates of health-risk behavior such as aggression, and biosocial developmental transitions such as puberty and pregnancy.

    Marie D. Cornelius is Associate Professor of Psychiatry and Epidemiology at the University of Pittsburgh Medical School. Dr. Cornelius has designed a program of research that assesses the correlates of tobacco and alcohol use among pregnant teenagers and the long-term effects of exposure on the development of the offspring of these women. She is also a Co-Investigator on an intervention study to reduce tobacco and alcohol use among pregnant teenagers.

    Robert L. Cook is Associate Professor of Epidemiology, Biostatistics and Medicine at the University of Florida, Gainesville, Florida. His primary research interests are prevention of HIV/STDs in high-risk populations, including youth with alcohol and drug use problems.

    Supported by grants from the National Institute of Drug Abuse (NIDA 009275 PI: M.C.) and National Institute on Alcohol Abuse and Alcoholism (NIAAA 08284 PI: M.C.). N.D. was supported by a training grant from the National Institute of Alcohol Abuse and Alcoholism, (NIAAA T32 07453 PI: M.C.) as well as the University of Pittsburgh.

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