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Abstract
We examined the association of illicit drug use with stress and sexual behaviors among 407 women, aged 18–31, who attended family-planning clinics in southeast Texas between June 2002 and May 2003 (n = 407). Paired comparisons of each of three types of drug users (of ecstasy, marijuana only, and other illicit drugs except ecstasy) with nonusers were assessed by logistic regressions. After controlling for demographics, both ecstasy users and marijuana-only users had a higher score on the stress scale than nonusers. All drug users were at higher risk of more lifetime sexual partners than those who had never used drugs, while those who had used ecstasy were more than twice as likely to have had prior sexually transmitted infections as those who had never used drugs. This study demonstrates that young, low-income women who use ecstasy experience higher levels of stress than nonusers. Stress level is correlated with drug use and participation in risky sexual behaviors. If stress is associated with drug use and risky sexual behavior, interventions designed to reduce substance use and risky sexual behavior in these women may need to also address factors that lead to increased stress. The study's limitations were noted.
RESUMEN
Examinamos la asociación del uso de drogas ilícitas con el estrés y el comportamiento sexual en mujeres de 18 a 31 años de edad. Mujeres que usan las clínicas de planeación familiar del suroeste de Tejas entre junio del 2002 a mayo del 2003 (n = 407). Comparando tres tipos de consumidor de drogas (de éxtasis, mariguana únicamente, y alguna otra droga ilícita con excepción del éxtasis), con no consumidores, evaluados con regresión logística. Después de controlar por datos demográficos, ambos, los consumidores de éxtasis y consumidores de mariguana únicamente tienen los niveles más elevados en la escala de estrés que los que no usan drogas. Todos los consumidores de drogas muestran un alto riesgo de tener más parejas sexuales que los que nunca utilizaron drogas. Mientras que los que utilizan éxtasis tienen más del doble de probabilidad de haber tenido previamente infecciones de transmisión sexual que los que nunca han usado drogas. Este estudio demuestra que las mujeres de bajos ingresos que usan éxtasis experimentan elevados niveles de estrés que las que no consumen drogas. Existe una correlación entre los niveles de estrés, el uso de drogas y la participación en el comportamiento sexual arriesgado. La intervención dirigida a reducir el uso de substancias y la conducta sexual peligrosa en mujeres de estas edades puede necesitar también señalar los factores que conllevan al incremento de estrés. Las limitaciones del estudio han sido señaladas.
THE AUTHORS
Zhao Helen Wu, PhD is Associate Professor in the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB). She has obtained funding as Principal Investigator on multiple NIDA grants focusing on substance abuse in hard-to-reach populations. Her studies in the last 10 years have specifically addressed emerging issues on substance use such as ecstasy use, as well as progression of substance abuse and dependence in young, low-income women. Many manuscripts have been published in peer review journals such as JAMA, the Annals of Epidemiology, Addictive Behaviors, Substance Use and Misuse, and the American Journal of Community Psychology.
James Grady, DrPH is Professor in the Department of Preventive Medicine and Community, Division of Epidemiology and Biostatistics at UTMB where he is active in research and teaching of Biostatistics courses. He is a Senior Biostatistician in the Office of Biostatistics, a campus-wide resource for statistical analysis and grant development. He is an active collaborator on several NIH grants. He was the GCRC statistician for over 10 before becoming the co-director of the Biostatistics portion of the Biostatistics, Epidemiology and Research Design core for the CTSA grant. His areas of interest in statistical research include analysis of correlated data from repeated measures and longitudinal studies, general linear models, power analysis, meta analysis, and design of clinical trials.
Stephen Rosales, MD received his MD from UTMB in 2005 after completing his BS program at Baylor University in Biology in 2001. He went on to complete his residency in Family Medicine at the University of Oklahoma Health Sciences Center in Oklahoma City, OK in 2008, having been Chief Resident of that program in his final year. Dr. Rosales now lives in Texas and works as a full time physician at the Department of Emergency Medicine at St Mark's Medical Center, La Grange, TX.
Abbey Berenson, MD is Professor of Obstetrics and Gynecology and Director of the UTMB Center for Interdisciplinary Research in Women's Health. She has developed a national reputation for her research programs in sexual abuse and contraception. Dr. Berenson has published over 100 peer-reviewed, patient-oriented research articles and is frequently sought out as an invited speaker. She has served on advisory panels to the FDA and CDC and has obtained funding as Principal Investigator from a number of federal agencies including NICHD, NIMH, HRSA and the Department of Defense. She is also the Director of the UTMB BIRCWH Program which trains junior faculty to conduct research in women's health and the UTMB NRSA funded postdoctoral program in reproductive health.