Aaron M. Martin

Sexting, substance use, and sexual risk behavior in young adults

PURPOSE Cell phone use has become more widespread over the past decade. Young adults are frequently early adopters of new technologies, including cell phones. Most previous research examining sexting, the act of sending sexually explicit or suggestive images via text message, has focused on the legal or social consequences of this behavior. The current study focused on the public health implications of sexting by examining associations between sexting, substance use, and sexual risk behavior in youth. METHODS Young adults (N = 763) completed online questionnaires assessing demographics, cell phone use (e.g., texting, sexting), substance use, and sexual risk behaviors. RESULTS Sexting was reported by a substantial minority of participants (44%). Compared with their nonsexting counterparts, participants who engaged in sexting were more likely to report recent substance use and high-risk sexual behaviors, including unprotected sex and sex with multiple partners. Of those who engaged in sexting, a considerable percentage (31.8%) reported having sex with a new partner for the first time after sexting with that person. In multivariate analyses, sexting was associated with high-risk sexual behavior, after accounting for demographic factors, total texting behaviors, and substance use. CONCLUSIONS Results suggest that sexting is robustly associated with high-risk sexual behavior. Many individuals exchange explicit or provocative photos with long-term sexual partners, but at least some participants in this study were incurring new sexual risks after sexting. Additional research is needed to understand the contexts in which sexting occurs, motivations for sexting, and relationship of sexting to risk behavior.

Non-medical use of prescription drugs and sexual risk behavior in young adults

In recent years, the non-medical use of prescription drugs (without a doctors prescription) has increased dramatically, particularly in young adults. Previous work has noted associations between the non-medical use of prescription drugs and the use of illicit drugs, and associations between the use of illicit drugs and sexual risk behavior. Investigations examining associations between the non-medical use of prescription drugs (NMUPD) and sexual risk behavior are sparse. In the present study, undergraduate students (n=435) ages 18-25 completed an instrument assessing these behaviors. Overall, 35.6% of participants reported NMUPD. Individuals who reported NMUPD were more likely to also report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, and poppers. Participants who indicated they had used prescription medications without a doctors consent had significantly higher rates of sexual risk behavior, including more sexual partners and more instances of unprotected sex in the previous 3 months. Results suggest that a significant minority of young adults are using prescription medication recreationally and are risking negative consequences, including the potential for addiction, dangerous interactions between prescription and recreational drugs, and greater risk for contracting sexually transmitted infections.

Nonmedical Use of Prescription Drugs and HIV Risk Behavior in Gay and Bisexual Men

Background: Previous research has demonstrated associations between substance use and sexual risk behavior in men who have sex with men (MSM). Recent trends in substance use show increasing use of prescription medications (e.g., Vicodin) without a physicians prescription, yet associations between the nonmedical use of prescription drugs (NMUPD) and HIV risk behavior have not been well examined in MSM. Methods: MSM attending a gay pride festival completed a self-report measure assessing NMUPD, motivations for use, use of traditional recreational drugs, and HIV risk behavior. Results: More than one-third of the sample (38%) reported lifetime NMUPD and 17% reported NMUPD in the previous 3 months. The most common class of medications used was prescription analgesics. Men reporting NMUPD also reported higher rates of the use of marijuana, poppers, ecstasy, cocaine, methamphetamine, GHB, ketamine, heroin, and rohypnol, and had significantly higher rates of HIV risk behaviors, including more sexual partners and more unprotected sex. Conclusions: A significant minority of MSM are using prescription medications without a doctors consent. Men who do so are risking negative consequences of such use, including the potential for addiction, potentially dangerous interactions between prescription and recreational drugs, and greater risk for contracting HIV.

Misleading Sexual Partners About HIV Status Among Persons Living with HIV/AIDS

Most people living with HIV/AIDS (PLWHA) disclose their serostatus to their sexual partners and take steps to protect their partners from HIV. Prior research indicates that some PLWHA portray themselves to their sexual partners as HIV-negative or otherwise misrepresent their HIV status. The aim of this study was to document the prevalence of misleading sexual partners about HIV status and to identify factors associated with misleading. A sample of 310 PLWHA completed a self-administered questionnaire assessing demographic information, disclosure, HIV knowledge, HIV altruism, psychopathy, and sexual risk behavior. Participants were also asked “Since you were diagnosed as having HIV, have you ever misled a sexual partner about your HIV status?” Overall, 18.6% of participants indicated that they had misled a sexual partner. Those who had misled a partner at some point since their diagnosis reported more current HIV transmission risk behaviors, including unprotected anal or vaginal sex with a partner who was HIV-negative or whose HIV status was unknown. Participants who had misled a partner did not differ from those who had not in terms of demographic characteristics. Individuals who had misled a partner scored significantly lower on a measure of HIV knowledge than those who had not misled a partner. HIV altruism and psychopathy were associated with sexual risk behavior, but did not differ between those who had misled and those who had not. Disclosure of HIV status can reduce HIV transmission, but only if people are candid. Interventions aimed at increasing knowledge and accurate disclosure may reduce the spread of HIV.

Driving Under the Influence of Prescription Drugs Used Nonmedically: Associations in a Young Adult Sample

BACKGROUND Over the past 20 years, there has been a dramatic increase in the nonmedical use of prescription drugs (NMUPD). However, minimal attention has been given to driving under the influence of prescription drugs used nonmedically. METHODS This study examines attitudes and characteristics that might be associated with driving while engaging in NMUPD. College students (N = 763) aged 18-25 years completed online surveys assessing demographic information, NMUPD, recreational use of other drugs, psychological variables, attitudes towards NMUPD and driving, and driving behavior. RESULTS Overall, 28.0% of participants reported lifetime NMUPD; 12.2% reported ever driving while engaging in NMUPD; and 7.9% reported this behavior in the past 3 months. Participants who reported engaging in NMUPD while driving were significantly more likely to report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, ketamine, GHB (γ-hydroxybutyric acid), rohypnol, and mephedrone. These participants also scored higher on measures of hopelessness, impulsivity, and sensation seeking. Individuals who engaged in NMUPD while driving also reported lower perceptions of the risks of this behavior and believed that NMUPD is more common in young adults. CONCLUSIONS A significant percentage of college students engage in driving under the influence of prescription drugs. Public health interventions designed to increase driving safety may wish to focus attention on this type of drugged driving.

Social Responsibility, Substance Use, and Sexual Risk Behavior in Men Who Have Sex With Men

Considerable public health literature focuses on relationships between problematic human characteristics (e.g., psychopathology) and unhealthy behaviors. A recent movement termed positive psychology emphasizes the advantages of assessing relationships between human strengths (e.g., altruism) and beneficial health behaviors. The present study assessed social responsibility, an orientation to help or protect others even when there is nothing to be gained as an individual, and its relationship to HIV-relevant behaviors. In our sample of 350 men who have sex with men (MSM), social responsibility was negatively correlated with substance use and HIV risk behaviors. Men who had been tested for HIV and knew their HIV status—a behavior that helps men protect their partners but does not protect themselves from the virus—also scored higher in social responsibility. Interventions designed to reduce HIV risk behavior in MSM may benefit from efforts to promote human strengths.

Health anxiety and the non-medical use of prescription drugs in young adults: A cross-sectional study

INTRODUCTION Studies have demonstrated a relation between health anxiety (hypochondriasis) and substance use, but this minimal body of literature has focused on alcohol or illicit drugs. The use of medications without a physicians prescription (i.e., non-medical use of prescription drugs, NMUPD) is increasingly prevalent among young adults. Health anxiety, a tendency to worry excessively about health, is a factor that could contribute to NMUPD, but this has not been examined. The purpose of the current study was to examine the relations among health anxiety, NMUPD, and other psychological variables related to substance use. METHODS In the present study, young adult college students (N = 758), ages 18-25, completed an anonymous online survey assessing demographics, health anxiety, NMUPD, and other psychological characteristics, including depression and general anxiety. RESULTS Participants who reported NMUPD had higher scores in health anxiety, as well as more frequent healthcare appointments, and were more likely to report having a chronic health condition. Given that multiple factors influence a decision to engage in NMUPD, a multivariable logistic regression analysis was performed. Results suggested that hopelessness, sensation-seeking, and health anxiety were risk factors for NMUPD, and that health anxiety predicted NMUPD over and above these other variables. CONCLUSIONS Medical professionals and mental health service providers should be aware of the increased risk of NMUPD for patients with health anxiety. Future research on NMUPD should more closely examine the role of health anxiety.

Dependency Traits, Relationship Power, and Health Risks in Women Receiving Sexually-Transmitted Infection Clinic Services

ABSTRACT In prior research, having traits consistent with a personality disorder has been shown to be related to substance use and high-risk sexual activity; however, few studies have examined relationships between dependency traits and health-jeopardizing behaviors. Individuals with traits consistent with dependent personality disorder may be more likely to be in a primary relationship characterized by unhealthy conditions, including physical abuse from a partner, low assertiveness in sexual situations, and partner infidelity. In addition, dependency traits may be associated with unhealthy coping (e.g., through substance use). To examine associations between dependent personality traits and these types of health-related behaviors, 198 women seeking sexually transmitted infection clinic services completed a computer-assisted assessment of dependent personality traits, substance use, unhealthy conditions in primary relationships, perceived sexual and relationship power, and sexual risk related to condom use. Dependency trait scores were correlated with the use of cocaine, heroin, and methamphetamine. Participants high in dependency traits reported low perceived power within their relationships and less say in sexual behaviors, including condom use. In a series of multivariate analyses, dependency traits significantly predicted having been hit by a partner, staying with a partner after he cheated, having sex because of threats, and fear of asking a partner to use a condom. Dependency traits were also associated with lower past condom use and lower future condom use intentions. Results suggest that dependent personality traits may place women at higher risk for physical abuse and harmful health behaviors.

Religiosity in the non-medical use of prescription medication in college students

Abstract Background: The non-medical use of prescription drugs (NMUPD) is a hazardous health behavior popular among young adults and college students. Past research has documented prevalence rates and risk factors associated with NMUPD, while little research has addressed protective factors. Objective: The present study examined the associations of religiosity and NMUPD in a sample of college students. Methods: Young adult (ages 18–25) college students (n = 767) completed an anonymous online survey assessing demographic variables, NMUPD, personality factors, perceptions of risk, mental health, and religiosity. Results: Results showed that greater religiosity scores were consistently associated with lower odds of engaging in NMUPD in the past 3 months. These associations were partially mediated by the personality characteristics of conscientiousness and openness to experience as well as perceived risk of NMUPD. The effect of religiosity on NMUPD was moderated by Greek (i.e. fraternity or sorority) membership, such that those in a Greek organization showed no relation between religiosity and NMUPD, while religiosity served as a protective factor for NMUPD among those who did not have Greek membership. Conclusion: These results extend past research demonstrating that religiosity is protective against substance abuse/misuse. Greek status appears to negate the protective influence of religiosity on NMUPD.