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David W. Brook, MD; Judith S. Brook, EdD; Tine Pahl, MA; Ivan Montoya, MD

Arch Pediatr Adolesc Med. 2002;156:1101-1107.

Objective  To identify the longitudinal relationships between drug use and risky sexual behaviors and early pregnancy in Colombian adolescents.

Design  Confidential survey of adolescents, consisting of structured individual interviews, at 2 time points, 2 years apart. A standard self-report questionnaire was adapted to ensure linguistic and cultural relevance.

Setting  Community samples representing differing levels of risky sexual behavior and drug use. Cohorts were drawn from higher- and lower-risk geographic areas and from various self-reported ethnic groups.

Participants  Adolescents (N = 2226) randomly selected from 3 major Colombian cities: Bogotá, Medellín, and Barranquilla.

Main Outcome Measures  Data were collected concerning adolescent drug use, sexual behaviors, and a history of pregnancy. The youths' drug use included measures of all illegal drugs.

Results  By using regression analyses (controlling for demographic variables) a reciprocal longitudinal relationship between risky sexual behaviors and drug use was identified. Those adolescents who reported higher levels of drug use at time 1 also had more sexual partners, had higher frequencies of unprotected sex, and were more likely to have experienced early pregnancy at time 2. The reverse relationship was true as well. The level of violence experienced by the adolescent emerged as a moderator of some of these relationships.

Conclusions  Reducing adolescent drug use may also reduce levels of risky sexual behavior and early pregnancy and vice versa. Furthermore, the importance of addressing violence as a risk factor for both problem behaviors is emphasized.

From the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY (Drs D. W. Brook and J. S. Brook and Ms Pahl); and the Department of Mental Health, School of Public Health, University of Antioquia, Medellín, Colombia (Dr Montoya).

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