Among 2,572 Bahamian secondary school students, both alcohol and marijuana use were independently associated with increased likelihood of engaging in sexual behavior, with 7.3% of males and 1.7% of females reporting recent marijuana use.
Read this if you are interested in how substance use relates to adolescent sexual behavior in developing countries.
7.3% of male and 1.7% of female Bahamian students reported marijuana use
What the researchers found
This study examined substance use and sexual behavior among over 2,500 secondary school students in Nassau, The Bahamas. Nearly half of both boys (46.5%) and girls (44.8%) reported alcohol consumption. Marijuana use was much less common overall but showed a stark gender difference: 7.3% of males versus only 1.7% of females reported use in the past 6 months.
Sexual experience also showed a gender gap, with 43% of males and 16% of females reporting vaginal sex. After controlling for age and gender, both alcohol and marijuana use were independently associated with increased likelihood of engaging in sexual behavior in the past 6 months.
The authors emphasize that this represents a global correlation rather than evidence that substance use causes sexual behavior, and call for longitudinal research to understand the temporal relationship.
Why it matters
In island nations where HIV and sexually transmitted infections remain significant health concerns, understanding the relationship between substance use and sexual risk behavior helps inform prevention programs. The finding that marijuana use is independently associated with sexual behavior supports integrating substance use education into sexual health programs.
The numbers in context
2,572 students (56% female). Mean age 14.2 years. Alcohol use: 46.5% males, 44.8% females. Marijuana use: 7.3% males, 1.7% females. Ever had vaginal sex: 43% males, 16% females. Being older, male, and using alcohol or marijuana all independently predicted recent sexual behavior.
How the study worked
Cross-sectional baseline survey from a longitudinal randomized controlled evaluation of a school-based HIV prevention program. 2,572 government secondary school students in New Providence, The Bahamas. Mean age 14.2 years. Logistic regression analysis controlling for age and gender.
What this study cannot tell us
Cross-sectional design cannot determine whether substance use leads to sexual behavior, vice versa, or both reflect shared risk factors. Self-reported data from school-based surveys may undercount sensitive behaviors. Only government school students were included.
How to read the evidence
Reasonably large school-based sample with multivariate analysis, but cross-sectional design and self-reported data limit causal conclusions.
When this study was published
Published in 2016 using baseline data from an HIV prevention program. Substance use patterns in Bahamian youth may have changed.
The bigger picture
This study supports the growing evidence that substance use and sexual risk behavior cluster together in adolescent populations worldwide. Effective prevention programs need to address these behaviors as interconnected rather than in isolation.
Questions still open
- Does marijuana use precede sexual debut, follow it, or do both reflect underlying risk-taking tendencies? Would combined substance use and sexual health prevention programs be more effective than addressing each separately?
Common questions
Is marijuana use linked to sexual behavior in teenagers?
How common is marijuana use among Bahamian youth?
Read the original research
Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas.
International journal of adolescent medicine and health, 28(2), 133-40
Citation
Kaljee, Linda; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Villar, Maria Elena; Stanton, Bonita. (2016). Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas.. International journal of adolescent medicine and health, 28(2), 133-40. https://doi.org/10.1515/ijamh-2014-0079
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