Association Between Cannabis Use and Sexual Risk Behavior Among Young Heterosexual Adults

DOI: 10.1007/s10461-006-9103-9AIDS and Behavior, Vol. 10, No. 5, September 2006 ( C 2006)Association Between Cannabis Use and Sexual Risk

Behavior Among Young Heterosexual AdultsJeannette Brodbeck,1,2 Monika Matter,1 and Franz Moggi1Published online: May 12, 2006To study the association between cannabis use and frequent sexual risk behavior, we tested

the hypothesis of a situational influence of cannabis use in sexual encounters using a combination of global association study and event-level analysis and examined possible mediator

variables, including the personality trait of hedonism/risk preference, psychosocial stress, and

HIV-related beliefs, using mediation models. The results of a computer-assisted telephone interview of a random sample of 2790 heterosexual men and women aged 1624 years showed

that risky sexual behavior was more frequent in cannabis-using men and women than in nonusing persons. The results did not support a situational effect of cannabis intoxication on

sexual risk behavior. The more frequent sexual risk behavior among cannabis users was mediated by decreased intentions to use HIV protection, by lower HIV-self-efficacy, and higher

risk preference/hedonism. Only among women psychosocial stress was a partial mediator.

The findings show that HIV prevention programs for cannabis-using young adults should

emphasize the role of person variables instead of situation variables.KEY WORDS: cannabis; sexual risk; HIV; young adults; mediation.INTRODUCTIONCannabis users show more sexual risk behavior

than non-users and are at higher risk for HIV

infection and sexually transmitted diseases (Bon,

Hittner, and Lawandales, 2001; Castilla, Barrio,

Belza, and de la Fuente, 1999; Poulin and Graham,

2001). Cannabis use is also related to early initiation

of sexual activity (Staton et al., 1999) and a greater

number of sexual partners (Poulin and Graham,

2001; Wingood and DiClemente, 1998). Different

models of the association between substance use

and unprotected sex (e.g., Stall, McKusick, Wiley,

Coates, and Ostrow, 1986) can be applied to explain

the association of cannabis use and sexual risk behavior. Situational effects of cannabis intoxication, such

as impairment of information processing (Kelleher,

Stough, Sergejew, and Rolfe, 2004), relaxation or eu-1University Hospital for Clinical Psychiatry, Berne, Switzerland.2Correspondence should be directed to Jeannette Brodbeck, University Hospital of Clinical Psychiatry Berne, Bolligenstrasse 111,

3000 Berne 60, Switzerland; e-mail: [email protected] mood (Green, Kavanagh, and Young, 2003),

and self-reported aphrodisiac effects (Kleiber and

Soellner, 1998), could reduce behavioral control and

increase the risk of unprotected...