Early onset marijuana use and suicidal ideation among African American college students.

Between 2013 and 2019 the suicide rate for African American young persons 15-24 years of age rose by 47% for males and 59% for females. Presently, little is known about factors that contribute to the suicidal behavior of African Americans in late adolescence and emerging adulthood. However, considering the coinciding increase in high potency marijuana use among African American young persons and literature suggesting a potential link between marijuana use and suicidal behavior, we examined early onset marijuana use as a risk factor for suicidal ideation. The sample included 221African American students (70% female and Mage = 20.3, SD = 1.97) attending an HBCU between 2019 and 2020. We employed multivariable logistic regression analysis that included suicidal ideation as the outcome variable and early onset marijuana use as the explanatory variable, while controlling for demographic factors and mental health treatment status. Approximately 19% of the sample reported suicidal ideation. Early onset marijuana use was reported by 28% of students. Compared to students who never used marijuana, early onset users were three times as likely to report suicidal ideation (AOR = 3.33, 95% CI = 1.06-10.44). In conclusion, early onset marijuana use may place African American young persons at increased risk for suicidal ideation. Marijuana use may be an important malleable risk factor that can be targeted in suicide prevention interventions designed for African American college students. More research is warranted.

Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females.

Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.

Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females.

Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans' increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (Mage = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 - 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.

Attitudes Toward and Sexual Partnerships With Drug Dealers Among Young Adult African American Females in Socially Disorganized Communities.

Drug markets in disadvantaged African American neighborhoods have altered social and sexual norms as well as sexual networks, which impact an individual's risk of contracting a sexually transmitted infection. Presently, we describe the prevalence of sexual partnerships with males involved with illegal drugs among a sample of non-drug-dependent females. In 2010, 120 Black females aged 18 to 30 years completed a semistructured HIV-risk interview. Descriptive statistics revealed approximately 80% of females perceived neighborhood drug activity as a major problem, 58% had sex with a male drug dealer, 48% reported sex with a male incarcerated for selling drugs, and 56% believed drug dealers have the most sexual partners. Our results suggest sexual partnerships with males involved in the distribution of drugs are prevalent. These partnerships may play a substantial role in the spread of sexually transmitted infections among low-risk females, as drug dealers likely serve as a bridge between higher HIV-risk drug and prison populations and lower HIV-risk females. However, the significance of partnerships with males involved in drug dealing has received little attention in HIV and drug abuse literature. Presently, there is a need for more research focused on understanding the extent to which the drug epidemic affects the HIV risk of non-drug-dependent Black female residents of neighborhoods inundated with drugs. Special consideration should be given to the role of the neighborhood drug dealer in the spread of sexually transmitted infections.

Examining racial/ethnic disparities in sexually transmitted diseases among recent heroin-using and cocaine-using women.

BACKGROUND: This study examined racial differences in the prevalence of sexual risk behaviors and their associations with sexually transmitted diseases (STDs) among recent heroin-using and cocaine-using women. METHODS: Participants were 214 women (59% black, 41% white) who were recruited during 2002-2010 using targeted sampling to participate in a study in Baltimore, Maryland, and reported using heroin, cocaine, or crack during the previous 6 months. Participants completed self-report questionnaires about their drug use, sexual risk behaviors, and lifetime history of one of six STDs, including gonorrhea, syphilis, chlamydia, genital herpes, genital warts, or trichomoniasis. RESULTS: More black women (50%) than white women (28%) reported a lifetime STD. Although there were no racial differences in the lifetime prevalence of sexual risk behaviors assessed, there were racial differences in the sexual behaviors associated with ever having a lifetime STD. Simple logistic regressions revealed that ever having a casual sex partner or anal sex were correlates of having a lifetime STD among black women but not among white women. Multiple logistic regression analyses revealed that ever having a casual sex partner was significantly associated with having a lifetime STD among black women, and ever trading sex for money was significantly associated with having a lifetime STD among white women. CONCLUSIONS: Findings are consistent with national studies and elucidate racial disparities in STDs and associated sexual behaviors among recent heroin-using and cocaine-using women. Findings underscore the need to tailor STD prevention interventions differently for black and white recent heroin-using and cocaine-using women.

The association between poly-substance use, coping, and sex trade among black South African substance users.

The current study examined the relationship between poly-substance use and sex trade among 343 black South African substance users recruited from the Pretoria region between 2002 and 2006 (57% males; mean age 24 years). The assessment comprised a HIV-risk behavior interview, urinalysis to confirm self-report of drug use, and an HIV test. Logistic regression analyses indicated poly-substance use was positively associated with sex trade among persons using drugs to cope with stress. Results indicate the importance of considering coping strategies as modifiable psychosocial factor related to sexual risk-taking behaviors and substance use. The study's implications and limitations are discussed.

Adolescent drug dealing and race/ethnicity: a population-based study of the differential impact of substance use on involvement in drug trade.

BACKGROUND: Among adolescents, peers are an important source of drug procurement. However, little is known about factors associated with youths' involvement in drug trade. OBJECTIVES: The aim of the study is to identify substance use behaviors and contextual factors related to drug dealing among Black and White adolescents. METHODS: The sample consisted of 13,706 White and Black youths who completed the National Survey on Drug Use and Health. Separate backward logistic regression was used to identify substance use behaviors and contextual factors associated with drug dealing among Black and White youths. RESULTS: Among White youths, drug dealing was associated with use of marijuana, hallucinogens, cocaine, prescription drug misuse, availability of cocaine, and socioeconomic status (SES). Among Black youths, marijuana use and availability of crack and marijuana were associated with drug dealing. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: For White youths, substance use seems to be more relevant to drug dealing. Consequently, preventing and treating substance abuse may reduce involvement in the illegal distribution of drugs among White youths. More research is needed to identify risk and protective factors for drug dealing among Black adolescents.

Early Sexual Initiation among Urban African American Male Middle School Youth in Baltimore City.

Data regarding the etiology of problem-based child and adolescent outcomes indicates neighborhood socioeconomic status, land use mix, traffic danger, availability of drugs and alcohol and collective socialization are factors that influence or confound behavior among youth in urban areas. With socio-ecological models in mind, this study examined associations between early sexual initiation and neighborhood condition, externalizing behavior, drug use and perceived peer acceptance of drug use. One hundred and fifteen African American male adolescents (ages 11 to 15) enrolled in a randomized control trial provided the data for analysis. Logistic regression models showed older age, perceived peer acceptance of drug use and externalizing behavior were predictors of early sex initiation. Although physical and social hazards as well as resource depletion in urban centers creates increased risk for poor health and social outcomes among adolescents, no neighborhood effects were found in this study. Interventions to delay sexual initiation among urban African American male adolescents may benefit from focus on both socially, and ecologically, relevant influences.

Gender differences in the prevalence and behavioral risk factors of HIV in South African drug users.

South Africa continues to be the global epicenter of HIV infection. Further, extensive gender disparities in HIV infection exist with females four times as likely to be infected with HIV/AIDS as males (UNAIDS, AIDS epidemic update, 2006; WHO, Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections, 2006). A cross-sectional collection of drug users recruited in the Pretoria region of South Africa (N = 385) was used to model HIV infection as a function of sexual risk behaviors and drug use as modified by gender. Receiving money from illicit sources and knowing someone with AIDS were loosely associated with HIV. Gender interactions were observed for age, cocaine use and condom use. Gender stratified analyses revealed that males who used condoms, were younger and tested negative for cocaine use were less likely to test positive for HIV. Findings suggest that males may have more control of risk behaviors and support the need for gender specific prevention strategies.

Prevalence and correlates of Hepatitis C among injection drug users: The significance of duration of use, incarceration and race/ethnicity.

The study examined associations between Hepatitis C (HCV) seropositivity and a lifetime history of jail or correctional facility incarceration among injection drug users. The sample consisted of 351 injection drug users recruited in inner-city neighborhoods of Baltimore. Multiple logistic regressions were fit to assess associations between HCV seropositivity and a lifetime history of incarceration for the total sample and stratified by race. Analyses demonstrated HCV nearly two times greater for whites than African Americans. In addition, HCV was 2.6 times greater in participants incarcerated in correctional facilities and HCV was 7.4 times greater in participants reporting more than 5 years of injection drug use compared to participants reporting less than 1 year of injection drug use. The study findings suggest that incorporating systematic HCV screening, prevention, and treatment programs within correctional systems represents a vital yet underutilized strategy to reduce HCV transmission in society as a whole.

Prevalence and correlates of hepatitis A among adult drug users: the significance of incarceration and race/ethnicity.

This report examines associations between hepatitis A virus (HAV) infection prevalence and a history of incarceration in jail or a correctional facility among a population of drug users in Baltimore stratified by African American and white racial/ethnic status. The study sample consisted of 509 non-injection and injection drug users recruited from inner-city neighborhoods of the Baltimore metropolitan region. The baseline prevalence of HAV infection was 36.9% (N=188). One-fourth (25.5%) of the sample reported no lifetime history of incarceration, 44.6% reported incarceration in a local jail in their lifetime, and 29.9% reported incarceration in a correctional facility in their lifetime. In the multivariate logistic analysis, HAV infection prevalence was higher for whites (44.3%) [adjusted odds ratio (AOR)=2.3, 95% CI=1.5-3.5] when compared to African Americans (30.5%) adjusting for gender, age, and education. In the analysis stratified by race/ethnicity, as anticipated, jail incarceration and correctional facility incarceration were each independently associated with elevated HAV prevalence among white drug users. African American drug users with a high school diploma had significantly lower HAV infection prevalence when compared to African American drug users who did not graduate from high school. Heightened HAV prevalence among white drug users compared to African American drug users is noteworthy given the opposite association of HAV infection prevalence and these two racial/ethnic groups in the general population. Since millions of incarcerated drug users in the US return to society each year, the results suggest that incorporating systematic HAV screening, prevention, and treatment programs within correctional systems represents a vital yet underutilized strategy to reduce HAV transmission in society as a whole.

Substance use among school-based youths in northern Mexico.

A small base of research suggests that adolescent substance use is a growing public health concern in Mexico. Employing confidential methods, the International Longitudinal Survey of Adolescent Health was administered to assess substance use among 1,238 students in northern Mexico. A large proportion of students indicated lifetime use of tobacco and alcohol. Gender differences in tobacco, alcohol, and marijuana were also evident. The current findings are congruent with the sparse extant data on youths' substance use in Mexico and highlight the need for early prevention interventions.

Substance use among school-based youths in Puerto Rico: differences between gender and grade levels.

The present study examined substance use rates among adolescents in Grades 7-12 in Puerto Rico. Nine hundred eighty-nine students completed the Spanish version of the International Survey of Adolescent Health. More than 50% of middle school youths and 75% of high-school youths reported lifetime alcohol use. Female gender was associated with tobacco use in middle school while male gender was associated with marijuana use in high school. High-school females reported lower rates of tobacco use and marijuana use than middle-school females. High-school males exhibited substantially higher drug-use rates than middle-school males for each substance. These findings may suggest that universal drug prevention interventions may be needed for females in Puerto Rico before they enter middle school, while targeted interventions aimed at high-risk females who continue to smoke tobacco or marijuana may be more effective during high school. In contrast, targeted drug prevention interventions for males probably need to begin in middle school and be maintained if not increased in intensity throughout the high-school years.

Peer and sibling substance use: predictors of substance use among adolescents in Mexico.

OBJECTIVE: To examine the extent to which peer drug use and sibling drug use predict alcohol abuse/dependence disorder status and the use of drugs other than alcohol among school-based youth in Mexico. METHODS: Data were collected on 1 203 middle and high school students in northern Mexico in May 1998. Participation was voluntary, and responses were confidential. Logistic regression analyses estimated the association that peer drug use and that sibling drug use had with alcohol abuse/dependence diagnosis and the lifetime use of drugs other than alcohol. RESULTS: Students who had siblings or peers who used alcohol and other drugs were more likely to meet the standard alcohol abuse/dependence criteria defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), and were more likely to have used drugs other than alcohol. Controlling for potentially important confounders, we found that adolescents with the highest level of peer substance use were eight times as likely to meet alcohol abuse/dependence criteria and four times as likely to use other drugs. Youth who had siblings who used drugs were about twice as likely to meet alcohol abuse/dependence criteria and about 2.5 times as likely to use drugs other than alcohol when compared to youth with no sibling substance use. CONCLUSIONS: Consistent with extant findings among youth in the United States of America, peer and sibling substance use are major risk factors for substance use among school-based youth in Mexico. Students in Mexico may benefit from prevention strategies found to be effective among students in the United States.

Screening for "substance abuse" among school-based youth in Mexico using the Problem Oriented Screening Instrument (POSIT) for Teenagers.

Indices of classification accuracy of the Substance Use/Abuse scale of a Spanish-language version of the Problem Oriented Screening Instrument for Teenagers (POSIT) were evaluated among school-based youth in Mexico. Participants were 1203 youth attending one middle school (N = 619) and one high school (N = 584) in the third largest city of Coahuila, a northern border state in Mexico in May 1998. More than 94% of youth enrolled in the participating middle school and 89% of youth enrolled in the participating high school completed the International Longitudinal Survey of Adolescent Health. Indices of classification accuracy of the POSIT Substance Use/Abuse scale were evaluated against a "drug abuse" problem severity criterion that combined youth meeting DSM-IV criteria for alcohol abuse/dependence disorders with youth having used other illicit drugs five or more times in their lifetime. The present study findings suggest that using a cut score of one or two on the POSIT Substance Use/Abuse scale generally yields optimal classification accuracy indices that vary somewhat by gender and school subgroups. Further, classification accuracy indices of the POSIT Substance Use/Abuse scale are slightly better when used among high school males due, in part, to the higher base rate of serious involvement among this group compared to others.

Peer and sibling substance use: predictors of substance use among adolescents in Mexico

OBJECTIVO: Examinar en qué medida el uso de drogas por los pares y hermanos es factor pronóstico del abuso o la dependencia del alcohol y del uso de drogas distintas del alcohol en escolares mexicanos. MÉTODOS: Se recolectaron datos acerca de 1 203 estudiantes de los últimos años de primaria y de secundaria en el norte de México en mayo de 1998. La participación en el estudio fue voluntaria, y las respuestas fueron confidenciales. Mediante análisis de regresión logística se estimó la asociación entre el uso de drogas por los pares y hermanos por un lado, y por el otro el diagnóstico de abuso o dependencia del alcohol y el uso de sustancias distintas del alcohol en algún momento de la vida. RESULTADOS: Los estudiantes cuyos hermanos o pares ingerían bebidas alcohólicas y consumían otras drogas mostraron mayores probabilidades de satisfacer los criterios estándares de abuso o dependencia del alcohol, según los define el Manual diagnóstico y estadístico de enfermedades mentales, cuarta edición (MDE-IV), y de haber consumido drogas distintas del alcohol. Después de controlado el efecto de posibles factores de confusión, los adolescentes con los niveles más altos de abuso de sustancias por parte de sus pares se mostraron ocho veces más propensos a satisfacer los criterios de abuso o dependencia del alcohol y cuatro veces más propensos a consumir otros tipos de sustancias. Los adolescentes cuyos hermanos consumían drogas tenían una probabilidad dos veces mayor de satisfacer los criterios de abuso o dependencia del alcohol y una probabilidad 2,5 veces mayor de consumir drogas en comparación con jóvenes cuyos hermanos no consumían ninguna sustancia. CONCLUSIONES: Tal como indican otros resultados obtenidos con adolescentes en Estados Unidos de América, el uso de sustancias por los pares y hermanos es un factor de riesgo de consumo de sustancias en escolares en México. Estos últimos podrían beneficiarse de estrategias preventivas cuya eficacia en jóvenes estadounidenses se haya demostrado.