Alcohol and Drug Use and Related Disorders: An Underrecognized Health Issue Among Adolescents and Young Adults Attending Sexually Transmitted Disease Clinics

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Abstract
The objectives of this study were to describe patterns of alcohol and drug use disorders among young persons attending a public sexually transmitted disease (STD) clinic and to determine their associations with sexual risk behaviors and STDs. Four hundred forty-eight men and women aged 15 to 24 who were attending an urban STD clinic completed an interviewer-administered questionnaire that assessed a broad range of substance use in general and for alcohol and marijuana use disorders. Overall, 42.9% had an alcohol or marijuana use disorder (51.6% of males and 34.2% of females), whereas 30.6% had a confirmed STD. Participants with a substance use disorder were significantly more likely to have multiple sexual partners (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.5-3.4), to be inconsistent condom users (OR = 3.1; 95% CI = 1.5-6.3), and to have an STD (OR = 1.7; 95% CI = 1.1-2.6). Among young STD clinic attendees, substance use disorders were more common than confirmed STDs. STD clinics may be an appropriate setting to screen for and address substance use disorders in young persons.