How do alcohol and drugs affect young people’s sexual behaviour?

There is limited evidence on the link between young people’s sexual behaviour and their alcohol and drug use. A new study from Uganda has cast light on the issue.

What is the research about?

How common it is for young people to have sex under the influence of alcohol or drugs, and which young people are more likely to do this.

The questionnaire study involved 744 young people (ages 18-24) living in informal settlements in Kampala. All the young people were sexually active and had used alcohol, marijuana, khat, tobacco and/or heroin in the last year. Most participants (78%) were male. Petty trade was the main source of income for 39%, followed by casual labour (20%). Sex work was the main source of income for 23% of female participants.

Why is this research important?

When people use alcohol or drugs they are more likely to take risks, including sexual risks. For example, they are less likely to use condoms or other contraception, and more likely to have casual sex. Some people can become sexually violent. Others may become unable to clearly refuse sex, or they may engage in sexual acts that they would not do when sober. All these things can increase the risk of HIV, sexually transmitted infections and unintended pregnancies.

What did they find out?

Just under two-thirds (61%) had sex under the influence of drugs or alcohol in the last 30 days. Just under half (45%) said either they or their partner had used alcohol or drugs the last time they had sex.

Young women were more likely to have sex under the influence than young men (71% compared to 58%).

Young people aged 20 to 24 were more likely to have had sex under the influence in the last 30 days than those aged 18 to 19 (65% compared to 47%).

Being married, separated or divorced, not living with parents or guardians, or earning less than UGX 250,000 (US$66) also increased the likelihood that a young person would have sex while intoxicated.

In the last 30 days, 74% of participants had used alcohol, 55% had used khat, 52% had used marijuana and 2% had used heroin. Sex under the influence was higher among young people who used alcohol, khat or marijuana.

What does this mean for HIV and sexual health services?

There is a need to educate young people on the risks of having sex under the influence of drugs or alcohol, and the things they can do to reduce these risks.

These programmes should be non-judgemental. Young people should be encouraged to be honest about their alcohol and drug use and their sexual behaviour. Our page on alcohol, drugs and sex provides some useful guidance on this topic.

It is important to remember that different young people will have different reasons for having sex while intoxicated, and things like gender and lifestyle are important factors to consider. Some young people may use alcohol and drugs for pleasure, to feel less inhibited, to deal with mental health issues or because of peer pressure, for example. If young people are selling sex they may use alcohol or drugs to help them do their job or because clients expect it.

Working with young people to understand why they use drugs and alcohol, and the situations they get in when intoxicated, is essential to designing risk-reduction programmes that work to protect young people’s well-being and their health.