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Background: Migration of the native populations from reservations to the urban areas has resulted in mixed ethnicities of American Indian/Alaskan Native (AIAN) children. Minority youth require special attention and services in urban schools as they disproportionately experience poverty, low educational attainment, unemployment, and single-parent status. Methods: We used 2005 and 2007 Youth Risk Behavior Survey data to examine alcohol/drug use patterns and their association with sexual risk taking among AIAN only (single-racial) and biracial youth in combination with White, African American, or Hispanic ethnicities (N = 1178). Results: Overall, one half of the students were sexually active, with significantly higher rates among males; AIAN-Black students initiated sex earlier than the other groups. Condom nonuse is higher among AIAN-Whites (greater than 50%) compared to one third of AIAN-Hispanics and one fourth of AIAN-Blacks. Nearly 10% of all students, except AIAN-Blacks, reported lifetime use of heroin/meth. Sexual behavior was significantly associated with episodic drinking. Students with Hispanic background have twice the odds of being sexually active compared to AIANs. Conclusions: Our findings underscore growing health care needs and targeted prevention initiatives for mixed racial underserved native youth. Urban school settings have potential to deliver services and offer alcohol/drug prevention programs to address the needs of mixed racial native urban youth. Using the School Based Health Clinic model has been successful; we need to reform prevention approaches to accommodate needs of multiracial urban native youth. (Contains 4 tables.)

This article examines the association between neighborhood characteristics at the census tract-level, couples' perceived neighborhood social cohesion and informal social control, and male-to-female (MFPV) and female-to-male (FMPV) partner violence in the United States. Data come from a second wave of interviews (2000) with a national sample of couples 18 years of age and older who were first interviewed in 1995. The path analysis shows that poverty is associated with perceived social cohesion and perceived social control as hypothesized. However, there is no significant mediation effect for social control or social cohesion on any type of violence. In the path analysis, Black ethnicity is associated with social cohesion, which is associated with MFPV. Intimate partner violence (IPV), as a form of domestic violence, may not be as concentrated in high-poverty neighborhoods as criminal violence. IPV may be more determined by personal and dyadic characteristics than criminal violence. (Contains 1 table and 1 figure.)

This paper examines the relationship between intimate partner violence and depression. A multicluster random household sample of U.S. couples was interviewed as part of a five-year national longitudinal study (response rate = 72%). Depression was assessed with the CES-D. The multivariate analyses for men showed that the odds of depression did not vary significantly by type of male-to-female (MF) or female-to-male (FM) aggression. Men who engaged in infrequent binge drinking, compared to those who never binged, were less likely to be depressed, as were men with greater collective efficacy. For women, the multivariate analysis, showed that FM aggression (psychological: minor and severe, and physical) was associated with a greater likelihood of depression. Exposure to parental violence was also associated with depression. Women may experience depression as the result of psychological and physical aggression even if they are the perpetrators of such aggression. (Contains 4 tables.)

Purpose: To estimate prevalence rates of intimate partner violence (IPV) among Brazilian couples and to assess the contribution of drinking and sociodemographic factors to the risk of IPV. Methods: A sample consisting of 1,445 married or cohabitating males and females in the Brazilian population was interviewed. The survey response rate was 66%. Results: The analyses indicate 10.7% and 14.6% prevalence, respectively for male-to-female and female-to-male IPV. Males were drinking in 38.1% of IPV events and females in 9.2%. The male's partner was drinking in 30.8% and the females' partner in 44.6% of IPV acts. Bivariate associations between violence and sociodemographics were found for age groups, household monthly income and educational level. Logistic regression analysis indicate that younger age for both male and female partners, men with no religious affiiliation and women who are homemakers are significant predictors of violence. Conclusion: This survey provides important information to further IPV research in Brazil. (Contains 4 tables.)

This article examines agreement on reports of male-to-female and female-to-male psychological, physical, and sexual violence among White, Black, and Hispanic couples in the United States. Using a probability sample, separate face-to-face interviews were conducted in respondents' homes with both members of 1,025 intact couples living in the 48 contiguous states. The overall survey response rate was 72%. Results indicate that agreement on each of the three types of violence is low, independent of perpetrator's gender and ethnicity. Kappa coefficients of agreement range from 0.07 to 0.48. Higher agreement is obtained for psychological violence, followed by physical and sexual violence. Depending on the type of violence, between 30% (psychological aggression) and 90% (sexual coercion) of events would not have been identified if identification required agreement between partners. Logistic analysis shows that the severity of violence is the only variable that increases the likelihood of agreement across the three types of violence. (Contains 4 tables.)

This article examines the cross-sectional association between acculturation, acculturation stress, drinking, and intimate partner violence (IPV) among Hispanic couples in the U.S. The data being analyzed come from a multi-cluster random household sample of couples interviewed as part of the second wave of a 5-year national longitudinal study. The overall survey response rate for the second wave is 72%. Participants are Hispanic couples 18 years of age or older (N = 387). Results show that, among men, lower acculturation is positively associated with higher acculturation stress, which is directly related to a greater likelihood of involvement in IPV. These associations are also present among women. However, data for women show an additional path linking higher levels of acculturation directly to IPV. Drinking is not associated with IPV, independent of gender. Acculturation, directly or through acculturation stress, increases the likelihood of IPV. (Contains 1 table and 1 figure.)

Ethnic minority groups such as Asian/Pacific Islanders (APIs) and native populations in Hawaii are seldom studied in the area of intimate relationships. Using the 1999 Hawaii Youth Risk Behavior Survey, this study examined gender and ethnic differences in experiencing physical dating violence and whether drinking (early initiation, binge drinking), unsafe sexual behaviors (early initiation, multiple partners, use of alcohol and drugs with sex, history of sexual abuse), and suicidality constitute risk for victimization among APIs, Native Hawaiian (NH), and Caucasian high school students in multiethnic state of Hawaii. The final analysis included 559 boys and 683 girls. The overall rate of experiencing physical violence was 7.8% with both genders reporting similar rates (boys 7.6%, girls 8.0%). Although not significantly different, NH students reported a higher rate (11.6%) than Caucasians (7.3%) and APIs (6.5%). Significant bivariate associations were found between victimization and many of the risk factors. Regression analyses indicated that students 16 years or older were nearly 3 times more at risk for experiencing dating violence. The risk was 8-fold if youth were sexually active by age 13 compared to those who abstained. The risk is 3-fold for those who reported prior sexual abuse. Early initiation of drinking (less than 12 years) and suicidality doubled the risk of being a victim. Clearly, the study highlights the risk of experiencing dating violence when a teen engages in sex very early or uses alcohol. Schools must routinely educate youth about various forms of dating violence, the effects of engaging in early sex, and drinking. Screening adolescents for associated risk factors such as drinking and depression is crucial to identify victimization. Dating violence is an antecedent for adult partner violence. Thus, by reducing youth dating violence, we may consequently reduce the incidence of adult partner violence.

This article examines the 5-year incidence, prevalence, and recurrence of intimate partner violence (IPV) among White, Black, and Hispanic intact couples in the United States. A national multistage household probability sample of couples, age 18 years or older, was interviewed in 1995 with a response rate of 85%, and reinterviewed in 2000 with a response rate of 72%. Results indicate that the incidence and recurrence of IPV are higher for Blacks and Hispanics than for Whites. Compared to Whites, Hispanics are 2.5 times more likely to initiate IPV between baseline and follow-up and Blacks are 3.7 times more likely to report IPV at baseline and follow-up. Couples reporting severe IPV in 1995 are more likely than others to report severe IPV at follow-up. The rate of recurrence for severe IPV among Black and Hispanic couples is 6 and 4 times higher, respectively, than the rate among Whites. The results suggest that Blacks and Hispanics may be more affected by IPV.

This article examines the 5-year association between acculturation, drinking, and male-to-female partner violence and female-to-male partner violence among Hispanic couples in the United States. A national representative sample of Hispanic couples 18 years of age or older was interviewed in 1995 and 2000. Both members of the couple were independently interviewed. Differences in prevalence rates of male-to-female partner violence and female-to-male partner violence, incidence, and recurrence across acculturation groups are not significant. Drinking is associated with acculturation among women. Couples with mixed acculturation level (high-medium) are less at risk for male-to-female partner violence. An increase of five standard drinks per week in men's drinking decreases the risk of female-to-male partner violence by 10%. Acculturation level at Time 1 is not associated with male-to-female partner violence and female-to-male partner violence status 5 years later.

This study examined ethnic differences in substance use and sexual behavior and whether drinking and drug use constitute risk factors for unsafe sexual practices among Native Hawaiian (NH), Caucasian, and Asian/Pacific Islander (API) high school students in Hawaii. A secondary data analysis of the Youth Risk Behavior Survey (1997 and 1999) using a representative sample of 2,657 students in 9-12 grades was performed. Chi-square tests for bivariate associations and multivariate regression analyses were conducted to identify predictors. NHs were more sexually active, initiated sex earlier, and tended to have multiple partners. Alcohol lifetime use was higher in NH, Caucasians, and males. NHs were more likely to initiate drinking by age 12 and engage more in episodic drinking. Non-episodic or episodic drinkers and students who use drugs were at risk to engage in sexual activity, have multiple partners, and use alcohol/drugs during sex. Risk was two times higher for substance use during sex if drinking was initiated at age 10 or younger compared to 15 years or older. Compared to abstainers, the risk doubled for lifetime multiple partners if drinking was initiated at ages 13-14. Overall, females were more sexually active. Because drinking was associated with sexual initiation and risky behavior, adverse effects of alcohol must be addressed in programs targeting underage drinking, thus helping youth delay of minimize sexual activity and prevent other associated problems. Intervention efforts should enhance life skills that endorse abstinence from alcohol and drug use.

Using a theoretical model, specific hypotheses about factors that moderate the benefits of attending the Preparing for the Drug-Free Years program were tested. Results for fathers (n=144) show that high levels of family stress reduce the benefits of program attendance and strong pre-program skills increase the benefits of program attendance. Mothers (n=150) who benefited most from program participation showed the weakest pre-program communication skills and reported the greatest marital difficulties. (Author/MKA)

Presents an overview of the sociocultural differences between U.S. and Asian Indian cultures, the implications of those differences, and suggestions for counseling techniques and approaches for working with Asian Indian immigrants. Discusses immigration pattern and history of Asian Indians, looks at cultural orientation of Asian Indians, and identifies indigenous models of therapy in traditional Asian societies. (Author/NB)

Objective: The purpose of this study was to examine the prevalence and correlates of alcohol-related problems across four Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans. Method: Using a multistage cluster sample design, 5,224 individuals ages 18 years and older were selected from the household population of five U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Results: Cuban Americans had the lowest prevalence of alcohol-related problems. Significant differences across national group for zero versus two or more problems and for one versus two or more problems existed among men. Puerto Rican women were most likely to report two or more problems. The presence of zero versus two or more problems varied significantly across groups. There was variation in problem type across national groups among both men and women. Regression analyses showed that all groups were more likely than Cuban Americans to report two or more problems (vs zero) (Puerto Ricans: odds ratio [OR] = 2.02, p < .05; Mexican Americans: OR 2.92, p [less than or equal to] .01; South/Central Americans: OR = 2.12, p [less than or equal to] .01). Being U.S. born (vs foreign born) increased the likelihood of experiencing one (OR = 1.57, p < .05) and two or more problems (OR = 1.95, p [less than or equal to] .01). The volume of consumption was associated with problems (one problem: OR 1.16, p [less than or equal to] .01; two or more problems: OR = 1.31, p [less than or equal to] .01). Heavy episodic drinking less than once a month was associated with two or more problems (OR = 6.15, p [less than or equal to] .01). Heavy episodic drinking one or more times a month was associated with one problem (OR = 1.74, p [less than or equal to] .01) and two or more problems (OR = 3.18, p [less than or equal to] .01). Conclusions: It is important to recognize that Hispanics are not a homogenous group. (J. Stud. Alcohol Drugs 70: 991-999, 2009), STUDIES OF DRINKING-RELATED PROBLEMS in the general population have shown that the prevalence of problems is, in general, lower among Hispanics than non-Hispanics for both men and women (Caetano, 1997; [...]

This article examines agreement on reports of male-to-female and female-to-male psychological, physical, and sexual violence among White, Black, and Hispanic couples in the United States. Using a probability sample, separate face-to-face interviews were conducted in respondents' homes with both members of 1,025 intact couples living in the 48 contiguous states. The overall survey response rate was 72%. Results indicate that agreement on each of the three types of violence is low, independent of perpetrator's gender and ethnicity. Kappa coefficients of agreement range from .07 to .48. Higher agreement is obtained for psychological violence, followed by physical and sexual violence. Depending on the type of violence, between 30% (psychological aggression) and 90% (sexual coercion) of events would not have been identified if identification required agreement between partners. Logistic analysis shows that the severity of violence is the only variable that increases the likelihood of agreement across the three types of violence. Keywords: violence; ethnicity; national survey: report agreement

Objective: The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Method: Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes either in English or Spanish. Results: There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40-49, 50-59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men. Conclusions: Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics., HISPANICS CONSTITUTED 12.5% of the United States population in the 2000 Census (Bureau of the Census, 2001). A recent update indicates that Hispanics already compose 14.4% of the population (Bureau [...]

Objective: This article examines the association between birthplace, acculturation, and self-reported driving under the influence of alcohol (DUI), 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans in the U.S. population. Method: Using a multistage cluster sample design, 5,224 adults (18 years of age or older) were interviewed from households in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. Results: Birthplace was not associated with DUI, 12-month DUI arrest rates, or lifetime DUI arrest rates. Mexican Americans in the medium- and high-acculturation groups were more likely to engage in DUI. A higher pro portion of U.S.-born than foreign-born respondents as well as those in the high-acculturation group, irrespective of national origin, reported having been stopped by police when driving. U.S.-born Cuban Americans, Mexican Americans, and South/Central Americans thought they could consume a higher mean number of drinks before their driving is impaired compared with those who are foreign born. Conclusions: There are considerable differences in DUI-related behavior across Hispanic national groups. U.S.-born Hispanics and those born abroad, but not those at different levels of acculturation, have equal risk of involvement with DUI. (J. Stud. Alcohol Drugs 69: 259-265, 2008), DRIVING UNDER THE INFLUENCE OF ALCOHOL (DUI) is a major public health problem in the United States. Alcohol-related traffic fatalities were about 40% of all traffic fatalities in 1999 and [...]

This article examines the cross-sectional association between acculturation, acculturation stress, drinking, and intimate partner violence (IPV) among Hispanic couples in the U.S. The data being analyzed come from a multi-cluster random household sample of couples interviewed as part of the second wave of a 5-year national longitudinal study. The overall survey response rate for the second wave is 72%. Participants are Hispanic couples 18 years of age or older (N = 387). Results show that, among men, lower acculturation is positively associated with higher acculturation stress, which is directly related to a greater likelihood of involvement in IPV. These associations are also present among women. However, data for women show an additional path linking higher levels of acculturation directly to IPV. Drinking is not associated with IPV, independent of gender. Acculturation, directly or through acculturation stress, increases the likelihood of IPV. Keywords: acculturation; intimate partner violence; Hispanics; acculturation stress

Ethnic minority groups such as Asian/Pacific Islanders (APIs) and native populations in Hawaii are seldom studied in the area of intimate relationships. Using the 1999 Hawaii Youth Risk Behavior Survey, this study examined gender and ethnic differences in experiencing physical dating violence and whether drinking (early initiation, binge drinking), unsafe sexual behaviors (early initiation, multiple partners, use of alcohol and drugs with sex, history of sexual abuse), and suicidality constitute risk for victimization among APIs, Native Hawaiian (NH), and Caucasian high school students in multiethnic state of Hawaii. The final analysis included 559 boys and 683 girls. The overall rate of experiencing physical violence was 7.8% with both genders reporting similar rates (boys 7.6%, girls 8.0%). Although not significantly different, NH students reported a higher rate (11.6%) than Caucasians (7.3%) and APIs (6.5%). Significant bivariate associations were found between victimization and many of the risk factors. Regression analyses indicated that students 16 years or older were nearly 3 times more at risk for experiencing dating violence. The risk was 8-fold if youth were sexually active by age 13 compared to those who abstained. The risk is 3-fold for those who reported prior sexual abuse. Early initiation of drinking (, During the last decade, there has been a continuous growth of research on dating violence focusing on high school and college students. (1,2) There is no universal consensus on the [...]

This article reports two exploratory studies testing a model guided by a social interactional perspective, positing an inverse relation between the quality of parent-child interactions and adolescent problem behaviors. It addresses mixed findings in the literature related to gender differences. Study 1 uses cross-sectional survey data from midwestern parents with either a boy (n = 377) or a girl (n = 335) between 11 and 13 years of age. Study 2 data, used to replicate the Study 1 results, are collected from a cross-sectional survey sample of midwestern parents with either a boy (n = 279) or a girl (n = 269) in the same age group. Multisample latent variable structural equation modeling confirms the hypothesized inverse relationships in both studies. Also, there are no significant young adolescent gender differences in these relationships. The consistency of findings from both studies is discussed with respect to results from earlier research. Keywords: parent-child interactions; problem behaviors; gender differences

The main goal of the study conducted was to provide an updated, scientifically sound estimate of the number of American children living in partner-violent households. Based on a secondary analysis of a large, national, multistage probability sample of married and cohabiting couples, the estimate reflects intimate partner violence in dual-partner households with children.

This article examines the 5-year incidence, prevalence, and recurrence of intimate partner violence (IPV) among White, Black, and Hispanic intact couples in the United States. A national multistage household probability sample of couples, age 18 years or older, was interviewed in 1995 with a response rate of 85%, and reinterviewed in 2000 with a response rate of 72%. Results indicate that the incidence and recurrence of IPV are higher for Blacks and Hispanics than for Whites. Compared to Whites, Hispanics are 2.5 times more likely to initiate IPV between baseline and follow-up and Blacks are 3.7 times more likely to report IPV at baseline and follow-up. Couples reporting severe IPV in 1995 are more likely than others to report severe IPV at follow-up. The rate of recurrence for severe IPV among Black and Hispanic couples is 6 and4 times higher, respectively, than the rate among Whites. The results suggest that Blacks and Hispanics may be more affected by IPV. Keywords: intimate partner violence; ethnic differences; general population survey; health disparities

This article describes the rates and risk factors of unidirectional and bidirectional intimate partner violence (IPV) among White, Black and Hispanic couples in the US. Subjects constitute a multistage area probability sample representative of married and cohabiting couples from the 48 contiguous United States. Results indicate that most couples reporting violence engage in bidirectional IPV. Blacks are more likely than Whites to report bidirectional IPV. In addition, severe unidirectional and bidirectional IPV are more common among Blacks and Hispanics. The results also indicate that predictors of IPV vary depending on whether it is unidirectional or bidirectional. Unidirectional female-to-male IPV and bidirectional IPV are more associated with the characteristics of the female. In contrast, the occurrence of unidirectional male-to-female IPV is associated with a single risk factor, male childhood physical abuse. These findings highlight the importance of distinguishing different types of IPV and have important epidemiological and prevention implications. Keywords: unidirectional partner violence; bidirectional partner violence; minority couple violence

Objective: The purpose of this study was to investigate the relationship between partner violence (male-to-female and female-to-male) and heavy drinking (consuming five or more drinks per occasion) and the effect of this relationship on marital separation. Method: Married and cohabiting couples were selected through multistage random probability sampling from U.S. households. In 1995, 1,635 couples were interviewed; 1,392 of these couples were re-interviewed in 2000. The final analysis included couples who were still married or living with the same partner (intact n = 1,136) from the baseline, and couples who had broken up (nonintact n = 191) sometime during the 5-year follow-up period. Results: The findings indicate that couples who reported female-perpetrated violence, female alcohol-related problems and male heavy-drinking episodes (one to three times a month) were 2.5-3 times more at risk for separation. On the other hand, female heavy drinking (one to three times a month) is less likely to predict separation. Cohabiting couples are also more at risk for separation than married couples. Couples with longer relationships are less at risk for separation. Conclusions: Marital counseling, therapy or intervention programs must address issues pertaining to partner violence and alcohol use among couples while concurrently providing information about healthy relationships and helping couples develop skills to attain them. The importance of preventing partner violence is increasingly recognized in the field of public health., INTIMATE PARTNER VIOLENCE (IPV) is an important risk marker for divorce or separation among married or cohabiting couples. For example, severe male violence is associated with lower marital quality, separation [...]

Objective: This study was undertaken to estimate the number of children nationwide exposed to an adult who has alcohol problems (AP) or alcohol dependence (AD) and to examine ethnic differences in the number of children exposed. Method: The study used survey data from the 1995 National Alcohol Survey, which constituted a nationally representative sample of household members 18 years of age and older in the 48 contiguous states, were randomly selected, with oversamples of blacks and Hispanics. A total of 4,925 subjects were interviewed, with a response rate of 77%. The questionnaire asked about AP and AD in the previous 12 months. Rates from the survey and data from the U.S. 2000 Census were used to calculate the estimates. Results: Overall, 11.6 million children (16%) were exposed to one or more AP and 2.1 million children (3%) were exposed to AD. A higher proportion, nearly 19%, of both black and Hispanic children as compared with 14.5% of white children were exposed to AP. Significantly higher proportions of black (5.2%) and Hispanic (4.9%) compared with white (2.0%) children were exposed to AD. Conclusions: A large number of children are being exposed to at least one adult suffering from alcohol problems or dependence. Black and Hispanic children are disproportionately affected by these problems., RESEARCH SUGGESTS that children of alcoholics (COAs) are at an increased risk for alcohol-related disorders. Studies have reported that COAs are four to nine times more likely than non-COAs to [...]

This article examines the 5-year association between acculturation, drinking, and male-to-female partner violence and female-to-male partner violence among Hispanic couples in the United States. A national representative sample of Hispanic couples 18 years of age or older was interviewed in 1995 and 2000. Both members of the couple were independently interviewed. Differences in prevalence rates of male-to-female partner violence and female-to-male partner violence, incidence, and recurrence across acculturation groups are not significant. Drinking is associated with acculturation among women. Couples with mixed acculturation level (high-medium) are less at risk for male-to-female partner violence. An increase of five standard drinks per week in men's drinking decreases the risk of female-to-male partner violence by 10%. Acculturation level at Time 1 is not associated with male-to-female partner violence and female-to-male partner violence status 5 years later. Keywords: Hispanic; intimate partner violence; acculturation; epidemiology; survey

This study examined ethnic differences in substance use and sexual behavior and whether drinking and drug use constitute risk factors for unsafe sexual practices among Native Hawaiian (NH), Caucasian, and Asian/Pacific Islander (API) high school students in Hawaii. A secondary data analysis of the Youth Risk Behavior Survey (1997 and 1999) using a representative sample of 2,657 students in 9-12 grades was performed. Chi-square tests for bivariate associations and multivariate regression analyses were conducted to identify predictors. NHs were more sexually active, initiated sex earlier, and tended to have multiple partners. Alcohol lifetime use was higher in NH, Caucasians, and males. NHs were more likely to initiate drinking by age 12 and engage more in episodic drinking. Non-episodic or episodic drinkers and students who use drugs were at risk to engage in sexual activity, have multiple partners, and use alcohol/drugs during sex. Risk was two times higher for substance use during sex if drinking was initiated at age 10 or younger compared to 15 years or older. Compared to abstainers, the risk doubled for lifetime multiple partners if drinking was initiated at ages 13-14. Overall, females were more sexually active. Because drinking was associated with sexual initiation and risky behavior, adverse effects of alcohol must be addressed in programs targeting underage drinking, thus helping youth delay of minimize sexual activity and prevent other associated problems. Intervention efforts should enhance life skills that endorse abstinence from alcohol and drug use., Current trends in sexual behavior and use of alcohol and other drugs by high school students pose a significant public health risk in the United States. According to the Youth [...]