Associations between substance use and sexual risk behaviour among women aged 16–44 years: evidence from Britain’s third national survey of sexual attitudes and lifestyles (NATSAL-3)

Background/introduction: Taking account of substance use may be important when developing a sexual risk assessment tool for use with women in community health settings. Aim(s)/objectives: To examine whether different measures of substance use have different associations with key sexual risk behaviours among women in the British general population (rather than women attending sexual health clinics who typically report higher risk behaviour). Methods: We analysed data from 4,911 female participants aged 16-44 in Natsal-3, a national probability sample survey undertaken 2010-2012, using multivariable regression to examine the associations between substance use variables and reporting: multiple (2+) partners in the last year; non-use of condoms with multiple partners in the last year; non-use of condoms at first sex with most recent partner. Results: Reporting multiple partners was associated with current smoking (OR 1.59, 95%CI 1.30-1.93), weekly binge drinking (OR 2.47, 95%CI 1.97-3.10), and drug use ever (OR 1.45, 95%CI 1.20-1.75). Similarly, reporting non-use of condoms with multiple partners was also associated with current smoking (OR 1.39, 95%CI 1.09-1.78), weekly binge drinking (OR 2.47, 95%CI 1.90-3.21) and drug use ever (OR 1.48, 95%CI 1.17-1.88). Non-use of condoms at first sex with most recent partner was only associated with current smoking (OR 1.47 95%CI 1.25-1.73) and weekly binge drinking (OR 1.41 95%CI 1.14-1.73). Discussion/conclusion: Differences were found to exist in how substance use variables are associated with the sexual risk behaviours studied. Different substance use questions may therefore be useful in identifying and distinguishing different sexual risk behaviours profiles in community settings.