Although authorities acknowledge that alcohol and drug use are associated with risky adolescent sexual activity, primary care physicians have been challenged to screen for the behaviors.
Physicians and public health officials believe proactive screening can help mitigate unwanted pregnancies, sexually transmitted diseases, drug overdoses and alcohol poisonings.
In response to this need, a diagnostic test has been developed and is currently being employed at Children’s Hospital Boston.
Developed by the Children’s Center for Adolescent Substance Abuse Research, the CRAFFT screen, which refers to the mnemonic acronym in the six screening questions, includes questions such as “do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?” and “do you ever forget things you did while using alcohol or drugs?” Answering “yes” to two or more questions is highly predictive of an alcohol- or drug-related disorder and now at-risk sexual behavior. It allows primary care physicians to accurately screen teens for high-risk drug and alcohol use in a matter of minutes.
Furthermore, according to a new study appearing in the Journal of Adolescent Health, Children’s researchers have established that the CRAFFT diagnostic test can also identify teens who are more likely to be engaging in high-risk sexual behaviors.
The study’s researchers found that teens who screened positive for substance use had significantly greater odds of having sexual contact after using drugs or alcohol. According to the findings, these teens were more likely to have unprotected sex, multiple sexual partners and sexually transmitted disease.
The cross-sectional survey consisted of 305 adolescents from ages 12 to 18 in three different urban clinics. Participants were asked the CRAFFT questions, and also completed a self-administered questionnaire about high-risk sexual behaviors.
Of those who screened positive, 42.6 percent reported having sexual contact without a condom, 26.1 percent after drinking alcohol, 15.6 percent after drug use and 21.7 percent with a partner who had been drinking alcohol.
“Primary care physicians are on the front line of identifying adolescents who are at-risk and all should be screened with questions like these at every routine medical visit,” says Sharon Levy, MD, co-author of the study and physician in the Adolescent Substance Abuse Program at Children’s.
“Clinicians should be prepared to discuss high-risk sexual behaviors with their patients along with the dangers of engaging in sexual activity while intoxicated. Something as simple as asking an adolescent a few questions during a clinical appointment might make the difference.”
The CRAFFT test is routinely administered during adolescent clinical appointments at Children’s. All adolescents who take the test receive brief advice on alcohol and drug use, and those who test positive are recommended for further assessment for substance abuse disorders.
The authors suggest that these adolescents also receive counseling to avoid high-risk sexual behaviors and sexual activity after alcohol or drug use.
Source: Children’s Hospital Boston