High-risk sexual behavior among Malaysian adolescents who use drugs: a mixed-methods study of a sample in rehabilitation

BackgroundThe high-risk sexual behaviors of drug-using adolescents in Malaysia is an under-researched topic.MethodsEighty adolescents undergoing rehabilitation participated in this mixed-methods study.ResultsThe sample was mostly males (70%), and the mean age was 18.2 years (SD = 1.40). More than three-fifths (63%) had used only methamphetamine and the mean duration of all drug use was 3.15 years. Sixty-nine percent reported previous sexual experience. High-risk sexual behaviors include having unprotected sex (11%), sex with more than one person (84%), and sex under the influence of drugs (94%). About 44% of the sample had intimate partners who use drugs. Most respondents (64%) were aware of the advantages of safe sex and were familiar with HIV transmission modes (74%). Results from multivariate logistic analysis indicate that females had significantly higher odds of engaging in unprotected sex and having intimate partners who use drugs, relative to males; males were, however, more likely to have sex under the influence of drugs. Responses from the interviews suggest that adolescents who use drugs engage in high-risk sexual behaviors primarily because drugs are used to enhance sex.ConclusionsA comprehensive sex education program tailored for drug-using adolescents should be made an integral part of rehabilitation.