Methods: The data used was from Year 7 youth assessment of the Oregon Youth Substance Use Project (OYSUP; Andrews, Tildesley, Hops, Duncan, & Severson, 2003). The sample includes students in 9th-12th graders (N = 937) and approximately half the sample was female (51%, n = 482). The mean age was 16.19 (range 13.31-19.41, SD = 1.46) and the mean body mass index (BMI) was 23.20 (SD = 4.70), which, according to the CDC (n.d.), is in the “normal” range. Body image was assessed using, “I frequently feel ugly and unattractive.” Unprotected sex after substance use was measured with two items, “During the past 12 months, how many people have you had unprotected sex with (sex without a condom) when you were high, stoned, or had too much to drink” and “In your lifetime, how many people have you had unprotected sex with (sex without a condom) when you were high, stoned, or had too much to drink.”.
Results: The first logistic regression model with having had having had unprotected sex while drunk or high in the past year as the dependent variable was statistically significant (χ2 = 32.29, p < .001) when controlling for BMI. Those who reported frequently feeling unattractive or ugly were 2.17 times more likely to engage in unprotect sex while drunk or high in the past 12 months compared to their counterparts who did not frequently feel unattractive or ugly (OR = 2.17, p = .026, CI = 1.10-4.30).
The second logistic regression model with having had unprotected sex while drunk or high in their lifetime as the dependent variable was also statistically significant (χ2 = 45.12, p < .001). Those who reported feeling unattractive or ugly were 2.33 times more likely to have engaged in unprotected sex while drunk or high during their lifetime compared their counterparts who did not frequently fee unattractive or ugly (OR= 2.33, p = .008, CI = 1.24-4.37).
Implications: The results imply there may be a relationship between body image and risky sexual decisions, including having unprotected sex while drunk or high. To our knowledge this is the first study to examine this relationship with an adolescent sample. Future studies should focus on better understanding this relationship and its severity. Such understanding could help guide interventions that work to improve adolescent body image and reduce teen pregnancy and STI rates.