Sex Differences in Risk for Substance Use Among High School Students in Myanmar

This study investigated sex differences in risk factors for alcohol and illicit drug use among high school students in Myanmar as part of a comprehensive substance abuse prevention approach. Participants (N = 1,918; Mage = 15.35 years, SD = 1.07 years, range = 14–18 years; 44.3% male) were recruited from 10 high schools in Myitkyina Township, Kachin State, Myanmar. Study constructs were assessed with a version of the Communities That Care survey adapted for use in Myanmar. Structural equation modeling was used to determine the strongest risk factors for recreational and hard drug use. Multiple group analyses indicated that patterns of risk differed by sex. Poor family management practices and peer drug use were risk factors for all youth and all recreational drugs; depressed affect was an additional risk factor for glue/solvent use and misuse of over-the-counter medication. Additional risk factors were specific to sex and to particular substances. The model predicting hard drug use had no common risk factors across sex. Low perceived dangerousness of drugs elevated risk for female adolescents. Parental attitudes favoring drug use, peer drug use and peer antisocial behavior, and low school commitment elevated risk of hard drug use for male adolescents. These data suggest that as Myanmar develops substance abuse prevention strategies for youth, one of the subpriorities in the United Nations’ sustainable development goals, approaches that are tailored specifically to male and female adolescents in addition to universal approaches may be dual effective strategies in curbing drug use.