Challenging mainstream assumptions about young adults, sex, and drugs.

Sex, Drugs and Young People: International Perspectives. Edited by P. Aggleton, A. Ball, & P. Mane. London and New York: Routledge, 2006, 224 pages. Softcover, $38.95.

This contemporary book addresses both the global similarities and differences about sexuality and substance use amongst young people from varying socio economic and cultural backgrounds. It challenges existing beliefs regarding mainstream assumptions associated with teenagers and young adults.

The book has received notable "cross-national" contributions, producing an interdisciplinary perspective upon sexual behavior and substance use. Best practice includes up-to-date theoretical opinions along with innovative ideas about the development of public health and educational programs. The theoretical context of the literature has been complemented by case examples that aid understanding and places the theory into practical context.

The book consists of 13 chapters divided into three main areas: (Part I) "The Structuring of Vulnerability," (Part II) "Young People, Sex and Drugs," and (Part III) "Special Circumstances, Special Needs?"

The Introduction (Chapter 1) draws upon various theorists looking at how the historical foundations remain ingrained within society's current understanding of young people. It provides a contemporary perspective about young people's sexual activities and substance use and argues that young people are "heterogeneous."

Chapter 2, "Young People, Poverty and Risk," explores poverty and its influence upon gender, limited economic resources, mental health issues, and sexual health problems. The chapter stresses that poor young people, predominantly within developing countries, are particularly vulnerable to sexual and drug-related ill health. The term "poor young people" requires further explanation, however, since it may vary globally. Chapter 3, "Gender, Vulnerability and Young People," further addresses gender issues as outlined in Chapter 2 and includes case examples from Nigeria, the United States, and the United Kingdom.

Chapter 4, "Ethnicity, Culture, Drugs and Sex," discusses race, culture, and ethnicity in relation to substance use and sexual practices. It further addresses the use of psychotropic drugs and discusses the global trends associated with club drugs. Here, reference to Viagra[TM] would have been interesting since this has generated considerable concern when addressing substance use and unsafe sexual practises (Leshner, 2000; Swanson & Cooper, 2002). Polysubstance use with Viagra[TM] is prominent amongst both young or homosexual men (Swanson & Cooper, 2002; Romanelli & Smith, 2004). The author concludes by outlining best practice and calls for more "humane, pragmatic and culturally responsive policies and programmes" (p. 59). Chapter 5, "Young People, Sexual Practice and Meanings," commences part 2 of the book. The chapter begins by looking at the relationship among sexual behavior, sexual well-being, and sexual vulnerability. The authors make reference to how poor education, negative role models, and cultural and gender factors all influence young people and sexual practice. The authors stress a need for a broader definition of sex, including masturbation and same-sex sexual practices.

Chapter 6, "Young People and Illicit Drug Use," adopts a global perspective regarding the use of illicit drugs. It stresses that the chapter needs to be supported by additional information. This may include the drug type, the amount of use, the route of administration, and the frequency of use. This chapter outlines an intervention including a constructive approach to devising programs addressing best practice in order to accommodate young people's diverse needs and circumstances.

Chapter 7, "Drug Use Among Same-Sex Attracted Young People," addresses how substance use, sexuality, and sexual behavior interact and how the different drugs have different meanings for young people. The chapter highlights how drug use amongst this group may be affected by different variables including homophobia, the stress related to coming out, societal oppression, unemployment, and the risks associated with socializing in bars and clubs. As with Chapter 4, no mention of Viagra[TM] in combination with other drugs was made and how such use is prevalent amongst young or homosexual men (Romanelli & Smith, 2004; Swanson & Cooper, 2002). This holds significant concerns regarding the sexual health of these groups and has a great impact upon the development of treatment programs. The authors conclude by calling for the development of environments offering support and protection to same-sex-attracted people.

Chapter 8, "Drinking Behavior, Coming of Age and Risk," emphasises the relationship between young people's drinking and sexual behavior along with looking at its association with violent conduct. It addresses the global patterns of alcohol consumption and how the diversity of alcohol consumption amongst this group is affected by socioenvironmental factors including societal restrictions. The chapter concludes by looking at these restrictions along with changing the cultural attitudes toward alcohol consumption with its associated hazards.

Chapter 9, "Sex, Drugs and Vulnerability," commences Part 3 of the book and examines young people who sell sex and use drugs. This chapter focuses on the links between sexual health risks including HIV and drug-using behavior and the absence of safer-sex materials. The importance of effective policies and strategies that take into account a wide range of sexual and drug-using behaviors are highlighted.

Chapter 10, "Young Migrants, Refugees and Displaced People," explores the challenges young migrants and refugees face regarding their health and development. It highlights some of the special circumstances young migrants and refugees may find themselves in, including drug and human trafficking. Young migrants and refugees will present with some of the same needs and wants regarding their health as other young adults. The authors outline the barriers this group encounter and call for both youth- and migrant-friendly services.

Chapter 11, "Young People, the Military, Sex and Drugs," begins by addressing the numbers of young people in the armed forces and states that the armed forces consist of younger men who are hierarchical and highly mobile. The author compares the sexual behavior of female soldiers, male soldiers, and civilian youths where consequent sexual health concerns are discussed. A descriptive overview of homosexuality within the armed forces is provided along with reference to sexual abuse. Discrimination also may be apparent, however, for ethnic minorities (Chin, 2002; Joseph, 1997) and those who are HIV positive wishing to enlist (Elliott, 2000). This chapter concludes by outlining best practice in relation to developing programs within education and support.

Chapter 12 was an interesting account of "Young People in Detention." The authors look at the numbers of children detained globally, the degree of violence within detention, substance use/dependency issues, and sexual abuse problems. The authors address the clinical methods of assisting this group, along with social factors both pre- and post-detention. Definitions surrounding sexual abuse are important to include within this context: otherwise, it limits the reader from understanding the full spectrum of sexual behavior and generates inconsistencies amongst globally related research (Hensley, 2002). Homophobia, racism, and an individual's HIV status all impact whether and how youth prisoners are victimised or sexually abused by other prisoners or staff (Heilpern, 1998; Hensley, 2002).

Chapter 13, "Sex, Drugs and Indigenous Young People," is the final chapter of the book. The authors compare the sexual behaviors of indigenous persons with nonindigenous persons where sexual health concerns are highlighted. Interestingly, the authors state that substance use is higher amongst indigenous young people compared with their nonindigenous counterparts and that, "the majority of people use drugs without problems" (p. 203). This reference was made to alcohol use, and it would be interesting to consider what "without problems" means. This chapter concludes by looking at best protection in relation to being part of their families and communities along with addressing substance use and sexual behavior amongst this group.

In closing, this book is an up-to-date contribution that focuses on the concerns surrounding young people globally. It takes into consideration their different social and cultural backgrounds, gender, sexuality, mental health issues, and physical ill health by adopting "a rights-based approach" (p. 8). It is thought provoking and would be most useful for those working within health and social care involving youth. Further, the book covers a wide range of academic subjects, including psychology, criminology, human sexuality, the addictions, public health, and sociology.

References

Chin, P. (2002). African Americans in the military: The struggle against racism & war. Workers World. Retrieved December 1, 2006, from Internet: www.hartford-hwp.com/archives/45a/190.html

Elliot, R. (2000). Nambia: Refusal to enlist HIV-positive in army ruled discriminatory. Canadian HIV AIDS Policy Law Review, 5(4), 30.

Heilpern, D. (1998). Fear or favour: Sexual assault of young prisoners. Lismore, Australia: Southern Cross University Press.

Hensley, C. (2002). Prison sex: Practice & policy. London: Lynne Rienner Publishers.

Joseph, H. J. (1997). Attitudes of army nurses toward African American and Hispanic patients. Military Medicine, 162(2), 96-100.

Leshner, A. I. (2000). A club drug alert. NIDA Notes, 14, 3-4.

Romanelli, F. & Smith, K. M. (2004). Recreational use of Sildenafil by HIV-positive and -negative homosexual/bisexual males. Annals of Pharmacotherapy, 38, 1024-1030.

Swanson, J. & Cooper, A. (2002). Dangerous liaison: Club drug use and HIV/AIDS. International Association of Physicians in AIDS Care. Retrieved December 1, 2006, from www.thebodypro.com

Reviewed by Samantha Anne Banbury, Ph.D, CPsychol., Rivendell Healthcare, Addictions Clinic, 1 Hanway Place, London, W1T 1HA, UK. E-mail: [e-mail].