Alcohol Policies and Sexually Transmitted Disease Among Youth

A 10 percent increase in the average state excise tax on beer will reduce the gonorrhea rate by 4.4 percent for boys 15-19 and by 3.7 percent for men aged 20-24.

Studies of teenagers suggest that heavy drinkers are more likely to be sexually active, more likely to have multiple partners, and less likely to use condoms. Because all of these behaviors are risk factors for sexually transmitted diseases (STDs), if alcohol control policies reduce alcohol consumption and thus the drunkenness that causes youths to engage in unsafe sex, then it is also possible that these policies will reduce the incidence of sexually transmitted disease.

In An Investigation of the Effects of Alcohol Policies on Youth STDs (NBER Working Paper No. 10949), co-authors Michael Grossman, Robert Kaestner, and Sara Markowitz use the incidence of AIDS and gonorrhea to explore the effect of alcohol control policies on these two STDs in teenagers and young adults. After collecting data across the U.S. states for the years 1981 to 2001, and testing 6 different statistical models, they find evidence that STD rates among youth can be altered with alcohol control policies.

The highest average gonorrhea rate during the sample period was in the population of 15-19 year-old girls: 457 per 100,000. Young men aged 15-19 had the lowest reported rate: 332 per 100,000. Average AIDS rates were about 37 per 100,000 for men aged 30-34. Females ages 20-29 had the lowest incidence of AIDS, about 4 cases per 100,000. These men and women were assumed to have contracted the AIDS virus 8 years earlier on average.

Because beer is the most popular alcoholic beverage among youth, the authors use state excise taxes on beer to represent the price of alcohol. State laws on drinking and driving changed continually during the period under observation, so the models also include indicators for the presence (or absence) of 0.08 and 0.10 blood alcohol concentration laws, and the presence (or absence) of zero tolerance laws for underage drinking and driving in each state in each period. Variables to control for regional religious differences, income, and education also were included.

In the short run, the estimates suggest, a 10 percent increase in the average state excise tax on beer "will reduce the gonorrhea rate by 4.4 percent for boys 15-19 and by 3.7 percent for men aged 20-24." Zero tolerance laws, which typically set the maximum blood alcohol percentage at 0.02 for underage drinkers, also reduce gonorrhea incidence by an estimated 7 to 8 percent in 15-19 year-old boys. Other drunk-driving laws appear to have no effect. Neither does living in a dry county. The female gonorrhea rate is not affected by any of the regulatory variables the authors tested.

AIDS rates are also likely to be influenced by changes in the beer tax. The authors' analysis predicts that a 10 percent increase in the average state excise tax on beer will reduce AIDS rates by a range of 5.1 to 8.5 percent among young males. The magnitude of the effect falls to a range of 3.2 to 6.4 percent for older males. The opposite patterns holds for female AIDS rates, where a bigger response is expected for older females. None of the drunk driving laws is associated with decreased AIDS rates for youth of either gender

-- Linda Gorman