Drug Resistance Strategies of Early Adolescents in Guadalajara, Mexico: Gender Differences in the Influence of Drug Offers and Relationship to the Offeror

Purpose: To address sharp increases in substance use among Mexican adolescents, particularly females, U.S. prevention programs are being adapted to the Mexican cultural context.  Understanding how responses to substance offers by Mexican adolescents are shaped by gender and by the adolescent’s relationship to those making the offers is an important adaptation step. This study explored whether and how drug resistance strategies of early adolescents differ by gender in a large metropolitan area in central Mexico, focusing on the four REAL strategies (Refuse-Explain-Avoid-Leave) that are  commonly used by US adolescents and the foundation of the keepin’ it REAL school-based universal substance use prevention intervention.  We tested for gender differences in use of these strategies and the extent to which the differences are explained by differential exposure to substance offers and susceptibility to offers from different people in the adolescents’ social networks.

Methods: Two socioeconomically similar public middle schools in Guadalajara were recruited for a substance use intervention pilot study. This analysis utilizes data from a Fall 2010 pretest survey administered to all 7th grade students, prior to the intervention’s start (N=431).  Dependent variables were frequency of use of each REAL drug resistance strategy.  Predictors were gender, exposure to offers of substances, and the students’ relationship to the sources of the offers (family adults, other adults, siblings or cousins, friends, and other peers.  Tests of gender differences utilized OLS regressions with mean centered interactions of gender by offer frequency and relationship to the offeror.

Results: Results indicated that the drug resistance strategies of Mexican early adolescents differ by gender, type of substance offered, and the youth’s relationship to the offeror.  Contrary to previous research on older Mexican adolescents, early adolescent females received more substance offers from age peers than males did, and employed a wider repertoire of drug resistance strategies, including active strategies such as direct refusals. Gender differences in use of the strategies persisted after controlling for number of offers. Gender differences were conditioned by greater exposure to offers. A larger volume of alcohol and cigarette offers predicted females’ use of direct strategies (Refuse) more strongly than for males, but less strongly than males for marijuana offers. Females’ use of REAL strategies was more strongly associated with offers from family adults, siblings and cousins, while males’ use of strategies was tied more strongly to offers from non-family adults.

Interpretations and implications:  Results may reflect changing gender norms in Mexico and gendered patterns of substance use.