including romantic partners (OR 1.79 [95% CI 1.47-2.18]; also associated with adolescent cannabis use, OR 4.54 [95% CI 3.73-5.53]). In addition, both rVUS and adolescent cannabis use were associated with a greater number of romantic partners, an earlier age at first romantic date, and an earlier age at sexual debut. Early sexual maturation in women, which has been linked to substance use (37), risky sexual behaviors (38;39) and delinquencies (40-42), might also index increased likelihood of interactions with older male peers and romantic partners; however this measure did not account for our findings both when including a measure of early pubertal timing (Table 1) as well as a self-evaluation of early maturation (available upon request). While we cannot determine whether these sexual behaviors were associated with rVUS, our findings highlight the added vulnerability associated with rVUS over and above other indices of sexual maturity or risky sexual behavior.
