As both cannabis use and sexual behaviors, both normative and risky (such as rVUS), are typically initiated during adolescence, it is likely that shared risk and protective influences at least partially contribute to their co-occurrence. This general liability to risk-taking and externalizing behaviors during youth is shaped by genetic and environmental factors (12-15). For instance, lack of self-regulation, which is associated with both reward-related (e.g. ventral striatum) and decision-making (e.g. dorsolateral prefrontal cortex) pathways in the brain (16), has been proposed as a common pathway to both substance use and risky sexual behaviors. Interactions between corticostriatal (i.e. ventral striatum) and corticolimbic (e.g. amygdala reactivity) circuitry have also been shown to modulate liability to substance use and risky sexual behaviors (17;18). Environmental factors (e.g. early trauma exposure; e.g. (19;20)) might also influence the likelihood of early onset of cannabis use and risky sexual behaviors, such as rVUS.
