Protective Factors Against Substance Use in Gender-Based Violence Exposed Adolescents
Lindsey Huang and Junpei Tarashi
11/08/2026
Adolescents exposed to gender-based violence (GBV) face elevated risk of substance use (SU), yet little research has examined what protects some exposed youth from this outcome. This study used the 2023 Youth Risk Behavior Surveillance System (YRBSS), a nationally representative U.S. dataset, to identify factors associated with substance-use resilience among GBV-exposed adolescents. Of 19,856 students with complete study variables, 3,319 (16.7%) reported GBV exposure. GBV-exposed youth showed substantially higher substance use severity than non-exposed peers (mean severity score 5.39 vs. 1.47) and elevated prevalence across nearly every substance examined, including a 3-fold increase in vaping and a 2.7-fold increase in prescription pain medication use. Despite this vulnerability, 32.7% of GBV-exposed youth reported no substance use. Using propensity-score matching to control for demographic differences, nine of eleven candidate protective factors were associated with resilience in bivariate comparisons; six remained independently significant after mutual adjustment in multivariable logistic regression: academic achievement (aOR=1.96), family monitoring (aOR=1.98), good mental health (aOR=1.75), safety from bullying (aOR=1.63), safe neighborhood (aOR=1.56), and healthy social media use (aOR=1.59). These findings, while cross-sectional and unable to establish causal direction, identify concrete, modifiable factors that could inform screening and intervention design for this high-risk population.