Background. Alcohol and other drug use and sexual risk behaviour are increasing among young Australians, with associated preventable health outcomes such as sexually transmissible infections (STIs) on the rise. Methods. A cross-sectional study of young people’s health behaviours conducted at a music festival in Melbourne, Australia, in 2011. Results. 1365 young people aged 16–29 completed the survey; 62% were female with a mean age of 20 years. The majority (94%, ) reported drinking alcohol during the previous 12 months; among those, 32% reported “binge” drinking (6+ drinks) at least weekly. Half (52%) reported ever using illicit drugs and 25% reported past month use. One-quarter (27%) were identified as being at risk of STIs through unprotected sex with new or casual partners during the previous 12 months. Multivariable analyses found that risky sexual behaviour was associated with younger age (≤19 years), younger age of sexual debut (≤15 years), having discussed sexual health/contraception with a doctor, regular binge drinking, and recent illicit drug use. Conclusion. Substance use correlated strongly with risky sexual behaviour. Further research should explore young people’s knowledge of alcohol/drug-related impairment and associated risk-taking behaviours, and campaigns should encourage appropriate STI testing among music festival attendees. 1. Introduction High-risk alcohol and other drug use are reportedly increasing among young Australians. Findings from population-based surveys suggest that Australians are starting to drink alcohol at an earlier age [1], that the tendency among young adults to drink to intoxication (or “until they cannot remember what happened”) is increasing, and that a substantial minority of young drinkers (around one in five) engage in regular (at least monthly) high-risk drinking (i.e., more than 20 drinks per occasion for young men and more than 11 drinks per occasion for young women) [2, 3]. Likewise, estimates suggest that Australians are among the largest per capita consumers of illicit psychostimulants (ecstasy, methamphetamine, or cocaine) in the world; an estimated 1 in 10 Australians has tried psychostimulants at some point, with well over half a million estimated to use the drugs annually [4, 5]. As recognition of young people’s harmful alcohol and other drug use has increased over recent years, so has concern about the sexual health of young Australians. Increasing proportions of young people report being sexually active, and the median age of sexual initiation has declined [6–9]. Young Australians report an
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