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Sexual activity during adolescence is a pivotal part of human development. Although early onset of sexual activity rates has steadily decreased over the past decade across the United States, there remains a high prevalence of early sexual initiation among adolescent girls. In 2021, nearly one-third of high school girls across the United States reported ever having sexual intercourse. While studies have identified a host of risk factors associated with early sexual activity, there is a lack of research exploring the adverse effects of this critical life event on substance using behaviors into adulthood. Using group-based trajectory modeling, the study identifies and describes trajectories of substance using behavior among women who have reported ever having sexual intercourse during adolescents.