Sexual risk behaviors of sexual minority students in Rhode Island, 2007-2013.

This study found that sexual health disparities exist in sexual minority students. In particular, the study found that sexual minority students were more likely to report having had intercourse, to have had intercourse before 13 years of age, and to have had intercourse with four or more people compared to heterosexual students. Gay or lesbian students were less likely to have used a condom at the last intercourse than heterosexual students. 1,2 Earlier age of first intercourse, number of sexual partners, and lack of condom use are associated with increased risk of getting cancer-related pathogens, for instance, human papilloma virus (HPV). 3 Risk sexual behaviors are also related to teenage pregnancy and sexually transmitted infections (STIs) among sexual minority students. In order to address the needs of sexual minority students and implement intervention programs effectively, Rhode Island needs statewide data on the sexual behaviors of this population. The objectives of this study were to focus on variability among sexual minorities, examine differences between sexual identity and sexual behavior, as well as examine differences between sex of sexual contacts and sexual behaviors using the Rhode Island-pooled YRBS data. METHODS Data source: The YRBS is an anonymous and voluntary survey among random samples of high school students in over 60 states and municipalities. The CDC developed the YRBS to monitor risk behaviors related to the major causes of mortality, disease, injury, and social problems among youth and adults in the United States. These weighted, self-reported data are representative of 9th to 12th grade public high school students statewide and can be used to make important inferences concerning health-risk behaviors. In order to increase the sample size, we combined the 2007, 2009, 2011, and 2013 Rhode Island high school YRBS data. The overall response rates across these four years ranged from 66% to 71%. Measures: Demographic characteristics included sex (male or female), grade (9th–12th), and race/ethnicity (White, Black, Hispanic/Latino, and other). Sexual minority students are determined by sexual identity and/or by sex of sexual contacts. Sexual identity was based on the state-added question, “Which of the following best describes you?” 1) heterosexual (straight); 2) gay or lesbian; 3) bisexual; and 4) not sure. Sex of sexual contacts was based on “What is your sex?” 1) female; 2) male and the stated-added question, “During your life, with whom have you had sexual contact?” 1) I have never had sexual contact; 2) females; 3) males; 4) females and males. We classified students as having had opposite-sex contact only, same-sex contact only, both-sex contact, or as never had sexual contact. For this study, sexual minority students were defined as those who identified as gay or lesbian, bisexual or unsure or who had same-sex contact or both-sex contact. Sexual risk behaviors in this study include: ever had sexual intercourse; had sexual intercourse for the first time before age 13 years; had sexual intercourse with four or more people during their life; had sexual intercourse with one or more people during the past three months; had sexual intercourse during the past three months and had not used a condom during last sexual intercourse; and had sexual intercourse during the past three months and had not used birth control pills to prevent pregnancy before last sexual intercourse. Statistics analyses: We calculated unweighted frequency and weighted percentages. We conducted all analyses with the Surveyfreq Procedure in SAS version 9.3 (SAS Institute, Inc, Cary, North Carolina) to account for the complex design of the YRBS.