Skip to main content

Advertisement

SpringerLink
Log in

Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Sexual minority adolescent sexual risk behavior studies often overlook young women, do not consider behavior- and identity-based sexual orientation indicators in combination, and focus mainly on condomless sex. We examined multiple risk behaviors in a large sample of adolescent young men and women using combined behavior- and identity-based indices. The 2015 Dane County Youth Assessment data included 4734 students in 22 high schools who had ever voluntarily engaged in sexual contact (51.7% male; 76.0% White, non-Hispanic). Items assessed having sex with unfamiliar partners, sex while using substances, using protection, and STI testing. Logistic regressions tested for disparities based on combined identity- and behavior-based sexual orientation indicators. For both young men and women, youth who reported heterosexual or questioning identities—but who had sex with same-sex partners—were at consistently greater risk than heterosexual youth with only different-sex partners. Also, for both young men and women, bisexuals with partners of both sexes more consistently reported higher risk than heterosexual youth than did bisexuals with only different-sex partners. Risk behavior for gay young men who had sex only with men mirrored those in extant literature. Risk levels differed for specific groups of sexual minority young women, thus deserving further attention. Findings underscore the need for sexual health research to consider sexual orientation in a more multidimensional manner.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bailey, J. V., Farquhar, C., Owen, C., & Mangtani, P. (2004). Sexually transmitted infections in women who have sex with women. Sexually Transmitted Infections, 80, 244–246.

    Article  Google Scholar 

  • Bailey, J. V., Farquhar, C., Owen, C., & Whittaker, D. (2003). Sexual behaviour of lesbians and bisexual women. Sexually Transmitted Infections, 79, 147–150.

    Article  Google Scholar 

  • Bauer, G. R., & Brennan, D. J. (2013). The problem with ‘behavioral bisexuality’: Assessing sexual orientation in survey research. Journal of Bisexuality, 13, 148–165.

    Article  Google Scholar 

  • Bauer, G. R., Jairam, J. A., & Baidoobonso, S. M. (2010). Sexual health, risk behaviors, and substance use in heterosexual-identified women with female sex partners: 2002 U.S. National Survey of Family Growth. Sexually Transmitted Diseases, 37, 531–537.

    Article  Google Scholar 

  • Bauermeister, J. A., Leslie-Santana, M., Johns, M. M., Pingel, E., & Eisenberg, A. (2011). Mr. Right and Mr. Right Now: Romantic and casual partner-seeking online among young men who have sex with men. AIDS and Behavior, 15, 261–272.

    Article  Google Scholar 

  • Blake, S. M., Ledsky, R., Lehman, T., Goodenow, C., Sawyer, R., & Hack, T. (2001). Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: The benefits of gay-sensitive HIV instruction in schools. American Journal of Public Health, 91, 940–946.

    Article  Google Scholar 

  • Bostwick, W. B., Hughes, T. L., & Everett, B. (2015). Health behavior, status, and outcomes among a community-based sample of lesbian and bisexual women. LGBT Health, 2, 121–126.

    Article  Google Scholar 

  • Celentano, D. D., Valleroy, L. A., Sifakis, F., MacKellar, D. A., Hylton, J., Thiede, H., et al. (2006). Associations between substance use and sexual risk among very young men who have sex with men. Sexually Transmitted Diseases, 33, 265–271.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (2015a). HIV surveillance report, 2015 (Vol. 27). Retrieved from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.

  • Centers for Disease Control and Prevention (2015b). YRBSS data and documentation. Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/data.htm.

  • Charlton, B. M., Corliss, H. L., Missmer, S. A., Frazier, A. L., Rosario, M., Kahn, J. A., et al. (2011). Reproductive health screening disparities and sexual orientation in a cohort study of U.S. adolescent and young adult females. Journal of Adolescent Health, 49, 505–510.

    Article  Google Scholar 

  • Clatts, M. C., Goldsamt, L. A., & Yi, H. (2005). Club drug use among young men who have sex with men in NYC: A preliminary epidemiological profile. Substance Use and Misuse, 40, 1317–1330.

    Article  Google Scholar 

  • Coker, T. R., Austin, S. B., & Schuster, M. A. (2010). The health and health care of lesbian, gay, and bisexual adolescents. Annual Review of Public Health, 31, 457–477.

    Article  Google Scholar 

  • Corliss, H. L., Austin, S. B., Roberts, A. L., & Molnar, B. E. (2009). Sexual risk in “mostly heterosexual” young women: Influence of social support and caregiver mental health. Journal of Women’s Health, 18, 2005–2010.

    Article  Google Scholar 

  • Davis, C. M., Yarber, W. L., & Bauserman, R. (Eds.). (1998). Handbook of sexuality-related measures. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Diamant, A. L., Wold, C., Spritzer, K., & Gelberg, L. (2000). Health behaviors, health status, and access to and use of health care: A population-based study of lesbian, bisexual, and heterosexual women. Archives of Family Medicine, 9, 1043–1051.

    Article  Google Scholar 

  • Diamond, L. M. (2008). Female bisexuality from adolescence to adulthood: Results from a 10-year longitudinal study. Developmental Psychology, 44, 5–14.

    Article  Google Scholar 

  • Everett, B. G. (2013). Sexual orientation disparities in sexually transmitted infections: Examining the intersection between sexual identity and sexual behavior. Archives of Sexual Behavior, 42, 225–236.

    Article  Google Scholar 

  • Everett, B. G., Schnarrs, P. W., Rosario, M., Garofalo, R., & Mustanski, B. (2014). Sexual orientation disparities in sexually transmitted infection risk behaviors and risk determinants among sexually active adolescent males: Results from a school-based sample. American Journal of Public Health, 104, 1107–1112.

    Article  Google Scholar 

  • Fethers, K., Marks, C., Mindel, A., & Estcourt, C. S. (2000). Sexually transmitted infections and risk behaviours in women who have sex with women. Sexually Transmitted Infections, 76, 345–349.

    Article  Google Scholar 

  • Friedman, M. R., Wei, C., Klem, M. L., Silvestre, A. J., Markovic, N., & Stall, R. (2014). HIV infection and sexual risk among men who have sex with men and women (MSMW): A systematic review and meta-analysis. PLoS ONE, 9, e87139.

    Article  Google Scholar 

  • Goldbaum, G., Perdue, T., & Higgins, D. (1996). Non-gay-identifying men who have sex with men: Formative research results from Seattle, Washington. Public Health Reports, 111, 36–40.

    PubMed  PubMed Central  Google Scholar 

  • Goodenow, C., Szalacha, L. A., Robin, L. E., & Westheimer, K. (2008). Dimensions of sexual orientation and HIV-related risk among adolescent females: Evidence from a statewide survey. American Journal of Public Health, 98, 1051–1058.

    Article  Google Scholar 

  • Guzman, R., Colfax, G. N., Wheeler, S., Mansergh, G., Marks, G., Rader, M., et al. (2005). Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men. Journal of Acquired Immune Deficiency Syndromes, 38, 82–86.

    Article  Google Scholar 

  • Huebner, A. J., & Howell, L. W. (2003). Examining the relationship between adolescent sexual risk-taking and perceptions of monitoring, communication, and parenting styles. Journal of Adolescent Health, 33, 71–78.

    Article  Google Scholar 

  • Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.

    Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.

    Google Scholar 

  • Lindberg, L. D., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents’ receipt of sex education, 2006–2013. Journal of Adolescent Health, 58, 621–627.

    Article  Google Scholar 

  • Logie, C. H., Navia, D., & Loutfy, M. R. (2015). Correlates of a lifetime history of sexually transmitted infections among women who have sex with women in Toronto, Canada: Results from a cross-sectional internet-based survey. Sexually Transmitted Infections, 91, 278–283.

    Article  Google Scholar 

  • Loosier, P. S., & Dittus, P. J. (2010). Group differences in risk across three domains using an expanded measure of sexual orientation. Journal of Primary Prevention, 31, 261–272.

    Article  Google Scholar 

  • Marrazzo, J. M., & Gorgos, L. M. (2012). Emerging sexual health issues among women who have sex with women. Current Infectious Disease Reports, 14, 204–211.

    Article  Google Scholar 

  • Mustanski, B., Birkett, M., Greene, G. J., Rosario, M., Bostwick, W., & Everett, B. G. (2014). The association between sexual orientation identity and behavior across race/ethnicity, sex, and age in a probability sample of high school students. American Journal of Public Health, 104, 237–244.

    Article  Google Scholar 

  • Mustanski, B., Donenberg, G., & Emerson, E. (2006). I can use a condom, I just don’t: The importance of motivation to prevent HIV in adolescent seeking psychiatric care. AIDS and Behavior, 10, 753–762.

    Article  Google Scholar 

  • Mustanski, B. S., Newcomb, M. E., Du Bois, S. N., Garcia, S. C., & Grov, C. (2011). HIV in young men who have sex with men: A review of epidemiology, risk and protective factors, and interventions. Journal of Sex Research, 48, 218–253.

    Article  Google Scholar 

  • Oshri, A., Handley, E. D., Sutton, T. E., Wortel, S., & Burnette, M. L. (2014). Developmental trajectories of substance use among sexual minority girls: Associations with sexual victimization and sexual health risk. Journal of Adolescent Health, 55, 100–106.

    Article  Google Scholar 

  • Ott, M. Q., Corliss, H. L., Wypij, D., Rosario, M., & Austin, S. B. (2011). Stability and change in self-reported sexual orientation identity in young people: Application of mobility metrics. Archives of Sexual Behavior, 40, 519–532.

    Article  Google Scholar 

  • Pathela, P., & Schillinger, J. A. (2010). Sexual behaviors and sexual violence: Adolescents with opposite-, same-, or both-sex partners. Pediatrics, 126, 879–886.

    Article  Google Scholar 

  • Riskind, R. G., Tornello, S. L., Younger, B. C., & Patterson, C. J. (2014). Sexual identity, partner gender, and sexual health among adolescent girls in the United States. American Journal of Public Health, 104, 1957–1963.

    Article  Google Scholar 

  • Rissel, C. E., Richters, J., Grulich, A. E., Visser, R. O., & Smith, A. (2003). Sex in Australia: Attitudes towards sex in a representative sample of adults. Australian and New Zealand Journal of Public Health, 27, 118–123.

    Article  Google Scholar 

  • Saewyc, E. M., Poon, C. S., Homma, Y., & Skay, C. L. (2008). Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. Canadian Journal of Human Sexuality, 17, 123–139.

    PubMed  Google Scholar 

  • Sanders, S. A., Graham, C. A., & Milhausen, R. R. (2008). T11-O-08 Bisexual women differ from lesbian and heterosexual women on several sexuality measures. Sexologies, 17, S157–S158.

    Article  Google Scholar 

  • Tat, S. A., Marrazzo, J. M., & Graham, S. M. (2015). Women who have sex with women living in low- and middle-income countries: A systematic review of sexual health and risk behaviors. LGBT Health, 2, 91–104.

    Article  Google Scholar 

  • Tolman, D. L., & McClelland, S. I. (2011). Normative sexuality development in adolescence: A decade in review, 2000–2009. Journal of Research on Adolescence, 21, 242–255.

    Article  Google Scholar 

  • Tornello, S. L., Riskind, R. G., & Patterson, C. J. (2014). Sexual orientation and sexual and reproductive health among adolescent young women in the United States. Journal of Adolescent Health, 54, 160–168.

    Article  Google Scholar 

  • Varghese, B., Maher, J. E., Peterman, T. A., Branson, B. M., & Steketee, R. W. (2002). Reducing the risk of sexual HIV transmission: Quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sexually Transmitted Diseases, 29, 38–43.

    Article  Google Scholar 

  • Wohl, A. R., Johnson, D. F., Lu, S., Jordan, W., Beall, G., Currier, J., et al. (2002). HIV risk behaviors among African American men in Los Angeles County who self-identify as heterosexual. Journal of Acquired Immune Deficiency Syndromes, 31, 354–360.

    Article  Google Scholar 

  • Young, R. M., & Meyer, I. H. (2005). The trouble with “MSM” and “WSM”: Erasure of the sexual-minority person in public health discourse. American Journal of Public Health, 95, 1144–1149.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Counseling, Developmental, and Educational Psychology, Boston College, Campion Hall 307, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA

    V. Paul Poteat

  2. Department of Human Development and Family Sciences, University of Texas, Austin, TX, USA

    Stephen T. Russell

  3. Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium

    Alexis Dewaele

Authors
  1. V. Paul Poteat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen T. Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexis Dewaele
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Paul Poteat.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in this study were in accordance with the ethical standards of the institutional and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed assent was obtained from all students who participated in the DCYA.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Paul Poteat, V., Russell, S.T. & Dewaele, A. Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation. Arch Sex Behav 48, 1087–1097 (2019). https://doi.org/10.1007/s10508-017-1082-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-017-1082-6

Keywords

Search

Navigation