Primary Sources: Can Sexual Identity Place a Young Man at Higher Risk for STIs?

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A young man wearing a gray hoodie

Sexual Orientation Disparities in Sexually Transmitted Infection Risk Behaviors and Risk Determinants Among Sexually Active Adolescent Males: Results From a School-Based Sample“ (abstract). Bethany G. Everett, Phillip W. Schnarrs, Margaret Rosario, Robert Garofalo and Brian Mustanski. American Journal of Public Health, Vol. 104, No. 6 (June 2014).

What it’s about: Researchers wanted to know whether young men’s sexual identity made a difference in their vulnerability to sexually transmitted infections. In other words, did it matter if young men having sex with men called themselves gay, straight or bisexual? The researchers analyzed data from the Youth Risk Behavior Surveys, an ongoing national school-based study of 12- to 18-year-olds.

The researchers compared the behavior of young men who identified as bisexual, heterosexual young men who have sex with women, heterosexual young men who have sex with men, and young men who identify as gay.

Why read it: Research has shown young men who have sex with men are more likely than young men who only have sex with women to report behaviors that put them at risk for STIs. This is one of the first studies to look at both behavior and identity—which don’t always correspond—to compare young men's risk for getting STIs. Understanding what factors might put boys and young men at higher risk for STIs is crucial for family and youth workers who want to develop effective prevention strategies.

Biggest takeaways for family and youth workers: Overall, young men who identified as bisexual were most likely to report multiple behaviors that put them at risk for getting STIs.

  • Number of sexual partners. Compared to the other young men surveyed, bisexual young men reported a higher number of sexual partners and were almost twice as likely to have more than one sexual relationship at a time.
  • Condom use. Compared to young men who only have sex with women, all men who have sex with men were more likely to have not used a condom the last time they had sex. Gay and bisexual men were more than twice as likely to have had sex without a condom the last time they had sex.
  • Younger age of sexual debut.  Bisexual young men were about a year younger, on average, the first time they had sex, than other young men in the study.
  • Forced sex and sexual assault. Gay-, bisexual- and heterosexual-identified young men who have sex with men were nearly four times more likely to report ever being forced to have sex than heterosexual young men who have sex with women.

The findings suggest sexual health educators must be aware that not all young men who have sex with men are the same, the authors say, nor do they face the same risks. STI- and HIV-prevention efforts that work for gay young men might not address challenges faced by bisexual- or heterosexual-identified young men who have sex with men. Targeted interventions may be needed, the authors say.

Additional references: Find abstracts of other literature on risky sexual behavior, HIV/STD prevention and STI/STD prevention in our digital library.

The Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System provided the data used in this study.

We summarized a recent study looking at links between sexual orientation and STI risk behavior among lesbian and bisexual young women, showing that bisexual young women reported the most STI risk behaviors.

Publications discussed here do not necessarily reflect the views of NCFY, FYSB or the Administration for Children & Families.

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