What Places Sexual Minority Youth At Heightened Risk for Sexually Transmitted Infections?

A smiling young woman.

Social and Sexual Risk Factors Among Sexual Minority Youth” (abstract). Katherine Quinn and Allison Ertl. Journal of LGBT Youth, Vol. 12, No. 3 (July 2015).

What it’s about: Researchers Katherine Quinn and Allison Ertl wanted to identify the sexual behaviors that place sexual minority youth at heightened risk of getting HIV and other sexually transmitted infections, or STIs. Using data from the 2011 Wisconsin Youth Risk Behavior Survey, the researchers analyzed information from 3,043 high school students across 99 factors related to their mental health, sexual behaviors, and social and environmental experiences. For the purpose of the study, the authors define sexual minority youth as young people who identify as lesbian, gay, or bisexual; those who have sexual relationships with people of the same or both sexes; and those who question their sexual identity.

Why read it: All sexually active teens are at-risk of becoming infected with HIV or other STIs, but sexual minority youth are infected at higher rates, the authors write. While a few researchers have explored the influence of sexual identity and behavior on young men’s STI risk, Quinn and Ertl are still among the first to examine sexual identity and sexual behavior as distinct factors. Exploring the impact of youth sexual identity is important because it is a complex issue that typically develops when young people are just beginning to experience sexual attractions and engage in sexual behaviors, the authors write. Moreover, teens' sexual identities and behaviors may differ from their sexual orientations.

Biggest takeaways from the research: Overall, participants who identified as lesbian, gay, bisexual, or questioning, as well as those who reported same-sex sexual contact, were more likely to experience a number of HIV and STI risk factors. These include: 

  • Cyberbullying. Youth who had engaged in same-sex sexual activities were nearly three times as likely to have been bullied online as those who hadn’t had same-sex partners. Similarly, youth who identified as lesbian, gay, bisexual, or questioning were more likely to have been bullied online and in-person within the past year.
  • Suicidal thoughts. Compared to other survey respondents, youth who identified as lesbian, gay, bisexual, or questioning were more likely to have reported excessive feelings of sadness or hopelessness, and to have considered suicide within the past year. Similarly, students who reported having sex with a same-sex partner were nearly five times more likely to consider suicide.
  • Getting drunk. Youth who reported same-sex partners were more than twice as likely to report being drunk within the past 30 days compared to youth who said they were virgins or had only had heterosexual sex.
  • Forced sex. Sexual minority youth were significantly more likely to report being verbally threatened or physically forced into having sex than heterosexual youth or those who had not engaged in same-sex sexual activity.
  • A high number of sex partners. Youth who reported same-sex sexual activities were significantly more likely to have had four or more lifetime sex partners than those who had never had same-sex sexual contact.
  • Lower condom use. Compared to their peers, youth with same-sex contact were less likely to have used a condom the last time they had sex.
  • Sex before age 13. Sexual minority youth were also more likely to have had sex for the first time before age 13.

Although the study did not determine a causal relationship, Quinn and Ertl suggest that various social factors may contribute to sexual minority youth's relatively high rates of contracting HIV and other STIs. Further studies are needed, they write, that look at youth sexual identity and sexual behaviors separately.

Additional references: Learn more about sexual minority youth and HIV/STI prevention in the NCFY library.

Data for this study are from the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System.

We've also examined a past study comparing the sexual and reproductive health of young women with different sexual orientations.

Publications discussed here do not necessarily reflect the views of the National Clearinghouse on Families and Youth, the Family and Youth Services Bureau, or the Administration for Children and Families.

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