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. 2001 Jun;91(6):940–946. doi: 10.2105/ajph.91.6.940

Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools.

S M Blake 1, R Ledsky 1, T Lehman 1, C Goodenow 1, R Sawyer 1, T Hack 1
PMCID: PMC1446472  PMID: 11392938

Abstract

OBJECTIVES: This study compared sexual risk behaviors of gay, lesbian, and bisexual (GLB) and heterosexual adolescents and evaluated associations between gay-sensitive HIV instruction and risk behaviors of GLB youths. METHODS: A random sample of high school students and HIV education teachers completed surveys. Self-reported risk behaviors of heterosexual and GLB adolescents were compared, with control for student and community demographic characteristics. Sexual risk behaviors of GLB youths in schools with and without gay-sensitive instruction were compared. RESULTS: GLB youths reported more substance use, high-risk sexual behaviors, suicidal thoughts or attempts, and personal safety issues than did heterosexual youths (P < .001). Among those who were sexually active, GLB youths reported more lifetime and recent sexual partners than did heterosexuals (P < .001), and more of them reported alcohol use before last sex (P < .01) and a history of pregnancy (P < .001). GLB youths in schools with gay-sensitive instruction reported fewer sexual partners, less recent sex, and less substance use before last sex than did GLB youths in other schools (P < .05). CONCLUSIONS: The findings document increased risk behaviors among GLB youths and demonstrate the potential benefits of providing gay-sensitive HIV instruction in schools.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brener N. D., Collins J. L., Kann L., Warren C. W., Williams B. I. Reliability of the Youth Risk Behavior Survey Questionnaire. Am J Epidemiol. 1995 Mar 15;141(6):575–580. doi: 10.1093/oxfordjournals.aje.a117473. [DOI] [PubMed] [Google Scholar]
  2. Cranston K. HIV education for gay, lesbian, and bisexual youth: personal risk, personal power, and the community of conscience. J Homosex. 1992;22(3-4):247–259. doi: 10.1300/J082v22n03_11. [DOI] [PubMed] [Google Scholar]
  3. D'Augelli A. R., Hershberger S. L. Lesbian, gay, and bisexual youth in community settings: personal challenges and mental health problems. Am J Community Psychol. 1993 Aug;21(4):421–448. doi: 10.1007/BF00942151. [DOI] [PubMed] [Google Scholar]
  4. Faulkner A. H., Cranston K. Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. Am J Public Health. 1998 Feb;88(2):262–266. doi: 10.2105/ajph.88.2.262. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fontaine J. H., Hammond N. L. Counseling issues with gay and lesbian adolescents. Adolescence. 1996 Winter;31(124):817–830. [PubMed] [Google Scholar]
  6. Garofalo R., Wolf R. C., Kessel S., Palfrey S. J., DuRant R. H. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998 May;101(5):895–902. doi: 10.1542/peds.101.5.895. [DOI] [PubMed] [Google Scholar]
  7. Garofalo R., Wolf R. C., Wissow L. S., Woods E. R., Goodman E. Sexual orientation and risk of suicide attempts among a representative sample of youth. Arch Pediatr Adolesc Med. 1999 May;153(5):487–493. doi: 10.1001/archpedi.153.5.487. [DOI] [PubMed] [Google Scholar]
  8. Katz M. H., McFarland W., Guillin V., Fenstersheib M., Shaw M., Kellogg T., Lemp G. F., MacKellar D., Valleroy L. A. Continuing high prevalence of HIV and risk behaviors among young men who have sex with men: the young men's survey in the San Francisco Bay Area in 1992 to 1993 and in 1994 to 1995. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Oct 1;19(2):178–181. doi: 10.1097/00042560-199810010-00012. [DOI] [PubMed] [Google Scholar]
  9. Kegeles S. M., Hays R. B., Coates T. J. The Mpowerment Project: a community-level HIV prevention intervention for young gay men. Am J Public Health. 1996 Aug;86(8):1129–1136. doi: 10.2105/ajph.86.8_pt_1.1129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kerr D. L., Allensworth D. D., Gayle J. A. The ASHA national HIV education needs assessment of health and education professionals. J Sch Health. 1989 Sep;59(7):301–307. doi: 10.1111/j.1746-1561.1989.tb04731.x. [DOI] [PubMed] [Google Scholar]
  11. Lemp G. F., Hirozawa A. M., Givertz D., Nieri G. N., Anderson L., Lindegren M. L., Janssen R. S., Katz M. Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. The San Francisco/Berkeley Young Men's Survey. JAMA. 1994 Aug 10;272(6):449–454. [PubMed] [Google Scholar]
  12. Proctor C. D., Groze V. K. Risk factors for suicide among gay, lesbian, and bisexual youths. Soc Work. 1994 Sep;39(5):504–513. doi: 10.1093/sw/39.5.504. [DOI] [PubMed] [Google Scholar]
  13. Radkowsky M., Siegel L. J. The gay adolescent: stressors, adaptations, and psychosocial interventions. Clin Psychol Rev. 1997;17(2):191–216. doi: 10.1016/s0272-7358(97)00007-x. [DOI] [PubMed] [Google Scholar]
  14. Remafedi G. Cognitive and behavioral adaptations to HIV/AIDS among gay and bisexual adolescents. J Adolesc Health. 1994 Mar;15(2):142–148. doi: 10.1016/1054-139x(94)90541-x. [DOI] [PubMed] [Google Scholar]
  15. Remafedi G., Farrow J. A., Deisher R. W. Risk factors for attempted suicide in gay and bisexual youth. Pediatrics. 1991 Jun;87(6):869–875. [PubMed] [Google Scholar]
  16. Remafedi G., French S., Story M., Resnick M. D., Blum R. The relationship between suicide risk and sexual orientation: results of a population-based study. Am J Public Health. 1998 Jan;88(1):57–60. doi: 10.2105/ajph.88.1.57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Remafedi G. Male homosexuality: the adolescent's perspective. Pediatrics. 1987 Mar;79(3):326–330. [PubMed] [Google Scholar]
  18. Remafedi G., Resnick M., Blum R., Harris L. Demography of sexual orientation in adolescents. Pediatrics. 1992 Apr;89(4 Pt 2):714–721. [PubMed] [Google Scholar]
  19. Remafedi G. The impact of training on school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality. J Sch Health. 1993 Mar;63(3):153–157. doi: 10.1111/j.1746-1561.1993.tb06105.x. [DOI] [PubMed] [Google Scholar]
  20. Resnick M. D., Bearman P. S., Blum R. W., Bauman K. E., Harris K. M., Jones J., Tabor J., Beuhring T., Sieving R. E., Shew M. Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997 Sep 10;278(10):823–832. doi: 10.1001/jama.278.10.823. [DOI] [PubMed] [Google Scholar]
  21. Rienzo B. A., Button J., Wald K. D. The politics of school-based programs which address sexual orientation. J Sch Health. 1996 Jan;66(1):33–40. doi: 10.1111/j.1746-1561.1996.tb06256.x. [DOI] [PubMed] [Google Scholar]
  22. Roesler T., Deisher R. W. Youthful male homosexuality. Homosexual experience and the process of developing homosexual idenity in males aged 16 to 22 years. JAMA. 1972 Feb 21;219(8):1018–1023. doi: 10.1001/jama.219.8.1018. [DOI] [PubMed] [Google Scholar]
  23. Rosario M., Meyer-Bahlburg H. F., Hunter J., Gwadz M. Sexual risk behaviors of Gay, Lesbian, and bisexual youths in New York City: prevalence and correlates. AIDS Educ Prev. 1999 Dec;11(6):476–496. [PubMed] [Google Scholar]
  24. Rotheram-Borus M. J., Fernandez M. I. Sexual orientation and developmental challenges experienced by gay and lesbian youths. Suicide Life Threat Behav. 1995;25 (Suppl):26–39. [PubMed] [Google Scholar]
  25. Rotheram-Borus M. J., Marelich W. D., Srinivasan S. HIV risk among homosexual, bisexual, and heterosexual male and female youths. Arch Sex Behav. 1999 Apr;28(2):159–177. doi: 10.1023/a:1018719922709. [DOI] [PubMed] [Google Scholar]
  26. Rotheram-Borus M. J., O'Keefe Z., Kracker R., Foo H. H. Prevention of HIV among adolescents. Prev Sci. 2000 Mar;1(1):15–30. doi: 10.1023/a:1010071932238. [DOI] [PubMed] [Google Scholar]
  27. Rotheram-Borus M. J., Reid H., Rosario M. Factors mediating changes in sexual HIV risk behaviors among gay and bisexual male adolescents. Am J Public Health. 1994 Dec;84(12):1938–1946. doi: 10.2105/ajph.84.12.1938. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Rotheram-Borus M. J., Rosario M., Reid H., Koopman C. Predicting patterns of sexual acts among homosexual and bisexual youths. Am J Psychiatry. 1995 Apr;152(4):588–595. doi: 10.1176/ajp.152.4.588. [DOI] [PubMed] [Google Scholar]
  29. Saewyc E. M., Bearinger L. H., Blum R. W., Resnick M. D. Sexual intercourse, abuse and pregnancy among adolescent women: does sexual orientation make a difference? Fam Plann Perspect. 1999 May-Jun;31(3):127–131. [PubMed] [Google Scholar]
  30. Safren S. A., Heimberg R. G. Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. J Consult Clin Psychol. 1999 Dec;67(6):859–866. doi: 10.1037//0022-006x.67.6.859. [DOI] [PubMed] [Google Scholar]
  31. Seage G. R., 3rd, Mayer K. H., Lenderking W. R., Wold C., Gross M., Goldstein R., Cai B., Heeren T., Hingson R., Holmberg S. HIV and hepatitis B infection and risk behavior in young gay and bisexual men. Public Health Rep. 1997 Mar-Apr;112(2):158–167. [PMC free article] [PubMed] [Google Scholar]
  32. Seal D. W., Kelly J. A., Bloom F. R., Stevenson L. Y., Coley B. I., Broyles L. A. HIV prevention with young men who have sex with men: what young men themselves say is needed. Medical College of Wisconsin CITY Project Research Team. AIDS Care. 2000 Feb;12(1):5–26. doi: 10.1080/09540120047431. [DOI] [PubMed] [Google Scholar]
  33. Telljohann S. K., Price J. H., Poureslami M., Easton A. Teaching about sexual orientation by secondary health teachers. J Sch Health. 1995 Jan;65(1):18–22. doi: 10.1111/j.1746-1561.1995.tb03333.x. [DOI] [PubMed] [Google Scholar]
  34. Treadway L., Yoakam J. Creating a safer school environment for lesbian and gay students. J Sch Health. 1992 Sep;62(7):352–357. doi: 10.1111/j.1746-1561.1992.tb01255.x. [DOI] [PubMed] [Google Scholar]
  35. Troiden R. R. Homosexual identity development. J Adolesc Health Care. 1988 Mar;9(2):105–113. doi: 10.1016/0197-0070(88)90056-3. [DOI] [PubMed] [Google Scholar]
  36. Uribe V., Harbeck K. M. Addressing the needs of lesbian, gay, and bisexual youth: the origins of PROJECT 10 and school-based intervention. J Homosex. 1992;22(3-4):9–28. doi: 10.1300/J082v22n03_02. [DOI] [PubMed] [Google Scholar]
  37. Valleroy L. A., MacKellar D. A., Karon J. M., Rosen D. H., McFarland W., Shehan D. A., Stoyanoff S. R., LaLota M., Celentano D. D., Koblin B. A. HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group. JAMA. 2000 Jul 12;284(2):198–204. doi: 10.1001/jama.284.2.198. [DOI] [PubMed] [Google Scholar]
  38. Waldo C. R., Hesson-McInnis M. S., D'Augelli A. R. Antecedents and consequences of victimization of lesbian, gay, and bisexual young people: a structural model comparing rural university and urban samples. Am J Community Psychol. 1998 Apr;26(2):307–334. doi: 10.1023/a:1022184704174. [DOI] [PubMed] [Google Scholar]

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