THE ASSOCIATION BETWEEN HEALTH RISK BEHAVIORS AND SEXUAL ORIENTATION AMONG A SCHOOL-BASED SAMPLE OF ADOLESCENTS

Objective. This study is one of the first to examine the association b etween sexual orientation and health risk behaviors among a representa tive, school-based sample of adolescents. Design. This study was condu cted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Se xual orientation was determined by the following question: ''Which of the following best describes you?'' A total of 104 students self-ident ified as gay, lesbian, or bisexual (GLB), representing 2.5% of the ove rall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly a ssociated with GLB youth were then analyzed by multiple logistic regre ssion models. Results. GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a vari ety of risk behaviors including suicidal ideation and attempts, multip le substance use, and sexual risk behaviors. Four separate logistic re gression models were constructed. Model I, Onset of Behaviors Before A ge 13, showed use of cocaine before age 13 years as strongly associate d with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10. 6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03- 3.23) also was associated with GLB orientation. Model II, Lifetime Fre quencies of Behaviors, showed that frequency of crack cocaine use (1.3 8; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual pa rtners (1.27; 1.06-1.43) was associated with GLB orientation. Model II I, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1.20-1.59) and number of sexual partners in the pr evious 3 months (1.47; 1.31-1.65) were associated with GLB orientation . Model IV, Frequency of Behaviors at School, showed having one's prop erty stolen or deliberately damaged (1.23; 1.08-1.40) and using mariju ana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were ass ociated with GLB orientation. Overall, GLB respondents engaged disprop ortionately in multiple risk behaviors, reporting an increased mean nu mber of risk behaviors (mean = 6.81 +/- 4.49) compared with the overal l student population (mean = 3.45 +/- 3.15). Conclusion. GLB youth who self-identify during high school report disproportionate risk for a v ariety of health risk and problem behaviors, including suicide, victim ization, sexual risk behaviors, and multiple substance use. In additio n, these youth are more likely to report engaging in multiple risk beh aviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention pro grams, and health services must be designed to address the unique need s of GLB youth.