HIV risk among homosexual, bisexual, and heterosexual male and female youths.

Variations in sexual risk acts and the social-cognitive mediators of sexual acts were examined among young homosexual, bisexual, and heterosexual males and females (N = 478; 13-21 years of age) from four community-based agencies in New York City, San Francisco, and Los Angeles (29% African American, 36% Latino, 36% White/other). The prevalence and frequency of sexual risk acts varied be gender but were similar across youth of different sexual orientations, ethnicities, and ages. Condom use and the social-cognitive mediators of risk varied by sexual orientation and gender. Homosexual youths reported a gap between their positive attitudes toward HIV prevention and their skills to implement safer sex acts, particularly under social pressure. Bisexual youths appeared at greatest risk; their reports of sexual risk were the highest, yet their perceived risk for HIV was relatively low and skills and knowledge were moderate (relative to their peers). Heterosexual youths appear at high risk for HIV based on reports of low rates of condom use and HIV-related beliefs and attitudes. However, heterosexual youths demonstrated the highest level of condom skills. The number of sexual partners was not associated with any HIV-related social cognitive mediator, suggesting that alternative theoretical models must be proposed for partner selection. Longitudinal research with similar subgroups of youths is needed.