Morgan M Philbin1, Xinzi Wang2, Daniel J Feaster3, Natalie J LaBossier4, Gregory Phillips2. 1. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York. Electronic address: mp3243@columbia.edu. 2. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois. 3. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida. 4. Boston University School of Medicine, Boston, Massachusetts.
Abstract
PURPOSE: Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for health outcomes and developmental trajectories. We examined whether adolescents living in jurisdictions with school climates that were more exclusionary toward LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. METHODS: Data on sexual identity, age at first sex, condom use at last sex and the number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. RESULTS: Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower likelihood of condom use (OR = .94[.90, .98]), but not the number of lifetime partners. Associations differed by subgroup: sexual identity modified the relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR = .86[.76, .98]) and gay adolescents (OR = .66[.64, .68]). CONCLUSIONS: Exclusionary LGB school climates are associated with a lower age at first sex and a lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address school-level climates to support adolescents' healthy sexual development.
PURPOSE: Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for health outcomes and developmental trajectories. We examined whether adolescents living in jurisdictions with school climates that were more exclusionary toward LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. METHODS: Data on sexual identity, age at first sex, condom use at last sex and the number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. RESULTS: Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower likelihood of condom use (OR = .94[.90, .98]), but not the number of lifetime partners. Associations differed by subgroup: sexual identity modified the relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR = .86[.76, .98]) and gay adolescents (OR = .66[.64, .68]). CONCLUSIONS: Exclusionary LGB school climates are associated with a lower age at first sex and a lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address school-level climates to support adolescents' healthy sexual development.
Authors: John Santelli; Mary A Ott; Maureen Lyon; Jennifer Rogers; Daniel Summers; Rebecca Schleifer Journal: J Adolesc Health Date: 2006-01 Impact factor: 5.012
Authors: Emily O'Malley Olsen; Laura Kann; Alana Vivolo-Kantor; Steve Kinchen; Tim McManus Journal: J Adolesc Health Date: 2014-04-24 Impact factor: 5.012
Authors: Chelsea N Proulx; Robert W S Coulter; James E Egan; Derrick D Matthews; Christina Mair Journal: J Adolesc Health Date: 2019-01-26 Impact factor: 5.012
Authors: Robert W S Coulter; Michelle Birkett; Heather L Corliss; Mark L Hatzenbuehler; Brian Mustanski; Ron D Stall Journal: Drug Alcohol Depend Date: 2016-02-23 Impact factor: 4.492
Authors: Gregory Phillips; Xinzi Wang; Megan M Ruprecht; Reno Stephens; Diogo Costa; Lauren B Beach; Patrick Janulis Journal: AIDS Care Date: 2021-10-20