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AJPH First Look, published online ahead of print Apr 29, 2008
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AJPH.2005.080531v1
98/6/1051    most recent
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June 2008, Vol 98, No. 6 | American Journal of Public Health 1051-1058
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2005.080531

RESEARCH AND PRACTICE

Dimensions of Sexual Orientation and HIV-Related Risk Among Adolescent Females: Evidence From a Statewide Survey

Carol Goodenow, PhD, Laura A. Szalacha, EdD, Leah E. Robin, PhD and Kim Westheimer, MA

Carol Goodenow is with the Massachusetts Department of Education, Malden. Laura Szalacha is with the College of Nursing, University of Illinois, Chicago. Leah Robin is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA. Kim Westheimer is an educational consultant in Boston, MA.

Correspondence: Requests for reprints should be sent to Carol Goodenow, Massachusetts Department of Education, 350 Main St, Malden, MA 021148 (e-mail: cgoodenow{at}earthlink.net).

Objectives. We examined the relationship of 2 dimensions of sexual orientation—sexual identity and sex of partners—with self-reported behaviors and experiences to identify factors that may place adolescent females at risk of HIV/AIDS.

Methods. We gathered data on sexually experienced female high school students from 4 waves of a population-based survey. We used logistic regression analyses to investigate the association between their sexual identity (3666 heterosexual; 184 lesbian, gay, or bisexual; 113 not sure) and sex of partners (3714 male only, 79 female only, and 180 both males and females) with HIV-related risk behaviors.

Results. Self-defined sexual identity was often inconsistent with sex of sexual partners. Sexual identities other than heterosexual and having same-sex partners (either exclusively or in addition to male partners) were associated with high rates of several HIV-related risk behaviors. Coerced sexual contact was significantly associated with every risk outcome. AIDS education in school predicted lower HIV risk on 4 of 6 indicators.

Conclusions. Programs to prevent HIV infection among adolescent females should take into account the complexity of sexual orientation and should address the needs and behaviors of sexual-minority youths.






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