Correction to: Sexual Identity and Behavior Among U.S. High School Students, 2005-2015.

The following correction should be noted to the caption of Fig. 1 in this article.

Sexual Identity and Behavior Among U.S. High School Students, 2005-2015.

Sexual orientation is a multidimensional construct which is increasingly recognized as an important demographic characteristic in population health research. For this study, weighted Youth Risk Behavior Survey data were pooled across 47 jurisdictions biennially from 2005 to 2015, resulting in a national sample of 98 jurisdiction-years (344,815 students). Respondents were a median of 15.5 years, 49.9% male, and 48.8% White. Sexual identity and behavior trends from 2005 to 2015 were assessed with logistic regression analysis. Overall, 13.9% of females and 7.0% of males identified as lesbian, gay, bisexual (LGB), or not sure, while 9.1% of females and 4.2% of males indicated both same-and-different-sex behavior or same-sex behavior. In total, 17.0% of female and 8.5% of male youth reported non-heterosexual (LGB or not sure) sexual identity, same-sex sexual behavior, or both. LGB youth were approximately twice as likely as other youth to report lifetime sexual behavior. White and Asian youth were less likely to report non-heterosexual identity and/or have engaged in same-sex sexual behaviors than youth of other races/ethnicities. Prevalence of non-heterosexual identities increased over time for both sexes, but only female youth reported significantly more same-sex behavior over time. This is the first study to simultaneously assess adolescent sexual identity and behavior over time within a national dataset. These findings are critical for understanding the sexual health needs of adolescents and for informing sexual health policy and practice.

An Investigation of Racial and Ethnic Homophily on Grindr Among an Ongoing Cohort Study of YMSM.

Men who have sex with men (MSM), and especially MSM of color, are disproportionately affected by HIV. Previous research shows that MSM have high levels of racial/ethnic homophily (the tendency for people to have sex with others who share the same racial/ethnic identification) in sexual dyads, which may help explain HIV disparities. This study fills a gap in previous research by grounding network data from a cohort study of young MSM in Chicago (RADAR) in the contexts of virtual spaces (VSs) and examining differences in levels of racial/ethnic homophily using multilevel-logistic-regression models. Results show that Grindr differs from other VSs in proportions of racially/ethnically homophilous dyads and by partner racial/ethnic identification. After controlling for general homophily trends, sex partnerships formed on Grindr by Black MSM were significantly less likely to be homophilous than those of White MSM. While racial/ethnic groups differ in likelihood to form homophilous partnerships, this trend varies by VS.

Interplay of Race and Criminal Justice Involvement on Sexual Behaviors of Young Men Who Have Sex With Men.

PURPOSE: Criminal justice involvement is a significant problem in the United States, and poses substantial negative immediate and long-term effects, particularly among adolescents and young adults. Research has been mixed on the association between a history of arrest or incarceration and an increased risk of human immunodeficiency virus, but there are clear trends in the association between criminal justice involvement and sexual risk behaviors. METHODS: Drawing from a racially or ethnically diverse sample of young men who have sex with men, we conducted an investigation into whether there was a temporal relationship between history of criminal justice involvement and engagement in high-risk sexual behaviors. We also examined whether sexual behaviors among black men who have sex with men (MSM) were more substantially impacted by arrest or incarceration than those of non-black MSM. Data were collected within a longitudinal study of young MSM in Chicago. RESULTS: More than one-third of participants (37.8%) reported having ever been in trouble with the police in their lifetime, and 10% had been incarcerated. In multivariable analysis, black race, history of incarceration, and the interaction were all significantly positively associated with an increase in reported number of male anal sex partners. CONCLUSIONS: We found that the intersection between race and criminal justice involvement plays a major role in sexual behaviors. More research is needed to understand why a history of arrest or incarceration has a much more profound effect on black MSM than on non-black MSM.

Condom and Substance Use at Last Sex: Differences between MSMO and MSWO High School Youth.

HIV disproportionately impacts youth, particularly young men who have sex with men (YMSM), a population that includes subgroups of young men who have sex with men only (YMSMO) and young men who have sex with men and women (YMSMW). In 2015, among male youth, 92% of new HIV diagnoses were among YMSM. The reasons why YMSM are disproportionately at risk for HIV acquisition, however, remain incompletely explored. We performed event-level analyses to compare how the frequency of condom use, drug and/or alcohol use at last sex differed among YMSMO and YMSWO (young men who have sex with women only) over a ten-year period from 2005⁻2015 within the Youth Risk Behavior Survey (YRBS). YMSMO were less likely to use condoms at last sex compared to YMSWO. However, no substance use differences at last sexual encounter were detected. From 2005⁻2015, reported condom use at last sex significantly declined for both YMSMO and YMSWO, though the decline for YMSMO was more notable. While there were no significant differences in alcohol and substance use at last sex over the same ten-year period for YMSMO, YMSWO experienced a slight but significant decrease in reported alcohol and substance use. These event-level analyses provide evidence that YMSMO, similar to adult MSMO, may engage in riskier sexual behaviors compared to YMSWO, findings which may partially explain the increased burden of HIV in this population. Future work should investigate how different patterns of event-level HIV risk behaviors vary over time among YMSMO, YMSWO, and YMSMW, and are tied to HIV incidence among these groups.

Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey.

BACKGROUND: Alcohol use among underage youth is a significant public health concern. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is the "drug of choice" among adolescents, meaning more youth use and abuse alcohol than any other substance. Prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers. We examined sexual identity and sexual behavior disparities in alcohol use, and the mediational role of bullying in a sample of high school students. METHODS: Data from the 2015 National Youth Risk Behavior Survey were used to assess the association between sexual minority status (identity and behavior) and alcohol use with weighted logistic regression. Due to well-documented differences between males and females, we stratified models by gender. Physical and cyberbullying were examined as mediators of the relationship between sexual minority status and alcohol use. RESULTS: We detected associations between certain subgroups of sexual minority youth and alcohol use across all four drinking variables (ever drank alcohol, age at first drink, current alcohol use, and binge drinking). Most of these associations were found among bisexual-identified youth and students with both male and female sexual partners; these individuals had up to twice the odds of engaging in alcohol use behaviors when compared with sexual majority students. Associations were strongest among females. Bullying mediated sexual minority status and alcohol use only among bisexual females. CONCLUSIONS: As disparities in alcohol use differ by gender, sexual identity, and sexual behavior, interventions should be targeted accordingly.

A Qualitative Study Examining Young Adults' Experiences of Disclosure and Nondisclosure of LGBTQ Identity to Health Care Providers.

Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ identity creates a barrier to accessing care. This qualitative study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers. Participants (n = 206, age range 18-27) completed questionnaires assessing health care access and use as part of a larger study. Participants' responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for nondisclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure and nondisclosure of LGBTQ identity. Reasons for participant nondisclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults' identity disclosure and provide avenues for health professionals' continuing education when working with LGBTQ patients.