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Leah Robin, PhD; Nancy D. Brener, PhD; Shaun F. Donahue, MEd; Tim Hack, MAEd; Kelly Hale, MA; Carol Goodenow, PhD

Arch Pediatr Adolesc Med. 2002;156:349-355.

Objective  To examine associations between health risk behaviors and sexual experience with opposite-, same-, or both-sex partners in representative samples of high school students.

Design  We used 1995 and 1997 data from the Vermont and Massachusetts Youth Risk Behavior Surveys. Logistic regression and multiple regression analyses were used to compare health risk behaviors among students who reported sex with opposite-sex partners only (opposite-sex students), with same-sex partners only (same-sex students), and with both male and female sexual partners (both-sex students).

Setting  Public high schools in Vermont and Massachusetts.

Participants  Representative, population-based samples of high school students. The combined samples had 14 623 Vermont students and 8141 Massachusetts students.

Main Outcome Measure  Violence, harassment, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices.

Results  In both states, both-sex students were significantly more likely to report health risk behaviors than were opposite-sex students. For example, both-sex students had odds 3 to 6 times greater than opposite-sex students of being threatened or injured with a weapon at school, making a suicide attempt requiring medical attention, using cocaine, or vomiting or using laxatives to control their weight. In both states, same-sex students were as likely as opposite-sex students to report most health risk behaviors.

Conclusion  Relative to opposite- and same-sex students, both-sex students may be at elevated risk of injury, disease, and death by experiencing serious harassment and engaging in violence, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices.

From the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Robin and Brener); Vermont Department of Education, Montpelier (Mr Donahue); Massachusetts Department of Education, Malden (Mr Hack and Dr Goodenow); and the Vermont Department of Health, Burlington (Ms Hale).

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