LGB-Affirming School Climates and Sexual Health Outcomes Among U.S. High School Students 2015-2017: Differences by Sex and Sexual Identity.
LGB-Affirming School Climates and Sexual Health Outcomes Among U.S. High School Students 2015-2017: Differences by Sex and Sexual Identity.
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DOI：
10.1016/j.jadohealth.2020.11.006
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Phillips G 2nd
中科院分区：
文献类型：
--
作者：
Philbin MM;Wang X;Feaster DJ;LaBossier NJ;Phillips G 2nd
女同性恋、男同性恋和双性恋（LGB）青少年在性健康结果方面与异性恋同龄人相比存在差异，这对健康结果和发展轨迹有影响。我们研究了生活在对LGB个体更具排斥性的学校环境的辖区内的青少年是否比生活在更具包容性学校环境的辖区内的青少年从事更高风险的性行为。
有关性取向、首次性行为年龄、上次性行为使用避孕套情况以及一生性伴侣数量的数据来自2015年（20个辖区）和2017年（19个辖区）的青少年危险行为监测调查。有关学校LGB环境的数据汇总到州一级，来自美国疾病控制与预防中心的学校健康概况调查。多层次多变量回归分析了LGB学校环境与性行为之间的关联，包括效应修正。
总体而言，生活在对LGB更具排斥性的学校环境的辖区内与首次性行为年龄较低（β = -0.04[-0.07, -0.02]）以及使用避孕套的可能性较低（OR = 0.94[0.90, 0.98]）显著相关，但与一生性伴侣数量无关。不同亚组的关联有所不同：性取向改变了学校环境与双性恋青少年首次性行为年龄之间的关系（β = -0.09[-0.15, -0.03]），以及学校环境与双性恋（OR = 0.86[0.76, 0.98]）和男同性恋青少年（OR = 0.66[0.64, 0.68]）使用避孕套之间的关系。
对LGB具有排斥性的学校环境与所有青少年，尤其是双性恋个体首次性行为年龄较低以及使用避孕套的可能性较低有关。进一步的研究和实践应关注学校层面的环境，以支持青少年健康的性发展。
“对LGB具有排斥性的学校环境与所有青少年，尤其是双性恋青少年首次性行为年龄较低以及使用避孕套的可能性较低有关；关于社会环境和LGB健康的研究应扩展到关注学校环境。”
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 towards LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. Data on sexual identity, age at first sex, condom use at last sex and number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on schools’ LGB climates, aggregated to the state level, came from the Centers for Disease Control and Preventions’ School Health Profile Survey. Multi-level multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β=−0.04[−0.07, −0.02]) and lower likelihood of condom use (OR=0.94[0.90, 0.98]), but not number of lifetime partners. Associations differed by sub-group: sexual identity modified the relationship between school climate and age at first sex (β=−0.09[−0.15, −0.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR=0.86[0.76, 0.98]) and gay adolescents (OR=0.66[0.64, 0.68]). Exclusionary LGB school climates are associated with a lower age at first sex and lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address the school-level climates to support adolescents’ healthy sexual development. “Exclusionary LGB school climates were associated with lower age of first sex and lower likelihood of condom use for all youth and especially bisexual youth; research on social context and LGB health should expand to focus on school climates.”
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