title: Health Risk Behaviors in a Representative Sample of Bisexual and Heterosexual Female High School Students in Massachusetts.
abstract: BACKGROUND
  Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents.
  
  
  METHODS
  Data from girls (N = 875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and psychosocial health by lifetime sexual behavior (behaviorally bisexual vs behaviorally heterosexual) and sexual identity (bisexual vs heterosexual) adjusting for grade and race/ethnicity.
  
  
  RESULTS
  Overall, 10.5% of girls reported lifetime bisexual behavior and 8.1% reported a bisexual identity. Behavior and identity were discordant for bisexual young women as 53.2% of behaviorally bisexual students had a bisexual identity and 46.8% had a heterosexual identity. Bisexual identity and behavior were associated with unprotected intercourse at last sexual encounter, early sexual debut, 4 or more lifetime partners, history of forced/unwanted sex, sexually transmitted infection testing history, past-year depression, and past-month drug use (all ps < .05).
  
  
  CONCLUSIONS
  Bisexuality, whether defined by identity or behavior, is associated with adverse sexual and psychosocial health outcomes in adolescent girls. Studies that explore wellness across the life span, and are designed to recognize developmental differences burgeoning in adolescence, may provide insights into the differential sexual risk outcomes observed among bisexual girls.
authors.affiliation: The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Jwhite@fenwayhealth.org.|Department of Chronic Disease Epidemiology, Yale School of Public Health. Jwhite@fenwayhealth.org.
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: White Hughto
authors.affiliation: The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Kbiello@fenwayhealth.org.|Departments of Behavioral & Social Sciences and Epidemiology, Institute for Community Health Promotion, Brown University School of Public Health. Kbiello@fenwayhealth.org.
authors.forename: Katie B
authors.initials: KB
authors.lastname: Biello
authors.affiliation: The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. SReisner@fenwayhealth.org.|Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School. SReisner@fenwayhealth.org.|Department of Epidemiology, Harvard T.H. Chan School of Public Health. SReisner@fenwayhealth.org.
authors.forename: Sari L
authors.initials: SL
authors.lastname: Reisner
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032. Agp2133@columbia.edu.
authors.forename: Amaya
authors.initials: A
authors.lastname: Perez-Brumer
authors.affiliation: Center for Health Care Strategies, 200 American Metro Blvd., Hamilton, New Jersey 08619. Kheflin@chcs.org.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Heflin
authors.affiliation: The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Mmimiaga@fenwayhealth.org.|Institute for Community Health Promotion, Brown University School of Public Health. Mmimiaga@fenwayhealth.org.|Harvard T.H. Chan School of Public Health. Mmimiaga@fenwayhealth.org.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001727:Bisexuality / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D008297:Male; D008404:Massachusetts; D012309:Risk-Taking; D011795:Surveys and Questionnaires
keywords: adolescents; bisexual; sexual risk; women