HIV and Sexually Transmitted Disease Testing Behavior Among Adolescent Sexual Minority Males: Analysis of Pooled Youth Risk Behavior Survey Data, 2005-2013.
Adolescent sexual minority males (ASMM) comprise a high-risk group that may benefit from expanded human immunodeficiency virus (HIV) and sexually transmitted disease (STD) prevention services. The purpose of this study was to estimate the prevalence of HIV and STD testing among ASMM from pooled high school Youth Risk Behavior Surveys (YRBSs).



Data came from 26 YRBSs from 2005 to 2013, which included questions on sexual identity and/or sex of sexual contacts and questions on ever being tested for HIV and/or STDs. Multivariable logistic regression was used to identify factors independently associated with lifetime HIV testing among sexually experienced ASMM.



Overall, 3027 of 43,037 (6.3%, 95% confidence interval [CI]: 5.8%-6.8%) males were categorized as ASMM. Among 1229 sexually experienced ASMM, 413 (26.6%, 95% CI: 21.8%-31.4%) reported ever being tested for HIV, and among 571 ASMM who reported not using a condom during last intercourse, 192 (29.4%, 95% CI: 21.3%-37.6%) reported testing. A longer duration since first intercourse (≥3 vs. ≤1 year: adjusted prevalence ratio [aPR]: 1.6, 95% CI: 1.0-2.6) and recent intercourse (within the past 3 months vs. earlier: aPR: 2.2, 95% CI: 1.4-3.4) was associated with a higher adjusted prevalence of HIV testing. Sixty-four of 252 (30.2%, 95% CI: 20.0%-40.4%) sexually experienced ASMM reported ever being tested for STDs.



Low levels of testing among sexually experienced ASMM, particularly those who reported sex without a condom at last intercourse, highlight the exigency of improving age-appropriate HIV and STD prevention services. Educating healthcare providers to better assess adolescent sexual histories is essential to increasing testing.
1 Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan , Ann Arbor, Michigan.
Akshay
A
Sharma
2 Division of Adolescent and School Health, Centers for Disease Control and Prevention , Atlanta, Georgia .
Li Yan
LY
Wang
2 Division of Adolescent and School Health, Centers for Disease Control and Prevention , Atlanta, Georgia .
Richard
R
Dunville
3 Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta, Georgia .
Rachel K
RK
Valencia
3 Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta, Georgia .
Eli S
ES
Rosenberg
3 Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta, Georgia .
Patrick S
PS
Sullivan
D000293:Adolescent; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008913:Minority Groups; D015999:Multivariate Analysis; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control
HIV testing; STD testing; adolescent sexual minority males; prevention services for adolescents; young men who have sex with men