Preventing Sexual Risk Behaviors Among Gay, Lesbian, and Bisexual Adolescents: The Benefits of Gay-Sensitive HIV Instruction in Schools

Gay, lesbian, and bisexual (GLB) youths continue to engage in sexual risk behaviors and are at greater risk of victimization, substance abuse, depression, and suicide. This study sought to compare the sexual, substance use, and safety risk behaviors of heterosexual and GLB high school students and to determine whether gay-sensitive HIV instruction in high school would be associated with reductions in rates of high-risk sexual behaviors among GLB youths.

A multistage cluster sampling design was employed to obtain a representative sample of adolescents enrolled in public high schools as part of the 1995 Massachusetts Youth Risk Behavior Survey. Students were classified as GLB based on self-identification or report of same-sex sexual contacts. Of participants, 3,496 (94.5 percent) were classified as heterosexual, while 151 (4.2 percent) were classified as GLB. Teachers who provided HIV instruction answered three questions related to their perceived ability to meet the needs of GLB students. Students were asked if they had ever received instruction on preventing HIV/AIDS.

To determine whether GLB adolescents were at increased risk of substance use, sexual behavior, suicide, and victimization, researchers compared the responses from GLB and heterosexual students. To determine whether gay-sensitive HIV instruction was associated with reduced sexual risk behaviors, they compared the responses of GLB adolescents in schools with and without gay-sensitive HIV instruction.

"Consistent with previous research, we found that GLB students in Massachusetts were significantly more likely than heterosexual youths to engage in substance use, sexual risk behaviors, and suicide attempts and to experience threats to personal safety. Unfortunately, GLB youths were less likely than heterosexuals to report having received HIV instruction or instruction related to condom use, which was surprising," the researchers reported. "However, in schools where gay-sensitive HIV instruction was provided, GLB youths reported lower sexual risk behaviors. . . . The teachers in this study were far more likely than teachers in earlier studies to report feeling confident to teach GLB youths (87% vs. 24%-37%) and to report that they had taught their students about sexual orientation (98% vs. 46%).

"We learned that GLB youths in schools where gay-sensitive HIV curricula and materials were available and teachers expressed greater confidence in being able to meet their needs were less likely to engage in sexual risk behaviors, and that GLB youths in schools that did not provide gay-sensitive instruction were at greater risk than all other youths for HIV infection, pregnancy, suicide, and victimization. These results highlight the importance of training teachers to provide gay-sensitive HIV prevention instruction and of making appropriate materials available. . . . Our findings strongly suggest that teachers who receive appropriate training, curricula, and materials to provide gay-sensitive instruction in schools can make a difference in the lives of GLB students."

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