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Trends in HIV-related risk behaviors among US adolescents: is progress stalling?
Presented by Laura Kann, United States.
L. Kann, A. Balaji, R. Lowry, D. Eaton, H. Wechsler
Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, United States
Background: Sexual risk behaviors provide an important marker for risk for HIV infection. Thus, it is important to understand how sexual risk behaviors change over time. The Youth Risk Behavior Surveillance System (YRBSS) is the largest public health surveillance system in the US measuring HIV-related risk behaviors among adolescents.
Methods: Nine national school-based surveys were conducted during 1991-2007. Each survey employed a 3-stage cross-sectional sample of students in grades 9-12 (ages 14-17). African American and Hispanic students were oversampled. Each survey provided self-report data from approximately 12,000 students. Secular trends were analyzed using logistic regression analyses that controlled for sex, grade in school, and race/ethnicity and simultaneously assessed linear and higher order time effects.
Results: From 1991-2007, significant linear decreases were identified in the prevalence of lifetime sexual intercourse (54.1% to 47.8%) and multiple sex partners (18.7% to 14.9%) among high school students. The prevalence of condom use among sexually active students increased from 46.2% to 63.0% in 2003 and did not change significantly from 2003-2007. Similar patterns were observed among female students. Among male students, the prevalence of lifetime sexual intercourse and multiple partners decreased from 1991-1997, but did not change significantly from 1997-2007. Condom use increased. Among white students, the prevalence of lifetime sexual intercourse and multiple partners decreased, while the prevalence of condom use increased. Among black students, the prevalence of sexual intercourse decreased from 1991-2001 but did not change significantly from 2001-2007; the prevalence of multiple partners decreased; and the prevalence of condom use increased from 1991-1999, but did not change significantly from 1999-2007. Among Hispanic students, no change was detected in the prevalence of lifetime sexual intercourse or multiple partners; the prevalence of condom use increased.
Conclusions: The lack of improvement in some HIV-related risk behaviors among some subgroups of students in recent years may be cause for concern.
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