Trends in HIV-Related Risk Behaviors Among U.S. Adolescents: Is Progress Stalling? Laura Kann, Ph.D. Lexi Balaji, Ph.D. Richard Lowry, M.D. Nancy Brener,

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Presentation transcript:

Trends in HIV-Related Risk Behaviors Among U.S. Adolescents: Is Progress Stalling? Laura Kann, Ph.D. Lexi Balaji, Ph.D. Richard Lowry, M.D. Nancy Brener, Ph.D. Danice Eaton, Ph.D. Howell Wechsler, Ed.D. Division of Adolescent and School Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of the CDC.

Purpose To examine trends in sexual risk behaviors among high school students in the U.S. during

National Youth Risk Behavior Survey Behaviors that contribute to unintentional injuries and violence Tobacco use Alcohol and other drug use Sexual behaviors Unhealthy dietary behaviors Inadequate physical activity

HIV-Related Risk Behaviors Ever had sexual intercourse (sexual experience) Sexual intercourse with >4 persons (multiple partners) Current sexual activity – sexual intercourse during the past 3 months Condom use at last sexual intercourse (among currently sexually active students)

Subgroups Overall Female Male White (non-Hispanic) Black or African American (non-Hispanic) Hispanic or Latino

Methods 9 National Youth Risk Behavior Surveys ( ) Independent 3-stage cluster sample designs Schools selected with probability proportional to size Classes selected randomly All students in selected classes included Oversampling of black and Hispanic students Nationally representative of public and private school students in grades 9-12

Sample Sizes and Response Rates Sample sizes – 10,904 to 16,296 School response rates – 70% to 81% Student response rates – 83% to 90% Overall response rates – 60% to 70%

Survey Administration Anonymous and voluntary Parental permission following local procedures Self-administered, computer-scannable questionnaire Completed in one class period (45 minutes)

Data Analysis Weighting Based on student sex, race/ethnicity, and grade Adjusted for oversampling of black and Hispanic students Temporal changes Logistic regression analyses Controlled for sex, race/ethnicity, and grade Simultaneously assessed linear and quadratic changes Subgroup differences and differences between T-tests

Results

Percentage of High School Students Who Ever Had Sexual Intercourse, by Sex* and Race/Ethnicity,** 2007 * M > F ** B > H > W

Percentage of High School Students Who Ever Had Sexual Intercourse, *Significant linear decrease, , p<.05.

Percentage of High School Students Who Ever Had Sexual Intercourse by Sex, 1991 – 2007 *Significant linear decrease, , p<.05. **Significant quadratic change, decreased , no change , p<.05.

Percentage of High School Students Who Ever Had Sexual Intercourse by Race/Ethnicity, 1991 – 2007 *Significant linear decrease, , p<.05 **Significant quadratic change, declined , no change , p<.05.

Percentage of High School Students Who Had Sexual Intercourse with >4 Persons During Their Life, by Sex* and Race/Ethnicity,** 2007 * M > F ** B > H > W

Percentage of High School Students Who Had Sexual Intercourse with >4 Persons During Their Life, 1991 – 2007 *Significant linear decrease, , p<.05

Percentage of High School Students Who Had Sexual Intercourse with >4 Persons During Their Life by Sex, 1991 – 2007 *Significant linear decrease, , p <.05. **Significant quadratic change, declined , no change , p<.05

Percentage of High School Students Who Had Sexual Intercourse with >4 Persons During Their Life by Race/Ethnicity, 1991 – 2007 *Significant linear decrease, , p<.05.

Percentage of High School Students Who Were Currently Sexually Active,* by Sex and Race/Ethnicity,** 2007 * Had sexual intercourse with at least one person during the 3 months before the survey. ** B > H > W

Percentage of High School Students Who Were Currently Sexually Active, – Had sexual intercourse with at least 1 person during the 3 months before the survey. *Significant linear decrease, , p<.05.

Percentage of High School Students Who Were Currently Sexually Active by Sex, 1991 – Had sexual intercourse with at least 1 person during the 3 months before the survey. *Significant linear decrease, , p <.05

Percentage of High School Students Who Were Currently Sexually Active 1 by Race/Ethnicity, 1991 – Had sexual intercourse with at least 1 person during the 3 months before the survey. *Significant linear decrease, , p<.05.

Percentage of High School Students Who Used a Condom During Last Sexual Intercourse, 1 by Sex** and Race/Ethnicity,*** Among students who were currently sexually active. ** M>F *** B>W

Percentage of High School Students Who Used a Condom During Last Sexual Intercourse, – Among students who were currently sexually active. *Significant linear increase, , p<.05. **Significant quadratic change, increased , no change , p<.05.

Percentage of High School Students Who Used a Condom During Last Sexual Intercourse 1 by Sex, 1991 – Among currently sexually active students. *Significant linear increase, , p <.05 **Significant quadratic change, increased , no change , p<.05.

Percentage of High School Students Who Used a Condom During Last Sexual Intercourse 1 by Race/Ethnicity, 1991 – Among currently sexually active students. *Significant linear increase, , p<.05. **Significant quadratic change, increased , no change , p<05. ***Significant quadratic change, increased , no change , p<.05.

Summary Sexual Experience Multiple (>4) Partners Currently Sexually Active Condom Use During Last Intercourse Total Female Male White Black Hispanic

Summary Sexual Experience Multiple (>4) Partners Currently Sexually Active Condom Use During Last Intercourse Total Female Male White Black Hispanic

Summary Sexual Experience Multiple (>4) Partners Currently Sexually Active Condom Use During Last Intercourse Total Female Male White Black Hispanic

Limitations Data apply only to youth who attend school Extent of under- or over-reporting cannot be determined Number of sexual risk behavior variables is very limited

Conclusions Renew efforts to delay onset of sexual activity and increase condom use – especially among black, Hispanic, and male students Involve parents and families, schools, youth serving community organizations, health care providers, the media, government agencies, and youth