Associations between Sexual Behaviors and School-Based Education on Condoms and HIV

The purpose of this study was to examine the relationship between adolescent sexual minority males (ASMM) education on condom use and HIV reports compared to their counterpart adolescent non-sexual-minority males (non-ASMM). Men who have sex with other men are at a much higher risk of contracting HIV. In 2014, men who have sex with men (MSM) made up over two-thirds of new HIV infections and about 56% of people living with HIV in the United States falls under the MSM category.

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MSM are at a high risk for contracting HIV, therefore this population is in need of interventions. The subjects of this study included 11,681 students from seven Florida high schools. Because this study was focused on male responses, 5740 responses were not included in the study due to the respondents being female. So, the resulting data set was slimmed down to 5563 male subjects. Of those 5563 students, 5.2% of them responded as ASMM.

The analyst used a propensity score to standardize the two groups, ASMM and non-ASMM, based on possible confounding variables. After this, there was 572 subjects, 286 of them being ASMM and 286 of them being non-ASMM. Before the paper and pencil questionnaire was distributed, parental permission forms were distributed to get permission for students to take part in the study. The questionnaire was composed of 46 questions and, on average, the students took less than 40 minutes to complete. The questions targeted the topics of sexual risk behavior, school environment/bully prevalence, and education on HIV and STD prevention. Subjects were asked to identify their own personal demographics which encompassed sex, gender, age, grade in school, race, and ethnicity. Race and ethnicity were sectioned into non-Hispanic black, Hispanic, multiracial, or non-Hispanic white.

Also, sexual identity, sexual behavior, and sexual attraction was recorded. Questions also included whether the subject had been tested from HIV or STDs, whether the subject used a condom during their last sexual encounter, whether education on HIV/STDs was provided in school, and whether education on condom use was provided in school. Those subjects who identifies as ASMM reported less likely to be taught about AIDS/HIV/STDs in school (odds ration [OR]=0.58, P=0.04). ASMM individuals were less likely to report condom usage during their last sexual encounter (OR=0.39, P<0.01) and ASMM subjects reported more likely to being tested for HIV/STDs (OR=1.88, P=0.02) than non-ASMM. Non-ASMM subjects reported a significant positive effect about being educated on condom usage in school and using a condom during their last sexual encounter (OR=4.78, P<0.01). Sexual education for ASMM students appears lacking compared the non-ASMM. Content on sexual safety and HIV/STD knowledge needs to be altered and better tailored to ASMM students. The audience for this article include general care health professionals and sex-education teachers. The implications for nurses would include spending more time on educated ASMM patients on the dangers of HIV/STDs and how using condoms can drastically decrease a patient's risk for sexual diseases.

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