Gay high school students have slightly more sex than their straight male classmates, but inject drugs in far higher numbers and face a much bigger risk of HIV infection, according to a new report.
The data from the Centers for Disease Control & Prevention – which details the HIV-related risk behaviors among U.S. male students in grades nine through 12 – was released Wednesday at the International AIDS Conference in Durban, South Africa.
The CDC analysis is the first of its kind to examine HIV-related risk behaviors among straight, gay and bisexual male high school students. It shows that even though gay male high school students engage in sex slightly more than straight male classmates, they face a substantially higher risk of HIV, according to the CDC.
The students reported that they:
- Had ever had sexual intercourse (51 percent of gay/bisexual and 41 percent of heterosexual).
- Were currently sexually active (35 percent of gay/bisexual and 30 percent of heterosexual).
- Had had sexual intercourse with four or more partners (15 percent of gay/bisexual and 11 percent of heterosexual).
- Had used a condom the last time they had sex (48 percent of sexually active gay/bisexual and 58 percent of sexually active heterosexual).
But because HIV rates are 57 times higher among men who have sex with men, gay and bisexual teens face a higher risk of HIV infection than heterosexual males, according to the CDC.
“Although most HIV infections occur after high school, it is critical to help teens establish behaviors today that will protect their health now and in the future,” Jonathan Mermin (photo), director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, said in a prepared statement. “Ensuring access to HIV prevention interventions and information is critical to avoiding HIV infections during the teen years – and could have lasting impact over the course of a lifetime.”
Most HIV infections among gay men are acquired through sex, but the CDC points out that the new analysis showed high levels of injection drug use among gay male students – which compounds their risk of HIV.
About 10 percent of gay and bisexual male students reported having ever injected drugs, compared with less than 2 percent of heterosexual male students. In addition to injection drug use, which can directly transmit HIV, CDC also found gay and bisexual male students are significantly more likely than heterosexual male students to have ever used a number of drugs that may contribute to increased sexual risk behavior, even if not injected, including:
- Heroin: eight times more likely (14 percent of gay/bisexual and 2 percent of heterosexual).
- Methamphetamines: six times more likely (15 percent of gay/bisexual and 2 percent of heterosexual).
- Cocaine: three times more likely (18 percent of gay/bisexual and 5 percent of heterosexual).
- And prescription drugs without a doctor’s prescription: two times more likely (30 percent of gay/bisexual and 17 percent of heterosexual).
The higher rates of substance use among gay male students could be impacted by stigma, discrimination and lack of family or social support, according to Laura Kann, chief of the School-Based Surveillance Branch within CDC’s Division of Adolescent & School Health
“Although these new national data do not address why these behaviors occur, they are an important first step toward better understanding the level of risks that exist among these young males and developing solutions to address them in homes, schools, and communities,” Kann said in a prepared statement.
The CDC called for additional research to help address the sexual and drug-related risks for HIV infection among gay teens, including:
- Continued access to HIV testing to reduce the number of undiagnosed infections.
- Education about and access to the full range of effective HIV risk reduction and prevention strategies.
- Increased linkages to and retention in HIV treatment for MSM living with HIV to reduce their viral load and risk of transmission to sexual and injection drug partners.
- School-centered HIV prevention.
- Family and community support.
- Additional research to better understand and address factors contributing to injection drug use and other substance abuse among gay and bisexual males.
The CDC culled the information about health risk behaviors of LGBT students through the National Youth Risk Behavior Survey. But Georgia education officials refuse to allow students to be asked about HIV and sexual behavior – nevermind the state's alarmingly high HIV rates. Via the AJC:
Schools in the state of Georgia have historically not addressed the issue in a comprehensive way, because, in part, sex education classes elicit strong responses from parents. One result has been that in 2013, when John Barge headed the Department of Education, it passed up an estimated $1.9 million in CDC funding for a more comprehensive HIV education curriculum. A DOE spokesperson confirmed that officials felt uncomfortable including questions regarding sexual behavior on the curriculum’s required survey of students.
The CDC funding, which would have covered costs for five years, specifically targeted areas most affected by HIV and AIDS for a series of initiatives, including school surveillance, a push for “exemplary sexual health education emphasizing HIV and other [sexually transmitted disease] prevention” and a program specifically tailored to young gay men.
Georgia was shortlisted to receive the grant because it has the fifth-highest rate of HIV in the nation. According to statistics from the Department of Public Health, more than 600 people were diagnosed with HIV in 2014 in Fulton County alone.
At least Fulton is trying to improve HIV and sex education efforts in its schools.