The Impact of Psychosocial Stress on Sexual Risk Behaviors Among Gay, Bisexual and Questioning Male Adolescents

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Capstone advisor: Albert Crawford, PhD., MBA, MS, Thomas Jefferson University


Compared to heterosexuals, adolescents that identify as gay, bisexual or questioning (GBQ) experience a higher prevalence of mental illness related to psychological and social stress. GBQ adolescent males also account for the largest proportion of new HIV infections among youth. The purpose of this Capstone project is to examine how a higher level of psychosocial stress among GBQ male adolescents predicts sexual risk behaviors, thus contributing to the incidence of HIV/sexually transmitted disease (STD). Data analysis of the 2011 New York City Youth Risk Behavior Survey (YRBS) was conducted to compare the level of psychosocial stress and sexual risk behaviors between GBQ and heterosexual male adolescents. Next, the relationship between psychosocial stress and sexual risk behaviors among GBQ male adolescents was assessed using general linear models. Dichotomous survey items measuring depressed mood, suicidality, and victimization were used to assess psychosocial stress. Sexual risk behaviors included multiple sexual partners, condom nonuse, and alcohol/drug use during intercourse. All indicators of psychosocial stress were found to be higher among GBQ male adolescents compared to heterosexual male adolescents. GBQ male adolescent were also more likely to recently pursue risky sexual behaviors. Finally, depressed mood, suicidality and victimization were found to significantly predict the likelihood of sexual risk behaviors, and all psychosocial variables predicted alcohol/drug use during recent intercourse. Therefore, mental health should be an essential component of HIV/STD prevention efforts to effectively change the sexual risk behaviors of GBQ adolescents. It is recommended that public health interventions target primary care physicians and enact mandatory training in how to appropriately identify and manage psychosocial stress among GBQ adolescents. Additionally, anti-bullying policy in schools should be reformed to specifically protect sexual minorities against the psychosocial stress of anti-GBQ victimization.

Presentation: 23 minutes