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Subgroups were compared on rates of recent alcohol abuse, symptoms of depression, and suicide risk behaviors. Cluster analysis was used to derive sexual behavior subgroups and multinomial regression was used to compare subgroups on alcohol abuse and psychiatric symptoms. Substantially higher proportions reporting alcohol abuse, depressive symptoms, suicide planning, and attempts were associated with membership in a subgroup defined primarily by forced sexual intercourse, in contrast with a low-sexual-risk behavior reference group. Younger age and more suicide attempts were linked with membership in a cluster subgroup defined primarily by having experienced early sexual intercourse compared with the reference group. Finally, older age, more alcohol abuse, and suicide attempts were associated with membership in a subgroup defined by having had four or more lifetime sexual partners as opposed to the reference group. The cluster subgroups of sexually experienced male high school students varied significantly in proportions reporting early coitus, forced sexual intercourse, and four or more lifetime sexual partners, and appear to represent relatively distinct sexual risk profiles. Intervention implications associated with sexual risk behavior and mental health problems identified among sexually active male high-school students are discussed.<\/jats:p>","DOI":"10.1007\/s10508-026-03459-5","type":"journal-article","created":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T16:58:47Z","timestamp":1779037127000},"page":"1651-1659","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Depression, Suicidality, and Substance Abuse Among Sexual Risk Behavior Subgroups of Male High School Students"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9280-4492","authenticated-orcid":false,"given":"Robert C.","family":"McMahon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"3459_CR1","doi-asserted-by":"crossref","unstructured":"Abma, J. 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Data collection for the 2021 national YRBS, covered by this clearance, was deemed voluntary, anonymous, and designed to protect student confidentiality.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}