{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:07:39Z","timestamp":1791803259891,"version":"4.3.4"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,5,1]]},"abstract":"<jats:p>Objective.\u2003This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents.<\/jats:p><jats:p>Design.\u2003This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: \u201cWhich of the following best describes you?\u201d A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models.<\/jats:p><jats:p>Results.\u2003GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45\u201315.20). Early initiation of sexual intercourse (2.15; 10.6\u20134.38), marijuana use (1.98; 1.04\u20134.09), and alcohol use (1.82; 1.03\u20133.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06\u20131.79), inhalant use (1.30; 1.05\u20131.61), and number of sexual partners (1.27; 1.06\u20131.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1.20\u20131.59) and number of sexual partners in the previous 3 months (1.47; 1.31\u20131.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08\u20131.40) and using marijuana (1.29; 1.05\u20131.59) and smokeless tobacco (1.53; 1.30\u20131.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 \u00b1 4.49) compared with the overall student population (mean = 3.45 \u00b1 3.15).<\/jats:p><jats:p>Conclusion.\u2003GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.<\/jats:p>","DOI":"10.1542\/peds.101.5.895","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"895-902","source":"Crossref","is-referenced-by-count":563,"title":["The Association Between Health Risk Behaviors and Sexual Orientation Among a School-based Sample of Adolescents"],"prefix":"10.1542","volume":"101","author":[{"given":"Robert","family":"Garofalo","sequence":"first","affiliation":[{"name":"From the Divisions of General Pediatrics and"},{"name":"JRI Health\/Sidney Borum Jr. Health Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Cameron","family":"Wolf","sequence":"additional","affiliation":[{"name":"Harvard School of Public Health; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari","family":"Kessel","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Education, Boston Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Palfrey","sequence":"additional","affiliation":[{"name":"From the Divisions of General Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"DuRant","sequence":"additional","affiliation":[{"name":"Adolescent\/Young Adult Medicine, Children's Hospital\/Harvard Medical School;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,5,1]]},"reference":[{"key":"2021121007123506000_B1","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1542\/peds.87.6.869","article-title":"Risk factors for attempted suicide in gay and bisexual youth.","volume":"87","author":"Remafedi","year":"1991","journal-title":"Pediatrics."},{"key":"2021121007123506000_B2","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/0197-0070(88)90055-1","article-title":"Theoretical perspectives accounting for adolescent homosexuality.","volume":"9","author":"Savin-Williams","year":"1988","journal-title":"J Adolesc Health Care"},{"key":"2021121007123506000_B3","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/0197-0070(88)90057-5","article-title":"Mental health issues of gay and lesbian adolescents.","volume":"9","author":"Gonsiorek","year":"1988","journal-title":"J Adolesc Health Care"},{"key":"2021121007123506000_B4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1037\/0022-006X.62.2.261","article-title":"Verbal and physical abuse stressors in the lives of lesbian, gay male, and bisexual youths: associations with school problems, running away, substance abuse, prostitution, and suicide.","volume":"62","author":"Savin-Williams","year":"1994","journal-title":"J Consult Clin Psychol"},{"key":"2021121007123506000_B5"},{"key":"2021121007123506000_B6","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/S0025-7125(16)30509-0","article-title":"Fundamental issues in the care of homosexual youth.","volume":"74","author":"Remafedi","year":"1990","journal-title":"Med Clin N Am"},{"key":"2021121007123506000_B7"},{"key":"2021121007123506000_B8","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1542\/peds.92.4.631","article-title":"Homosexuality and adolescence.","volume":"92","author":"American Academy of Pediatrics, Committee on Adolescence","year":"1993","journal-title":"Pediatrics"},{"key":"2021121007123506000_B9","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1542\/peds.79.3.331","article-title":"Adolescent homosexuality: psychological and medical implications.","volume":"79","author":"Remafedi","year":"1987","journal-title":"Pediatrics"},{"key":"2021121007123506000_B10","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/0197-0070(88)90056-3","article-title":"Homosexual identity development.","volume":"9","author":"Trodien","year":"1988","journal-title":"J Adolesc Health Care"},{"key":"2021121007123506000_B11","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1746-1561.1991.tb05993.x","article-title":"School counselors' perceptions of adolescent homosexuals.","volume":"61","author":"Price","year":"1991","journal-title":"J School Health"},{"key":"2021121007123506000_B12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1300\/J082v13n04_07","article-title":"Suicide among homosexual adolescents.","volume":"13","author":"Kourany","year":"1987","journal-title":"J Homosexuality"},{"key":"2021121007123506000_B13"},{"key":"2021121007123506000_B14","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1001\/jama.1994.03520060049031","article-title":"Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men in the San Francisco\/Berkeley Young Men's Survey.","volume":"272","author":"Lemp","year":"1994","journal-title":"JAMA."},{"key":"2021121007123506000_B15","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1542\/peds.89.4.714","article-title":"Demography of sexual orientation in adolescents.","volume":"89","author":"Remafedi","year":"1992","journal-title":"Pediatrics"},{"key":"2021121007123506000_B16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/1054-139X(91)90007-K","article-title":"Risk behavior in adolescence: a psychological framework for understanding and action.","volume":"12","author":"Jessor","year":"1991","journal-title":"J Adolesc Health"},{"key":"2021121007123506000_B17"},{"key":"2021121007123506000_B18"},{"key":"2021121007123506000_B19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1093\/oxfordjournals.aje.a117473","article-title":"Reliability of the Youth Risk Behavior Survey Questionnaire.","volume":"141","author":"Brener","year":"1995","journal-title":"Am J Epidemiol."},{"key":"2021121007123506000_B20","doi-asserted-by":"crossref","first-page":"262","DOI":"10.2105\/AJPH.88.2.262","article-title":"Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students.","volume":"88","author":"Faulkner","year":"1998","journal-title":"Am J Public Health."},{"key":"2021121007123506000_B21","first-page":"326","article-title":"Male homosexuality: the adolescent's perspective.","volume":"79","author":"Remafedi","year":"1987","journal-title":"Pediatrics."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/5\/895\/890349\/pe059800895o.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/5\/895\/890349\/pe059800895o.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T07:34:55Z","timestamp":1734507295000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/101\/5\/895\/65292\/The-Association-Between-Health-Risk-Behaviors-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,5,1]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1998,5,1]]},"published-print":{"date-parts":[[1998,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.101.5.895","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,5,1]]}}}