Objective: To describe sexual behaviors, sexual violence, and sexual identity among a population-based sample of adolescents according to the sex of their sex partners, considering separately those with partners of both sexes.
Methods: From the 2005-2007 New York City Youth Risk Behavior Surveys, 3805 male and 3456 female adolescents reported having had sex and the sex of their sexual contacts. Subgroups were constructed: only opposite-sex partners; only same-sex partners; and partners of both sexes (both-sex partners). Weighted prevalence, risk behaviors (eg, using drugs/alcohol with sex), and sexual identity among subgroups were described.
Results: Similar numbers of sexually active male (3.2%) and female adolescents (3.2%) reported only same-sex behavior, but fewer male than female adolescents reported both-sex partners (3.7% vs 8.7%; P < .001). Male adolescents with both-sex partners reported a higher prevalence of sexual risk behaviors than male adolescents with only opposite-sex or only same-sex partners. Female adolescents with both-sex or only same-sex partners reported a higher prevalence of risk behaviors than female adolescents with only opposite-sex partners. Adolescents with both-sex partners reported a marked prevalence of dating violence and forced sex. Many adolescents with only same- or both-sex partners (38.9%) self-identified as straight.
Conclusions: Of sexually active adolescents, 9.3% reported a same-sex partner, a higher estimate than other published rates. Those who reported both male and female partners reported behaviors that placed them at risk for sexually transmitted infections (STIs), including HIV. Pediatricians and school health providers must inquire about behaviors, not identity, to determine STI risk, and STI education should be appropriate for youth with same-sex partners.