Division of Adolescent and Young Adult Medicine, Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Womens Health (Larchmt). 2009 Dec;18(12):2005-10. doi: 10.1089/jwh.2009.1488.
Female youth who describe their sexual orientation as "mostly heterosexual," rather than exclusively heterosexual, display greater sexual risk, yet reasons for this greater risk are not understood. Research is needed to identify factors responsible for health disparities in this population comprising the majority of youth who report a minority sexual orientation.
We compared indicators of perceived social support, parental/caregiver mental health, and sexual risk (age at first sexual intercourse, lifetime history of a sexually transmitted infection (STI), lifetime number of sexual partners) among 33 young women describing themselves as mostly heterosexual and 337 indicating they were 100% heterosexual (aged 18-24 years) participating in an urban, multiethnic, community-based cohort study. Linear, logistic, and Cox proportional hazards regression were used to test whether social support and caregiver mental health explained greater sexual risk among mostly heterosexual compared with heterosexual participants.
Compared with exclusively heterosexuals, mostly heterosexuals reported less social support from family (p=0.01) and friends (p=0.02) and were more likely to report primary male caregiver (though not primary female caregiver) histories of depression (p<0.0001), treatment for depression (p<0.0001), and problems with drug use (p=0.005). Differences in perceived family social support and caregiver mental health and substance use partially mediated relationships between sexual orientation and sexual risk.
Compared with exclusively heterosexual female youth, mostly heterosexual female youth may have poorer relationships with their family and others in their social networks, and this may contribute to their elevated health risks. Additional research is needed to understand causal mechanisms responsible for sexual orientation disparities in sexual risk.
描述性取向为“主要异性恋”而非完全异性恋的年轻女性表现出更大的性风险，但导致这种更高风险的原因尚不清楚。需要开展研究，以确定导致这一人群（大多数报告少数性取向的青年）存在健康差异的因素。
我们比较了 33 名自认为主要异性恋的年轻女性和 337 名表示自己完全异性恋（年龄在 18-24 岁之间）的年轻女性在感知社会支持、父母/照顾者心理健康以及性风险（首次性行为年龄、性传播感染史、性伴侣数量）方面的指标。采用线性、逻辑回归和 Cox 比例风险回归分析来检验社会支持和照顾者心理健康是否可以解释主要异性恋者比异性恋者具有更高的性风险。
与完全异性恋者相比，主要异性恋者报告来自家庭（p=0.01）和朋友（p=0.02）的社会支持较少，更有可能报告主要男性照顾者（尽管不是主要女性照顾者）有抑郁史（p<0.0001）、抑郁治疗史（p<0.0001）和药物使用问题（p=0.005）。感知到的家庭社会支持和照顾者心理健康以及物质使用方面的差异部分解释了性取向和性风险之间的关系。
与完全异性恋的女性青年相比，主要异性恋的女性青年可能与他们的家庭和社交网络中的其他人的关系较差，这可能导致她们的健康风险更高。需要进一步研究以了解导致性取向与性风险差异的因果机制。
