Joseph P. Robinson and Dorothy L. Espelage are with the Department of Educational Psychology, University of Illinois at Urbana-Champaign.
Am J Public Health. 2013 Oct;103(10):1810-9. doi: 10.2105/AJPH.2013.301387. Epub 2013 Aug 15.
Before and after accounting for peer victimization, we estimated sexual risk disparities between students who self-identified as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) and students who self-identified as nontransgender heterosexual.
Students in grades 7 through 12 in Dane County, Wisconsin, were given the Web-administered Dane County Youth Assessment. One set of analyses was based on a sample that included 11 337 students. Subsequent analyses were based on a sample from which we screened out students who may not have been responding to survey items truthfully. Various multilevel-modeling and propensity-score-matching strategies ensured robustness of the results, examined disparities at lower and higher victimization rates, and explored heterogeneity among LGBTQ-identified youths. Finally, propensity-score-matching strategies estimated LGBTQ-heterosexual disparities in 2 matched samples: a sample that reported higher victimization and one that reported lower victimization.
Across 7 sexual risk outcomes, and in middle and high school, LGBTQ-identified youths reported engaging in riskier behavior than did heterosexual-identified youths after we accounted for peer victimization. Risk differentials were present in middle and high school. The LGBTQ group was heterogeneous, with lesbian/gay- and bisexual-identified youths generally appearing most risky, and questioning-identified youths least risky. In the matched sample with lower average victimization rates, LGBTQ-identified youths perceived a greater risk of sexually transmitted infections despite not engaging in sexually risky behavior at significantly higher rates; in the matched sample with higher average victimization rates, all outcomes were significantly different.
Demonstrated LGBTQ-heterosexual risk differentials in grades 7 through 8 suggest that interventions need to be implemented during middle school. These interventions should also be differentiated to address the unique risk patterns among LGBTQ subgroups. Finally, models of sexual risk disparities must expand beyond peer victimization.
在考虑同伴受害情况前后，我们评估了自我认同为女同性恋、男同性恋、双性恋、跨性别或疑问（LGBTQ）的学生与自我认同为非跨性别异性恋的学生之间的性风险差异。
威斯康星州戴恩县的 7 至 12 年级学生接受了网络管理的戴恩县青年评估。一组分析基于包括 11337 名学生的样本。随后的分析基于一个样本，我们从该样本中筛选出可能没有如实回答调查项目的学生。各种多层次建模和倾向评分匹配策略确保了结果的稳健性，考察了较低和较高受害率下的差异，并探讨了 LGBTQ 认同青年之间的异质性。最后，倾向评分匹配策略在 2 个匹配样本中估计了 LGBTQ 异性恋的差异：一个报告较高受害率的样本和一个报告较低受害率的样本。
在 7 种性风险结果中，在初中和高中阶段，在考虑同伴受害情况后，LGBTQ 认同的青年报告的风险行为比异性恋认同的青年更具风险。在初中和高中阶段都存在风险差异。LGBTQ 群体具有异质性，女同性恋/男同性恋和双性恋认同的青年通常风险最高，疑问认同的青年风险最低。在平均受害率较低的匹配样本中，尽管 LGBTQ 认同的青年没有以更高的比率从事风险性行为，但他们认为感染性传播感染的风险更大；在平均受害率较高的匹配样本中，所有结果都有显著差异。
在 7 至 8 年级证明的 LGBTQ 异性恋风险差异表明，需要在中学阶段实施干预措施。这些干预措施还应区分开来，以解决 LGBTQ 亚群体之间独特的风险模式。最后，性风险差异模型必须超越同伴受害情况。
