州级高中艾滋病毒教育政策与青少年艾滋病毒风险行为之间的关联。

Associations between State-Level High School HIV Education Policies and Adolescent HIV Risk Behaviors.

机构信息

Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115.

Stanford Children's Health, 750 Welch Road Suite 212, Palo Alto, CA, 94304.

出版信息

J Sch Health. 2022 Mar;92(3):316-324. doi: 10.1111/josh.13130. Epub 2021 Dec 23.

DOI:10.1111/josh.13130

PMID:34951018

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10069761/

Abstract

BACKGROUND

School-based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state-level content policies. The purpose of this study was to evaluate the associations between state-level high school HIV education policies and adolescent HIV risk behaviors.

METHODS

This was a cross-sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state-level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex.

RESULTS

Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth.

CONCLUSIONS

Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education.

摘要

背景

学校层面的艾滋病毒（HIV）教育可以覆盖大多数青少年，但州级层面的内容政策存在不一致。本研究旨在评估州级高中 HIV 教育政策与青少年 HIV 风险行为之间的关联。

方法

这是对 2019 年青少年风险行为调查与古特马赫研究所性与 HIV 教育报告进行的横断面分析。逻辑回归模型检验了 HIV 教育授权和内容政策与 3 种 HIV 风险行为的关联：（1）4 个或更多的性伴侣；（2）上次性行为前使用药物；（3）上次性行为时未使用安全套。

结果

在 33 个州中，共纳入了 128986 名高中生。多变量调整模型表明，强制进行 HIV 教育与风险行为之间没有关联。涵盖禁欲和其他安全性行为选择与较低的风险相关，而强调禁欲则与至少 4 个性伴侣和无保护的最后一次性行为的风险增加相关。歧视性的性取向内容与无保护的最后一次性行为增加相关；所有 HIV 风险行为的关联在性少数青年中更强。