Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop US8-1, Atlanta, GA 30329, USA; and U.S. Public Health Service Commissioned Corps, Rockville, MD, USA.
Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop US8-1, Atlanta, GA 30329, USA.
Sex Health. 2022 Oct;19(5):456-463. doi: 10.1071/SH22007.
There are notable disparities by race/ethnicity in the sexual health of US adolescents and young adults. Our objective was to examine change over time in racial-ethnic disparities in sexual behaviours among US high school students.
Data were analysed from six biennial cycles of the national Youth Risk Behavior Survey (2009-19), conducted among cross-sectional, nationally representative samples of 9th-12th grade students. Data were collected via self-administered questionnaires. Multivariable logistic regression models tested for linear trends by race/ethnicity (White, Black, Hispanic) and differences in these trends in: ever had sex, current sexual activity, having four or more lifetime sexual partners, and condomless sex. Prevalence ratios and risk differences by race/ethnicity for each cycle were used to calculate average percent change in the estimates to determine if health disparities changed over time.
During 2009-19, prevalence estimates for ever had sex, current sexual activity, and having four or more lifetime sexual partners decreased overall and across all racial-ethnic groups. For condomless sex, prevalence estimates increased over time overall (38.9-45.7%) and for Black (37.6-51.8%) and White (36.7-44.2%) students, but not Hispanic (45.1-43.8%) students. Significant differences in trends by race/ethnicity were observed for all variables. Data suggest that racial-ethnic health disparities for sexual behaviours decreased over time, except for condomless sex.
Although racial-ethnic gaps in sexual behaviours may be shrinking for many behaviours, work is still needed to achieve health equity in risks associated with HIV/AIDS, sexually transmitted infections, and pregnancy.
美国青少年和年轻人的性健康存在明显的种族/族裔差异。我们的目的是研究美国高中生性行为中的种族/族裔差异随时间的变化。
对全国青少年风险行为调查（2009-19 年）的六个两年期周期的数据进行了分析，该调查在全国代表性的 9 至 12 年级学生的横断面样本中进行。数据通过自我管理的问卷收集。多变量逻辑回归模型测试了种族/族裔（白种人、黑种人、西班牙裔）的线性趋势，以及这些趋势在以下方面的差异：曾经有过性行为、当前的性行为、有四个或更多的终生性伴侣，以及无保护的性行为。每个周期的种族/族裔的比例和风险差异用于计算估计值的平均百分比变化，以确定健康差异是否随时间而变化。
在 2009-19 年期间，曾经有过性行为、当前的性行为和有四个或更多的终生性伴侣的流行率估计值总体上和在所有种族/族裔群体中都有所下降。对于无保护的性行为，总体上（38.9-45.7%）和黑种人（37.6-51.8%）和白种人（36.7-44.2%）学生的流行率估计值随着时间的推移而增加，但西班牙裔（45.1-43.8%）学生的流行率估计值没有增加。所有变量的趋势都存在显著的种族/族裔差异。数据表明，除了无保护的性行为外，性行为方面的种族/族裔健康差异随时间缩小。
尽管许多行为的种族/族裔差距在性行为方面可能在缩小，但仍需要努力实现与艾滋病毒/艾滋病、性传播感染和怀孕相关风险的健康公平。
