Illicit drug use and associated health risk behaviors among sexual minority youth.

OBJECTIVE

This study examined the links between lifetime illicit drug use (e.g., cocaine, hallucinogens, ecstasy, heroin) and proximal health risk behaviors among adolescents and investigated sexual identity as a moderator.

METHODS

We analyzed data from the Center for Disease Control's 2021 Youth Risk Behavior Survey (N = 17,232), a biennial, cross-sectional survey of a nationally representative sample of youth enrolled in grades 9 through 12 in the United States. Bivariate tabulations of weighted data were used to estimate the prevalence of health risk behaviors among lifetime illicit drug users and sexual minority youth who identified as lesbian, gay, bisexual, questioning, or another sexual identity (LGBQ+). Structural equation modeling was used to examine their associations. Wald testing was employed to test for effect modification.

RESULTS

Illicit drug use was associated with a broad range of health risk behaviors among adolescents (e.g., cigarette and marijuana use, drinking and driving, use of alcohol and drugs before sex, and having multiple sex partners). There was a significant interaction between lifetime illicit drug use and sexual identity such that LGBQ+ youth who have ever engaged in illicit drug use had the greatest odds of health risk behaviors.

CONCLUSIONS

Adolescents with a history of ever using illicit drugs are likely to engage in a wide array of health risk behaviors. Screening and offering counseling on these health risk behaviors may play a crucial role in ensuring that the sequela of drug use among adolescents is minimized, especially for LGBQ+ youth.