Trends in Sex of Sex Partners and Sexual Identity Among US Adolescents, 2015-2021.

PURPOSE

We sought to assess recent trends in both sex of sex partners and sexual identity among US adolescents. One motivation for this investigation is that incidence of sexually transmitted infections is high among US adolescents, and varies along these dimensions; awareness of such trends may help to anticipate shifts in the upcoming needs for prevention and care.

METHODS

We analyzed four biennial Youth Risk Behavior Survey waves (2015-2021; total n = 61,298). We used multinomial trend tests to assess changes in sex of sex partners among all respondents, and among those who had ever had sex. We then assessed trends in sexual identity, and in sex of sex partners disaggregated by sexual identity and by age.

RESULTS

The proportion of female respondents reporting prior same-sex sexual contact increased significantly over time (7.4%-12.2%, p < .001), as it did for males (3.1%-3.8%, p < .02). Proportions with bisexual female, bisexual male, and lesbian identities also increased significantly, while gay male identity did not. There was no significant increase in the proportion of heterosexually-identified adolescents having same-sex contacts, but there was a significant decline in the proportion of gay male respondents having only female partners. Increases in female respondents with female partners occurred across individual ages from 14 to 17.

DISCUSSION

Sexual identity and sexual contact patterns are both shifting among US adolescents. These may yield upcoming shifts in the distributions of different sexually transmitted infections, including HIV. The early age for some of these shifts are especially important to consider for sexual health education.