Health Risk Behaviors in a Representative Sample of Bisexual and Heterosexual Female High School Students in Massachusetts

BACKGROUND:

Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents.

METHODS:

Data from girls (N = 875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and psychosocial health by lifetime sexual behavior (behaviorally bisexual vs behaviorally heterosexual) and sexual identity (bisexual vs heterosexual) adjusting for grade and race/ethnicity.

RESULTS:

Overall, 10.5% of girls reported lifetime bisexual behavior and 8.1% reported a bisexual identity. Behavior and identity were discordant for bisexual young women as 53.2% of behaviorally bisexual students had a bisexual identity and 46.8% had a heterosexual identity. Bisexual identity and behavior were associated with unprotected intercourse at last sexual encounter, early sexual debut, 4 or more lifetime partners, history of forced/unwanted sex, sexually transmitted infection testing history, past-year depression, and past-month drug use.

CONCLUSION:

Bisexuality, whether defined by identity or behavior, is associated with adverse sexual and psychosocial health outcomes in adolescent girls. Studies that explore wellness across the life span, and are designed to recognize developmental differences burgeoning in adolescence, may provide insights into the differential sexual risk outcomes observed among bisexual girls.

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By:   White Hughto JM1,2, Biello KB3,4, Reisner SL5,6,7, Perez-Brumer A8, Heflin KJ9, Mimiaga MJ10,11,12.

• 1The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Jwhite@fenwayhealth.org.
• 2Department of Chronic Disease Epidemiology, Yale School of Public Health. Jwhite@fenwayhealth.org.
• 3The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Kbiello@fenwayhealth.org.
• 4Departments of Behavioral & Social Sciences and Epidemiology, Institute for Community Health Promotion, Brown University School of Public Health. Kbiello@fenwayhealth.org.
• 5The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. SReisner@fenwayhealth.org.
• 6Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School. SReisner@fenwayhealth.org.
• 7Department of Epidemiology, Harvard T.H. Chan School of Public Health. SReisner@fenwayhealth.org.
• 8Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032. Agp2133@columbia.edu.
• 9Center for Health Care Strategies, 200 American Metro Blvd., Hamilton, New Jersey 08619. Kheflin@chcs.org.
• 10The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215. Mmimiaga@fenwayhealth.org.
• 11Institute for Community Health Promotion, Brown University School of Public Health. Mmimiaga@fenwayhealth.org.
• 12Harvard T.H. Chan School of Public Health. Mmimiaga@fenwayhealth.org. 

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