LATEBREAKER
Health Disparities
Discrimination and Impacts on Youth Sexual Behaviors Elizabeth Swart* Elizabeth Swart Ashley Hill Phoebe Balascio
Introduction:
Promoting positive sexual health and well-being, including physical, emotional, mental and social well-being, are integral to advancing sexual and reproductive equity for young people. This includes an examination of social and structural factors, such as race-based discrimination. Several studies have examined community-level characteristics, such as neighborhood disadvantage, in youth and their impact on sexual risk behaviors, such as age at sexual debut and engaging in unprotected sex. However, few studies examine influences of interpersonal and individual racism and discrimination on sexual risk behavior. This study explored experiences of discrimination among Black youth aged 14-18 and influences of sexual/reproductive health behaviors (SRH).
Methods:
This study assessed adolescents’ perceptions of racism (PRaCY), gender equitable attitudes (GEA), psychological distress, and teen dating/sexual violence victimization (TDV/SV) in adolescents living in lower-resource neighborhoods in Pittsburgh, PA. Participants were 14-18 years old and were recruited from community organizations. Data was collected from baseline surveys completed in-person at one of the study sites.
Multivariable logistic regression was used to examine associations between discrimination and SRH in youth. Sample characteristics included self-reported age, race/ethnicity, sexuality and gender. The study assessed three outcome variables: ever engaging in vaginal/anal sex, number of lifetime partners and age at sexual debut. Chi-square tests examined differences in distributions between girls and boys.
Results:
The study sample comprised of 244 adolescents with a mean age of 15. Approximately 75% of the sample identified as Black and the majority identified as straight. Girls reported higher mean PRaCY scores than boys (3.3 vs 2.4; p=0.02) and GEA significantly differed between genders (1.9 vs 2.3; <0.0001).
For the full sample, GEA, TDV, SV and experiencing any TDV or SV victimization were significantly associated with a higher likelihood of ever having had sex. The associations remained significant for all four variables after adjusting for age, race and sexuality. The magnitude of the associations increased after adjusting: GEA (OR: 2.02; p=0.03), TDV (OR: 3.5; p=0.02), SV (OR: 6.19; p=0.007), any TDV or SV victimization (OR: 3.83; p=0.02).
A higher PRaCY score was significantly associated with having more than one partner after adjusting for age, race and sexuality (OR 1.27; p=0.03). GEA (OR: 2.94; p=0.13), experiencing any TDV (OR 8.57; p=0.04), any SV (OR 5.37; p=0.008) were all significantly associated with early sexual encounters. Clinically significant distress also showed a marginally significant association (OR 4.14, p=0.07).