@article{ref1,
title="LGB-affirming school climates and sexual health outcomes among U.S. high school students 2015-2017: differences by sex and sexual identity",
journal="Journal of Adolescent Health",
year="2021",
author="Phillips, Gregory 2nd and LaBossier, Natalie J. and Feaster, Daniel J. and Wang, Xinzi and Philbin, Morgan M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for  health outcomes and developmental trajectories. We examined whether adolescents  living in jurisdictions with school climates that were more exclusionary toward LGB  individuals engaged in higher risk sexual behaviors than those in jurisdictions with  more inclusive school climates. <br><br>METHODS: Data on sexual identity, age at first sex,  condom use at last sex and the number of lifetime partners came from the 2015 (20  jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School  Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel  multivariable regressions examined the association between LGB school climate and  sexual behaviors, including effect modification. <br><br>RESULTS: Overall, living in  jurisdictions with more exclusionary LGB school climates was significantly  associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower  likelihood of condom use (OR =.94[.90,.98]), but not the number of lifetime  partners. Associations differed by subgroup: sexual identity modified the  relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for  bisexual adolescents, and school climate and condom use for bisexual (OR =.86[.76,.98]) and gay adolescents (OR =.66[.64,.68]). <br><br>CONCLUSIONS: Exclusionary LGB school  climates are associated with a lower age at first sex and a lower likelihood of  condom use for all adolescents, and particularly bisexual individuals. Additional  research and practice should address school-level climates to support adolescents'  healthy sexual development.<p /> <p>Language: en</p>",
language="en",
issn="1054-139X",
doi="10.1016/j.jadohealth.2020.11.006",
url="http://dx.doi.org/10.1016/j.jadohealth.2020.11.006"
}