Gender of partners, sexual behavior, and reproductive health care among sexually active adolescents

Purpose: Sexual minority youth are at increased STD and pregnancy risk, yet little is known about their receipt of reproductive health care. This study investigates relationships among these factors.

Methods: 5,930 high school students completed an in-class survey, of whom 2,658 reported sexual experience and were included in analyses. Measures included sexual behaviors, partner gender, and reproductive health care.

Results: Females more frequently reported partners of both genders (6.1% vs. 2.1% of males, p<.0001); but not same sex partners (1.5% vs. 2.5%). Sexual risk differed by partner gender. More participants with partners of both genders reported ever having been/gotten someone pregnant (12.5% vs. 7.1% of those with single gender partners, p<.05). Females with partners of both genders were 2.4 times as likely as females with only opposite sex partners to have received reproductive care (95% CI=1.38-4.31); females with only same gender partners did not differ in reproductive care. Partner gender was not related to reproductive care among males. In multivariable analyses, age, pregnancy history, having partners of both genders, and four or more lifetime sex partners were related to reproductive care among females.

Conclusions: Adolescents with partners of both genders reported increased sexual risk and pregnancy history. Although females with partners of both genders were more likely to have received reproductive health care, males were not. Interventions to reduce sexual risk should consider partner gender. Males with partners of both genders should be increasingly targeted to improve access to and utilization of care.