Correlates of Sexual Risk Behaviors among High School Students in Colorado: Analysis and Implications for School-based HIV/AIDS programs

Objectives: To examine correlates of sexual risk behaviors associated with HIV/AIDS infection among adolescents participating in the 2005 Colorado Youth Behavioral Risk Survey, since previous studies have produced mixed findings. Methods: Multinomial logistic regression assessed relationships among dependent variables (sexual risk behaviors, age at first sex, and number of sexual partners in the past 3 months) and independent variables (in-school HIV/AIDS education, use of illegal substances, physically-forced sex, and alcohol use). Results: We found no significant effect of having received in-school HIV/AIDS education on all outcome measure. Compared with females, males were more likely to initiate sex at a relatively younger age, report unprotected sex with multiple partners, and drink alcohol before sexual intercourse. Among females, using 2 illegal substances increased to 12 times the odds of early sexual debut while using ≥3 substances increased the same odds to 44-fold. Likewise, binge drinking was also associated with higher odds of having multiple partners. Hispanic ethnicity and being physically forced for sex were consistently associated with high risk sexual behaviors, early sexual initiation, and increased number of sexual partners. Conclusions: Efforts to control the HIV/AIDS epidemic among adolescents may need to focus on targeted interventions aimed at addressing gender- and racial/ethnic-specific risk exposures among this population group, including risk behaviors linked with lifetime sexual abuse. The need to re-examine the role of in-school HIV prevention programs to build adequate competencies among students, parents and community leaders to reduce risk exposures associated with HIV/AIDS infection among youth is emphasized.