Sex, drugs, and depression: The importance of sexual minority status in differentiating health behaviors and outcomes in a national sample of male US college students

Background: Limited research has examined associations of sexual minority status with the prevalence of health outcomes/behaviors affecting US male college students. Purpose: To investigate the association between sexual minority status, defined by both sexual identity and behavior, and a variety of behaviors and outcomes, including sexual behaviors, alcohol and substance use, violence and sexual abuse, and mental health, as reported by a national sample of male college students. Significance: Examining the prevalence of a variety of risk factors strengthens the ability of public health professionals to respond to the unique needs of these priority populations. Methodology: Analyses utilized secondary data from 14,766 non-married male undergraduates (aged 18-24) responding to the Spring 2009 American College Health Association-National College Health Assessment II. Findings/Results: When controlling for socio-demographic factors, gay and bisexually identified men who have sex with men (MSM) were more likely than heterosexually identified men who have sex with women (MSW) to report multiple sex partners. MSM, regardless of identity, were more likely than MSW to be tested for HIV and test positive for STIs. Sedative use was more common among gay and bisexually identified MSM, whereas bisexually and heterosexually identified MSM were more likely than MSW to report antidepressant use. MSM, regardless of identity, were more likely to be sexual abuse/stalking victims. Gay, bisexually, and heterosexually identified MSM were more likely to report depression and to have considered/attempted suicide. Conclusions/Recommendations: Findings suggest that targeted prevention interventions and strengthened mental health support services are needed on American college campuses.