Sexual behaviors and outcomes associated with syndemics for lesbian and bisexual girls

Background: Lesbian and bisexual (LB) girls, compared to heterosexual girls, are more likely to report psychosocial health problems, multiple sexual partners, sexually transmitted infections (STIs), and teen pregnancies.  Syndemics, or the co-occurrence and interaction of psychosocial problems that exacerbate outcomes, have explained sexual risk behaviors among sexual-minority boys, but their existence and relationship to sexual health remains unexamined among LB girls.

Methods: The 2010 MetroWest Adolescent Health Survey was a census of students from 24 high schools in MetroWest Boston; 23,187 students completed surveys, including 561 self-identified lesbian and bisexual girls. Questionnaire items were directly from CDC’s Youth Risk Behavior Survey. Bivariate analyses were conducted on multiple psychosocial variables, including binge drinking, polydrug use, depressive symptoms, sexual abuse, and physical partner violence. Sexual outcomes (3+ sexual partners, STIs, and pregnancy) were regressed on number of psychosocial factors and sociodemographics.

Results: Sixty percent of LB girls reported depressive symptoms, and the prevalence of other psychosocial problems ranged from 8% (polydrug use) to 21% (sexual abuse). Nine percent reported 3+ sexual partners, 5% reported STIs, and 11% reported pregnancy. Psychosocial health problems co-occurred, as shown by significant positive associations between 8 of 10 bivariate relationships. Fourteen percent of LB girls reported 3+ psychosocial health problems, 19.9% reported two, 36.8% reported one, and 29.8% reported none. Each increase in the number of psychosocial health problems significantly doubled the odds of multiple sexual partners (AOR=2.2), STIs (AOR=2.5), and pregnancy (AOR=2.7).

Conclusions: Syndemics appear to be present and related to sexual health among LB girls.