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Sex under the influence in sexual minority youth—What have we learned in 20 years?
Underage drinking and risky sexual behaviors are among the most common risk-taking partaken by adolescents, especially by sexual minority youth (SMY), with important individual and public health consequences. We analyzed 20 years of scientific publications around the world regarding sex under the influence of alcohol in SMY.
Methods
We systematically reviewed quantitative, mixed, and qualitative studies (either global correlation, situational covariation, or event analyses) published between 1995-2014 that examined alcohol use–risky sexual behavior relationships in SMY. We included 5 large databases and manually searched relevant references. Studies were not restricted by language or geographic location and are reported using the PRISMA standard.
Results
Literature search returned 680 unique records, one third published in 1995-2005 and two thirds published in 2005-2014. Ninety-one articles met the inclusion criteria and are narratively reported across four themes: [1] alcohol use before or during sexual intercourse (n=39), [2] condom and alcohol use (n=29), [3] alcohol use and multiple sexual partners (n=17), and [4] transactional sex under the influence of alcohol (n=6). Mixed-methods and qualitative studies (n=14) further informed these themes, providing individual and contextual factors mediating and moderating sex under the influence. Studies were mostly quantitative (n=77), published in English (n=89), and performed in the US (n=81).
Conclusions
Compared to their heterosexual peers, SMY engages in more frequent and heavier drinking behaviors. Despite some conflicting results, most evidence points to individual and contextual factors synergizing both risk-taking behaviors. To be effective, risk-taking prevention programs must be cognizant of these factors specific to SMY.
Learning Areas:
Assessment of individual and community needs for health educationDiversity and culture
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences
Learning Objectives:
Name the four key themes in the literature regarding underage drinking and risky sexual behaviors in sexual minority youth (i.e., alcohol use before or during sexual intercourse, condom and alcohol use, alcohol use and multiple sexual partners, and transactional sex under the influence of alcohol).
Differentiate the three levels of analyses that can be performed in the study of underage drinking and risky sexual behaviors in sexual minority youth (i.e., global correlation studies, situational covariation studies, and event analyses).
List the individual and contextual factors driving risk-taking behaviors in sexual minority youth published in the last 20 years.
Keyword(s): Alcohol Use, Lesbian, Gay, Bisexual and Transgender (LGBT)
Qualified on the content I am responsible for because: I have conceptually designed this study and have been involved in every step of its development along with my doctoral committee. I have analyzed the data to the best of my knowledge and skills. I have experience performing searches in the databases used and am familiar with the systematic literature review methods.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.