Young men who have sex with men (MSM) are at much higher risk of HIV infection compared to their peers, but a new study led by a Boston University School of Public Health researcher suggests young MSM are less likely to receive school-based HIV education than young men who only have sex with women.
In the study, published in LGBT Health, 84 percent of MSM reported learning about HIV in school, compared to 90 percent of men who had sex only with women. HIV education was associated with reduced sexual risk behaviors among all students, with much more dramatic reductions among young MSM than their peers.
“It is striking that the young people who are most at risk of HIV are least likely to report HIV education in school,” says lead author Dr Julia Raifman, assistant professor of health law, policy & management. The authors wrote that young MSM accounted for 95 percent of estimated HIV diagnoses among adolescents aged 13 to 24 in 2015.
The researchers used data from the Centers for Disease Control and Prevention (CDC) Youth Risk Behaviors Surveillance System, which monitors health risk behaviors among US high school students. Because the national survey does not ask about the sex of sexual partners or about HIV education, the researchers used the 2011 and 2013 surveys from the 13 states that included this information for one or both of those years. States in the Northeast, Southeast, Midwest, and Southwest were represented.
Students who had not had sex, students who did not report age and/or race in the survey, and students who in another survey question reported ever having been forced to have sex, were eliminated from the study group. Of the remaining 16,372 male students, 94.1 percent reported sex only with women, 2.9 percent reported sex only with men, and 3 percent reported sex with both men and women.
School-based HIV education was associated across the board with lower odds of having three or more partners in the past three months and higher odds of condom use at last sexual encounter. The researchers found the risk behavior differences associated with HIV education were much more pronounced in MSM than in men who only had sex with women, more than doubling the odds of using a condom at last sexual encounter and reducing five-fold the odds of having had three or more partners in the last three months.