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Background: Studies show that food insecurity is associated with adverse health behaviors for children and adults. However, published data among adolescents are limited. The objective of this study was to examine the association between food insecurity and substance use behaviors among US high school students. Methods: Data from the 2017 Youth Risk Behavior Survey in 10 states were combined to examine the association between household food insecurity and adolescent use of alcohol, marijuana, prescription opioid misuse, and illicit drugs using logistic regression. Results: Among surveyed respondents, 12.3% of high school students reported experiencing food insecurity. In unadjusted analyses, the prevalence of substance use was higher among students with food insecurity compared to food secure students: current binge drinking (16.2% vs 11.5%), current marijuana use (24.0% vs 16.2%), lifetime prescription opioid misuse (21.3% vs 12.6%), and lifetime use of illicit drugs (12.3% vs 5.0%) (all p < 0.05). In adjusted models, food insecurity was associated with lifetime prescription opioid misuse and lifetime use of illicit drugs (aPR 1.38 and 1.70, respectively). Conclusion: Students with food insecurity are a potential group at a higher rise of substance misuse and may benefit from prevention programs designed to address their needs.

Sexual health education, including HIV prevention information, can help prevent unintended pregnancy and sexually transmitted infections. National Youth Risk Behavior Survey data from 2011 and 2013 were used to determine HIV education prevalence among 9,825 currently sexually active students in grades 9-12. Associations between HIV education and contraceptive methods used at last sexual intercourse were examined for: (1) condom use; (2) any contraceptive method; (3) dual use of a condom and either birth control pills; IUD or implant; or shot, patch, or birth control ring; and (4) primary contraceptive method. Primary contraceptive method options were (1) no method; (2) birth control pills; (3) condoms; (4) IUD or implant; (5) shot, patch, or birth control ring; (6) withdrawal or some other method; and (7) not sure. Logistic regression (prevalence ratios [PRs] and 95% confidence intervals [CIs]) and Chi-squares were used for testing. Students who received HIV education were more likely than students who did not to use a condom (PR:1.09;CI:1.01,1.18) and any contraceptive method (PR:1.08;CI:1.04,1.12); there was no significant association with dual use. Primary contraceptive method varied significantly by receipt of HIV education (p < 0.001). School-based HIV education may be important for promotion of adolescent condom and contraceptive use.

Limited information exists on heterosexual youth with sexual contact with same-sex partners in the United States (i.e., discordant heterosexual). We compared the prevalence of health risks between discordant heterosexual, heterosexual with only opposite-sex sexual contact, lesbian/gay, and bisexual students using the 2015 national Youth Risk Behavior Survey (YRBS). Nationwide, 3.2% of students were identified as discordant heterosexuals. The prevalence of several risk behaviors was significantly higher among discordant heterosexual students than their heterosexual peers with only opposite-sex sexual contact. Clinicians should consider sexual identity and sex of sexual partners when conducting risk-assessments to ensure they appropriately target populations for intervention.

Adolescence is an important period of risk for substance use initiation and substance use-related adverse outcomes. To examine youth substance use trends and patterns, CDC analyzed data from the 2009-2019 Youth Risk Behavior Survey. This report presents estimated prevalence of current (i.e., previous 30-days) marijuana use, prescription opioid misuse, alcohol use, and binge drinking and lifetime prevalence of marijuana, synthetic marijuana, cocaine, methamphetamine, heroin, injection drug use, and prescription opioid misuse among U.S. high school students. Logistic regression and Joinpoint analyses were used to assess 2009-2019 trends. Prevalence of current and lifetime substance use by demographics, frequency of use, and prevalence of co-occurrence of selected substances among students reporting current prescription opioid misuse are estimated using 2019 data. Multivariable logistic regression analysis was used to determine demographic and substance use correlates of current prescription opioid misuse. Current alcohol, lifetime cocaine, methamphetamine, heroin, and injection drug use decreased during 2009-2019. Lifetime use of synthetic marijuana (also called synthetic cannabinoids) decreased during 2015-2019. Lifetime marijuana use increased during 2009-2013 and then decreased during 2013-2019. In 2019, 29.2% reported current alcohol use, 21.7% current marijuana use, 13.7% current binge drinking, and 7.2% current prescription opioid misuse. Substance use varied by sex, race/ethnicity, grade, and sexual minority status (lesbian, gay, or bisexual). Use of other substances, particularly current use of alcohol (59.4%) and marijuana (43.5%), was common among students currently misusing prescription opioids. Findings highlight opportunities for expanding evidence-based prevention policies, programs, and practices that aim to reduce risk factors and strengthen protective factors related to youth substance use, in conjunction with ongoing initiatives for combating the opioid crisis. [ABSTRACT FROM AUTHOR]

Adolescent interpersonal violence victimization is an adverse childhood experience and a serious public health problem for youths, their families, and communities. Violence victimization includes dating violence, sexual violence, and bullying. Youth Risk Behavior Survey data for 2019 were used to examine physical and sexual dating violence; sexual violence by anyone; and bullying victimization, whether on school property or electronic, of U.S. high school students by sex, race/ethnicity, and sexual identity. In addition, this report explores frequency of dating violence and frequency of sexual violence among students who reported these forms of victimization and presents composites of dating violence and bullying. Findings reveal that 8.2% of students reported physical dating violence; 8.2% reported sexual dating violence; 10.8% reported sexual violence by anyone, of which 50% of cases were by a perpetrator other than a dating partner; 19.5% reported bullying on school property; and 15.7% reported electronic bullying victimization during the previous 12 months. Approximately one in eight students reported any dating violence, and one in four reported any bullying victimization. Female students; lesbian, gay, and bisexual students; and students not sure of their sexual identity reported the highest prevalence estimates across all five violence victimization types, any and both forms of dating violence, and any bullying victimization. Non-Hispanic white students reported the highest prevalence of bullying victimization. Among students experiencing physical or sexual dating violence or sexual violence by anyone, the most common frequency reported was one time during the previous year; higher frequency was more prevalent among male students compared with female students. These findings provide a contextual understanding of the prevalence of interpersonal violence of U.S. high school students, highlighting those with highest prevalence. Findings can be used by public health professionals to guide prevention efforts with youths in schools and communities. [ABSTRACT FROM AUTHOR]

Sexual minority youth (SMY) report more substance use and experience more physical and sexual dating violence victimization than heterosexual youth; however, few studies have explored the relationship between substance use and disparities in teen dating violence and victimization (TDVV) using national-level estimates, and examined if these relationships vary by sexual minority subgroups. Data from the nationally representative 2015 and 2017 national Youth Risk Behavior Surveys were used to examine differences in TDVV and substance use by sexual identity, and to determine if substance use was associated with TDVV disparities between SMY and heterosexual high school students who dated 12 months prior to the survey (n = 18,704). Sex-stratified logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to determine if substance use mediated the relationship between sexual identity and TDVV. Compared with their heterosexual peers, SMY experienced higher rates of TDVV and were more likely to report using most types of substances, although differences were more pronounced among female students compared with male students. Disparities in TDVV were reduced for male gay and bisexual students as well as for female bisexual students once substance use was entered into the model, suggesting that there is a relationship between substance use and some of gay and bisexual students' risk for experiences of TDVV. Comprehensive efforts for violence prevention among sexual minority students may benefit from incorporating substance use prevention, given its relationship to disparities in TDVV. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections are increasing among young adults, and males who have sex with males (MSM) are at high risk for both infections. Limited Hawai'i data exists on the extent to which populations, such as MSM, are engaging in behaviors that place them at increased risk for either infection. This analysis quantified the proportion of Hawai'i public high school students who are MSM and are at risk for HCV and HIV infections. Data from the 2013, 2015, and 2017 Hawai'i Youth Risk Behavior Surveys (YRBS) were combined (n=16,751) to investigate the prevalence of risk factors associated with HIV and HCV infections (eg, sexual risk behaviors, substance use) and protective factors among MSM public high school students. Among sexually experienced male students (n=3,391), 13.1% were classified as MSM and among these, 40.3% identified as heterosexual despite reporting same-sex sexual contact. Multivariate modeling demonstrated that MSM students are significantly more likely than non-MSM students to engage in behaviors that increase their risk for HIV and HCV infections (composite risk variable; adjusted Prevalence Ratio: 1.40, 95% CI 1.15 - 1.70) and are significantly less likely to have protective factors. Evidence-based prevention strategies for reducing HIV and HCV risk behaviors while improving protective factors among sexual minority youth in Hawaii are necessary and must address sexual behavior along with other dimensions of sexual orientation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little information is available on the associations between nonmedical use of prescription drugs (NMUPD) and dating violence victimization (DVV) among high school students and how associations vary by sex. METHODS: We used data from the 2015 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of students in grades 9 to 12. The sample was restricted to students who dated during the 12 months before the survey, resulting in a sample of 5136 boys and 5307 girls. Sex-stratified logistic regression models estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between lifetime NMUPD and DVV. In our analyses, we examined a 4-level DVV measure: no DVV, physical only, sexual only, and both physical and sexual. RESULTS: Male students had a significantly lower prevalence of DVV compared with female students. By using the 4-level measure of DVV, after adjusting for covariates, sexual DVV only (aPR = 1.61, 95% CI: 1.21-2.12) and both physical and sexual DVV (aPR = 1.65, 95% CI: 1.26-2.17) were positively associated with NUMPD among boys, whereas among girls, physical DVV only (aPR = 1.42, 95% CI: 1.16-1.75) and both physical and sexual DVV (aPR = 1.43, 95% CI: 1.03-1.99) were positively associated with NMUPD. CONCLUSIONS: NMUPD was associated with experiences of DVV among both male and female students. Community- or school-based adolescent violence and substance use prevention efforts would be enhanced by considering the association between DVV and substance use, particularly NMUPD among both male and female adolescents, to address these public health problems. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Data are limited on the behavioral risk correlates of syntheticabstract cannabinoid use. The purpose of this study was to compare the behavioral risk correlates of synthetic cannabinoid use with those among marijuana users. METHODS: Data from the 2015 Youth Risk Behavior Survey, a cross-sectional survey conducted in a nationally representative sample of students in grades 9 through 12 (N = 15 624), were used to examine the association between self-reported type of marijuana use (ie, never use of marijuana and synthetic cannabinoids, ever use of marijuana only, and ever use of synthetic cannabinoids) and self-report of 36 risk behaviors across 4 domains: substance use, injury/violence, mental health, and sexual health. Multivariable models were used to calculate adjusted prevalence ratios. RESULTS: Students who ever used synthetic cannabinoids had a significantly greater likelihood of engaging in each of the behaviors in the substance use and sexual risk domains compared with students who ever used marijuana only. Students who ever used synthetic cannabinoids were more likely than students who ever used marijuana only to have used marijuana before age 13 years, to have used marijuana >1 times during the past 30 days, and to have used marijuana >20 times during the past 30 days. Several injury/violence behaviors were more prevalent among students who ever used synthetic cannabinoids compared with students who ever used marijuana only. CONCLUSIONS: Health professionals and school-based substance use prevention programs should include strategies focused on the prevention of both synthetic cannabinoids and marijuana. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescent use of tobacco in any form is unsafe; yet the use of electronic cigarettes and other electronic vapor products (EVPs) has increased in recent years among this age group. We assessed the prevalence and frequency of cigarette smoking and EVP use among high school students, and associations between health-risk behaviors and both cigarette smoking and EVP use. METHODS: We used 2015 national Youth Risk Behavior Survey data (N = 15 624) to classify students into 4 mutually exclusive categories of smoking and EVP use based on 30-day use: nonuse, cigarette smoking only, EVP use only, and dual use. Prevalence of cigarette smoking and EVP use were assessed overall and by student demographics and frequency of use. Prevalence ratios were calculated to identify associations with health risk-behaviors. RESULTS: In 2015, 73.5% of high school students did not smoke cigarettes or use EVPs, 3.2% smoked cigarettes only, 15.8% used EVPs only, and 7.5% were dual users. Frequency of cigarette smoking and EVP use was greater among dual users than cigarette-only smokers and EVP-only users. Cigarette-only smokers, EVP-only users, and dual users were more likely than nonusers to engage in several injury, violence, and substance use behaviors; have ≥4 lifetime sexual partners; be currently sexually active; and drink soda ≥3 times/day. Only dual users were more likely than nonusers not to use a condom at last sexual intercourse. CONCLUSIONS: EVP use, alone and concurrent with cigarette smoking, is associated with health-risk behaviors among high school students. [ABSTRACT FROM AUTHOR]