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Background: To identify whether school health policies and programs vary by demographic characteristics of schools, using data from the School Health Policies and Programs Study (SHPPS) 2006. This study updates a similar study conducted with SHPPS 2000 data and assesses several additional policies and programs measured for the first time in SHPPS 2006. Methods: SHPPS 2006 assessed the status of 8 components of the coordinated school health model using a nationally representative sample of public, Catholic, and private schools at the elementary, middle, and high school levels. Data were collected from school faculty and staff using computer-assisted personal interviews and then linked with extant data on school characteristics. Results: Results from a series of regression analyses indicated that a number of school policies and programs varied by school type (public, Catholic, or private), urbanicity, school size, discretionary dollars per pupil, percentage of white students, percentage of students qualifying for free lunch funds, and, among high schools, percentage of college-bound students. Catholic and private schools, smaller schools, and those with low discretionary dollars per pupil did not have as many key school health policies and programs as did schools that were public, larger, and had higher discretionary dollars per pupil. However, no single type of school had all key components of a coordinated school health program in place. Conclusions: Although some categories of schools had fewer policies and programs in place, all had both strengths and weaknesses. Regardless of school characteristics, all schools have the potential to implement a quality school health program. (Contains 3 tables.)

In 2016, more than 90% of HIV diagnoses among young men aged 13–19 years were attributed to male-male sexual contact. Little is known about how binge drinking and non-injection drug use may be associated with risky sexual behavior among adolescent sexual minority males (ASMM). Using data from the National HIV Behavioral Surveillance, we examined how binge drinking and non-injection drug use may be associated with sexual risk among ASMM. ASMM were recruited for interviews in 3 cities: Chicago, New York City, and Philadelphia. Among 16–18-year-olds (N = 488), we evaluated the association between binge drinking (≥ 5 drinks in one sitting in the past 30 days), non-injection drug use (past 12-month use of methamphetamines, powder cocaine, downers, painkillers, ecstasy, poppers, and "other"), and two past 12-month sexual risk outcomes: condomless anal intercourse with a casual partner and having multiple sex partners. We used log-linked Poisson regression models with robust standard errors to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Overall, 26% of 16–18-year-old ASMM binge drank, and 21% reported non-injection drug use. Among ASMM who binge drank, 34% reported condomless anal intercourse with a casual partner compared with 22% of those who did not (PR: 1.53, 95% CI: 1.04–2.26). Similarly, 84% of ASMM who binge drank reported having multiple partners compared with 61% of those who did not (PR: 1.38, 95% CI: 1.09–1.76). Among ASMM who used non-injection drugs, 37% reported condomless anal intercourse compared with 22% of those who did not (PR: 1.70, 95% CI 1.09–2.50), while 86% of those who used non-injection drugs had multiple partners compared with 62% of those who did not (PR: 1.40, 95% CI: 1.06–1.80). Our findings suggest that the prevalence of substance misuse is high among sexual minority youth and is associated with sexual risk in this population. Our findings highlight the need for high-quality HIV prevention programs for ASMM especially as HIV prevention programs for this population are scarce. [ABSTRACT FROM AUTHOR]

Adolescent men who have sex with men (MSM) are at increased risk for sexually transmitted infections (STIs) and HIV; however, data documenting STI screening, STI burden, and associated risk factors for STIs are extremely limited. Using 2015 data from the National HIV Behavioral Surveillance among Young MSM, we examined self-reported STI screening and STI diagnosis of chlamydia, gonorrhea, or syphilis among sexually active adolescent MSM by selected characteristics. Analysis of STI diagnosis was limited to participants who reported an STI screening. Differences in STI screening and STI diagnosis and factors associated with screening and diagnosis were examined using bivariate and multivariable binomial regression models. Less than half of adolescent MSM reported having ever been screened for an STI. Among these, more than a quarter reported having ever been diagnosed with chlamydia, gonorrhea, or syphilis. STI screening was associated with visiting a healthcare provider in the past 12 months and having ever been tested for HIV. Having ever had an STI diagnosis was associated with the participant age of 18 years and having sex before 13 years old. Among adolescent MSM, STI screening was suboptimal and STI burden was significant. STI intervention and prevention programs are urgently needed to promote STI awareness, timely screening, and early diagnosis to interrupt transmission among this vulnerable population. [ABSTRACT FROM AUTHOR]

We examined the association between mental health issues, social support, and HIV among adolescent sexual minority males (SMM), who are disproportionally affected by HIV. National HIV Behavioral Surveillance among Young Men Who Have Sex with Men (NHBS-YMSM) data among SMM aged 13–18 years were collected in three cities (Chicago, New York City, and Philadelphia). Separate log-linked Poisson regression models were used to estimate associations between mental health issues and social support (general and family), and 3 HIV-related sexual risk behavior outcomes: past-year condomless anal intercourse (CAI) with a male partner, past-year sex with ≥ 4 partners, and first vaginal or anal sex before age 13. Of 547 adolescent SMM, 22% reported ever attempting suicide and 10% reported past-month suicidal ideation. The majority (52%) reported depression and anxiety. Thirty-nine percent reported CAI, 29% reported ≥ 4 sex partners and 22% reported first sex before age 13. Ever attempting suicide, suicidal ideation, and depression and anxiety were associated with CAI. Separately, ever attempting suicide and lack of family support were associated with ≥ 4 sex partners. None of the mental health or support measures were associated with having sex before age 13. General social support was not associated with any sexual risk behaviors. Mental health issues are common among adolescent SMM and associated with sexual risk behaviors. Including mental health support in comprehensive HIV prevention for adolescent SMM could potentially reduce HIV risk in this population. [ABSTRACT FROM AUTHOR]

Background. Much has been written about the impact of human immunodeficiency virus (HIV) among young (13-24) sexual minority men (SMM). Evidence for concern is substantial for emerging adult (18-24 years) SMM. Data documenting the burden and associated risk factors of HIV among adolescent SMM (<18 years) remain limited. Methods. Adolescent SMM aged 13-18 years were recruited in 3 cities (Chicago, New York City, and Philadelphia) for interview and HIV testing. We used χ² tests for percentages of binary variables and 1-way analysis of variance for means of continuous variables to assess differences by race/ethnicity in behaviors. We calculated estimated annual HIV incidence density (number of HIV infections per 100 person-years [PY] at risk). We computed Fisher's exact tests to determine differences in HIV prevalence by selected characteristics. Results. Of 415 sexually active adolescent SMM with a valid HIV test result, 25 (6%) had a positive test. Estimated annual HIV incidence density was 3.4/100 PY; incidence density was highest for blacks, followed by Hispanics, then whites (4.1, 3.2, and 1.1/100 PY, respectively). Factors associated with higher HIV prevalence included black race; ≥4 male partners, condomless anal sex, and exchange sex in the past 12 months; and a recent partner who was older, black, HIV-infected, or had ever been in jail or prison (P < .05). Conclusions. HIV-related risk behaviors, prevalence, and estimated incidence density for adolescent SMM were high, especially for minority SMM. Our findings suggest that initiating intervention efforts early may be helpful in combating these trends. [ABSTRACT FROM AUTHOR]

Adolescents need information about sex-related topics in order to reduce risk behavior and engage in healthy sexual decision-making. Parents have the potential to be an important source of this information. Using the 2006–2010 and 2011–2013 National Survey of Family Growth, we examined associations between parent–adolescent communication before age 18 about sex-related topics and HIV testing among respondents aged 18–24 that ever had sexual intercourse (women = 3893; men = 3359). Analyses showed that for both men and women, discussing how to prevent HIV/AIDS and how to use a condom with a parent before age 18 were positively associated with HIV testing. Among women only, discussions about methods of birth control, where to get birth control, and STDs were positively associated with HIV testing. Developing strategies and interventions to facilitate parent–adolescent communication about sex-related topics, particularly HIV prevention and condom use, may be important to increase HIV testing among young women and men. [ABSTRACT FROM PUBLISHER]