Exploring Sexual and Behavioral Health Inequities among College Students: A Need for LGB-Specific Risk Reduction

Many studies have examined differences in sexual behavior based upon self-identified sexual orientation, with results often indicating that those with same-sex partners engage in greater risk behaviors than those with opposite sex partners. However, few of those studies consisted of large, national sample studies. To address that gap, the present study examined the relationship between sexual orientation and both behavioral and sexual health outcomes in a national sample of U.S. college students. The Fall 2012 through Spring 2014 American College Health Association National College Health Assessment was used to examine behavioral and sexual health related responses from self-identified heterosexual, gay, lesbian, and bisexual students (N = 152,050). Items related to depression, abusive relationships, suicidal ideation, substance use, and engagement in consensual and nonconsensual sexual behaviors were examined. A series of cross tabulations indicated that sexual orientation was significantly associated with antecedents to sexual risk, including diagnoses of depression and engagement in abusive relationships. Self-identified sexual minorities reported significantly greater suicidal ideation and attempts, as well as engage in greater quantities of cigarette, alcohol, and marijuana use. Not only was sexual orientation significantly associated with the number of sexual partners in the previous 12 months, but similarly the occurrence of unprotected sex, sexual behaviors without providing consent, and sexual behaviors without receiving consent. Such findings were consistently found when disaggregating by sexual orientation and gender, and suggest that, as universities continue to foster a culture of diversity and acceptance, the unique experiences and prevention-based needs of sexual minority students must be addressed.