High-School Students: Sexual Orientation and Pregnancy Risk
High-School Students: Sexual Orientation and Pregnancy Risk
The dependent variable in this study was pregnancy; approximately 14% of female students reported that they had ever been pregnant (Table 1). More than 85% of female students identified as heterosexual and almost 90% had only had male sexual partners. Female students were primarily Black (43%) with a mean age of 16.0 years. Most were 14 or 15 years old when they first had sexual intercourse (53%); 40.9% had only had 1 sexual partner and 17.2% reported ever having been physically forced to have sexual intercourse.
Approximately 11% of male students reported that they had gotten someone pregnant. Most male students identified as heterosexual (96%) and had only had female sexual partners (97%). Male students were primarily Hispanic (41.2%) with a mean age of 15.9 years. More than 50% were younger than 13 years when they first had sexual intercourse; 23.7% had only had 1 sexual partner and 6.9% reported ever having been physically forced to have sexual intercourse. Additional details on the sample characteristics are provided in Table 1.
Table 2 presents bivariate associations between sexual orientation and our dependent variable and covariates by gender. Among female students, sexual identity and gender of sexual partners were significantly associated with pregnancy; 22.6% of lesbian or bisexual female students and 20.1% of female students who had had both male and female sexual partners reported ever having been pregnant compared with 13.3% of heterosexual female students and 13.7% of female students who reported having had only male sexual partners. Female students who had had male and female sexual partners were younger at first sexual intercourse and were more likely to report having been physically forced to have sexual intercourse than female students with only male sexual partners. We also found similar patterns by sexual identity.
Among male students, sexual identity and gender of sexual partners were significantly associated with pregnancy involvement risk; 28.6% of gay or bisexual male students and 37.7% of male students who had had sexual intercourse with male and female partners had ever gotten someone pregnant compared with 10% of heterosexual male students and 9.9% of male students with only female sexual partners. Male students who had had male and female sexual partners were younger at first sexual intercourse, had more lifetime sexual partners, and more than 30% reported having been physically forced to have sexual intercourse compared with 6.2% of male students with only female partners. Similar patterns were also found by sexual identity.
We examined the association between sexual orientation and pregnancy risk among female students in Table 3 by using multivariable logistic regression. Results from models 1 and 2, the least-restrictive models, revealed significantly higher odds of pregnancy for female students who identified as lesbian or bisexual (odds ratio [OR] = 1.90; 95% confidence interval [CI] = 1.25, 2.89) compared with heterosexual female students, as well as for those who had had both male and female partners (OR = 1.58; 95% CI = 1.07, 2.33) compared with those with only male partners. Including both measures of sexual orientation attenuated the association between gender of sexual partner and pregnancy (model 3); however, female students who identified as lesbian or bisexual remained at higher risk for pregnancy (OR = 1.82; 95% CI = 1.13, 2.93).
After we adjusted for demographics (model 4), the odds of pregnancy remained significantly higher among female students who identified as lesbian or bisexual (OR = 1.80; 95% CI = 1.12, 2.87) compared with their heterosexual counterparts. With further adjustment for sexual behaviors, sexual identity was no longer significantly associated with pregnancy (OR = 1.63, 95% CI = 0.94, 2.81; model 5).
Next, we examined the association between sexual orientation and pregnancy involvement risk among male students in Table 4. Results from models 1 and 2 revealed significantly higher odds of pregnancy involvement for male students who identified as gay or bisexual (OR = 3.62; 95% CI = 1.84, 7.14) or who were unsure of their sexual identity (OR = 4.40; 95% CI = 1.89, 10.25) compared with their heterosexual counterparts, as well as for those who had both female and male partners (OR = 5.48; 95% CI = 3.05, 9.85) compared with those with only female partners. Including both measures of sexual orientation attenuated the association between sexual identity and pregnancy, although male students who were unsure of their sexual identity continued to have higher odds of pregnancy involvement (OR = 2.09; 95% CI = 1.07, 4.07) than their heterosexual counterparts (model 3). Male students who had had both male and female sexual partners continued to have higher odds of pregnancy involvement (OR = 4.65; 95% CI = 2.07, 10.45) than those with only female sexual partners.
After adjustment for demographics (model 4), the odds of pregnancy involvement remained significantly higher among male students who were unsure of their sexual identity (OR = 2.22; 95% CI = 1.15, 4.28) compared with heterosexual male students, as well as among male students who had had both male and female sexual partners (OR = 5.32; 95% CI = 2.31, 12.28) compared with only female partners. Further adjustment for sexual behaviors (model 5) explained about 37% of the odds of pregnancy involvement among male students who were unsure of their sexual orientation (e.g., change in odds between model 4 and model 5), and about 23% of the odds of pregnancy involvement among male students who had had male and female sexual partners.
Results
The dependent variable in this study was pregnancy; approximately 14% of female students reported that they had ever been pregnant (Table 1). More than 85% of female students identified as heterosexual and almost 90% had only had male sexual partners. Female students were primarily Black (43%) with a mean age of 16.0 years. Most were 14 or 15 years old when they first had sexual intercourse (53%); 40.9% had only had 1 sexual partner and 17.2% reported ever having been physically forced to have sexual intercourse.
Approximately 11% of male students reported that they had gotten someone pregnant. Most male students identified as heterosexual (96%) and had only had female sexual partners (97%). Male students were primarily Hispanic (41.2%) with a mean age of 15.9 years. More than 50% were younger than 13 years when they first had sexual intercourse; 23.7% had only had 1 sexual partner and 6.9% reported ever having been physically forced to have sexual intercourse. Additional details on the sample characteristics are provided in Table 1.
Bivariate Associations
Table 2 presents bivariate associations between sexual orientation and our dependent variable and covariates by gender. Among female students, sexual identity and gender of sexual partners were significantly associated with pregnancy; 22.6% of lesbian or bisexual female students and 20.1% of female students who had had both male and female sexual partners reported ever having been pregnant compared with 13.3% of heterosexual female students and 13.7% of female students who reported having had only male sexual partners. Female students who had had male and female sexual partners were younger at first sexual intercourse and were more likely to report having been physically forced to have sexual intercourse than female students with only male sexual partners. We also found similar patterns by sexual identity.
Among male students, sexual identity and gender of sexual partners were significantly associated with pregnancy involvement risk; 28.6% of gay or bisexual male students and 37.7% of male students who had had sexual intercourse with male and female partners had ever gotten someone pregnant compared with 10% of heterosexual male students and 9.9% of male students with only female sexual partners. Male students who had had male and female sexual partners were younger at first sexual intercourse, had more lifetime sexual partners, and more than 30% reported having been physically forced to have sexual intercourse compared with 6.2% of male students with only female partners. Similar patterns were also found by sexual identity.
Multivariable Logistic Regression
We examined the association between sexual orientation and pregnancy risk among female students in Table 3 by using multivariable logistic regression. Results from models 1 and 2, the least-restrictive models, revealed significantly higher odds of pregnancy for female students who identified as lesbian or bisexual (odds ratio [OR] = 1.90; 95% confidence interval [CI] = 1.25, 2.89) compared with heterosexual female students, as well as for those who had had both male and female partners (OR = 1.58; 95% CI = 1.07, 2.33) compared with those with only male partners. Including both measures of sexual orientation attenuated the association between gender of sexual partner and pregnancy (model 3); however, female students who identified as lesbian or bisexual remained at higher risk for pregnancy (OR = 1.82; 95% CI = 1.13, 2.93).
After we adjusted for demographics (model 4), the odds of pregnancy remained significantly higher among female students who identified as lesbian or bisexual (OR = 1.80; 95% CI = 1.12, 2.87) compared with their heterosexual counterparts. With further adjustment for sexual behaviors, sexual identity was no longer significantly associated with pregnancy (OR = 1.63, 95% CI = 0.94, 2.81; model 5).
Next, we examined the association between sexual orientation and pregnancy involvement risk among male students in Table 4. Results from models 1 and 2 revealed significantly higher odds of pregnancy involvement for male students who identified as gay or bisexual (OR = 3.62; 95% CI = 1.84, 7.14) or who were unsure of their sexual identity (OR = 4.40; 95% CI = 1.89, 10.25) compared with their heterosexual counterparts, as well as for those who had both female and male partners (OR = 5.48; 95% CI = 3.05, 9.85) compared with those with only female partners. Including both measures of sexual orientation attenuated the association between sexual identity and pregnancy, although male students who were unsure of their sexual identity continued to have higher odds of pregnancy involvement (OR = 2.09; 95% CI = 1.07, 4.07) than their heterosexual counterparts (model 3). Male students who had had both male and female sexual partners continued to have higher odds of pregnancy involvement (OR = 4.65; 95% CI = 2.07, 10.45) than those with only female sexual partners.
After adjustment for demographics (model 4), the odds of pregnancy involvement remained significantly higher among male students who were unsure of their sexual identity (OR = 2.22; 95% CI = 1.15, 4.28) compared with heterosexual male students, as well as among male students who had had both male and female sexual partners (OR = 5.32; 95% CI = 2.31, 12.28) compared with only female partners. Further adjustment for sexual behaviors (model 5) explained about 37% of the odds of pregnancy involvement among male students who were unsure of their sexual orientation (e.g., change in odds between model 4 and model 5), and about 23% of the odds of pregnancy involvement among male students who had had male and female sexual partners.
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