Associations of body mass index with sexual risk-taking and injection drug use among US high school students.

Richard Lowry,Deborah A Galuska,Leah Robin,Laura Kann

doi:10.1155/2014/816071

Abstract

The purpose of this study was to determine if body mass index (BMI) is associated with behaviors that may increase risk for HIV and other sexually transmitted diseases (STDs) among US high school students. We analyzed nationally representative data from the 2005–2011 national Youth Risk Behavior Surveys (YRBS) to examine associations of BMI categories with sexual risk behaviors and injection drug use among sexually active high school students, using sex-stratified logistic regression models. Controlling for race/ethnicity and grade, among female and male students, both underweight (BMI < 5th percentile) and obesity (BMI ≥ 95th percentile) were associated with decreased odds of being currently sexually active (i.e., having had sexual intercourse during the past 3 months). However, among sexually active female students, obese females were more likely than normal weight females to have had 4 or more sex partners (odds ratio, OR = 1.59), not used a condom at last sexual intercourse (OR = 1.30), and injected illegal drugs (OR = 1.98). Among sexually active male students, overweight (85th percentile ≤ BMI < 95th percentile) was associated with not using a condom at last sexual intercourse (OR = 1.19) and obesity was associated with injection drug use (OR = 1.42). Among sexually active students, overweight and obesity may be indicators of increased risk for HIV and other STDs.

Highlights

The public health impact of both childhood obesity and current rates of HIV infection and other sexually transmitted diseases (STDs) among adolescents is substantial, and each problem represents a significant threat to the health of young people in the United States
Among currently sexually active students, male students were more likely than female students to have multiple sex partners and inject illegal drugs but were less likely to have sex without a condom
For example, the lower rates of sexual experience and current sexual activity we found among obese students may result in lower rates of HIV infection and STDs among the total population of obese students even though, among sexually active students, obese students are more likely than normal weight students to engage in some sexual risk behaviors and injection drug use

Summary

Introduction

The public health impact of both childhood obesity and current rates of HIV infection and other sexually transmitted diseases (STDs) among adolescents is substantial, and each problem represents a significant threat to the health of young people in the United States. Findings in the literature suggest the possibility that obesity, or perhaps body mass index (BMI) more generally, may be related to sexual and nonsexual behaviors that increase risk for HIV and other STDs. Several possible mechanisms exist whereby childhood obesity may be associated with sexual risk-taking and injection drug use among youth. One study found that the type of health-risk behavior most strongly associated with suicide attempts among both female and male US high school students was injection drug use [12]. Another possible mechanism for associations between obesity and sexual risk-taking involves early initiation of sexual intercourse. Overweight and obese youth may appear more physically mature and

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