Neighborhood Violence Impacts on HIV and STI Testing Among Sexual Minority Youth in the United States.

In the United States (U.S.), sexual minority youth (SMY) are disproportionately impacted by HIV and other sexually transmitted infections (STIs) and structurally marginalized from routine testing for HIV and STI. This study examines neighborhood violence predictors (saw violence, safety concerns, and being threatened) on HIV and STI testing among a sample of SMY in the U.S. Data came from the 2021 Youth Risk Behavioral Surveillance System (YRBSS). Weighted bivariate and multilevel logistic regressions examined the odds of ever testing for HIV and STIs in the past 12 months and neighborhood violence. Our weighted sample (n = 806) had a mean age of 16 years, majority female (80%), and identified as White (53%). SMY reported increased odds of testing for HIV and STI when witnessing someone get physically attacked, beaten, stabbed, or shot in their neighborhood, felt unsafe at school or on their way to or from school, or threatened or injured with a weapon on school property. Additionally, increased odds of testing for HIV and STIs patterned exposure to neighborhood violence among SMY who identified as male, of color (non-White), and multi-ethnoracial background. The study highlights the need for examining potential protective social-structural factors that complicate the relationship between HIV and STI testing and exposure to neighborhood violence.