Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs.

BACKGROUND

Adolescent sexual minority males (ASMM) are disproportionately at risk of HIV.

PURPOSE: This study documents the sexual debut behaviors of ASMM, tests whether sexual debut and sexual behavior differed by race/ethnicity, and explores the association between early anal sex debut and engaging in condomless anal sex.

METHODS

Sexually active ASMM (N = 118; ages 14-17) in the United States completed an online sexual health survey. We used Fisher exact tests to explore differences by race/ethnicity in sexual debut characteristics and hypothesized relationships between sexual debut and risk behavior.

RESULTS

The average age of sexual debut with a male partner was 14 years (SD = 2.4). Approximately one-third (31%) reported anal sex at their sexual debut, with non-Latino black/African American ASMM more likely to report anal sex at debut (63%) compared with non-Latino white (28%), Latino (21%), or mixed race/other identified youth (19%; χ = 12.1, P = 0.01). All participants (100%) who reported an anal sex debut before the age of 14 years reported engaging in condomless anal sex in their lifetime, compared to 60% of those who reported an anal sex debut when they were 14 years old or older (χ = 5.6, P = 0.03). Participants wanted information about how to safely and comfortably have anal sex (59%) and skills around partner communication (>50%) before debut.

CONCLUSION

Sexually active ASMM begin engaging in sexual behavior with other males early and with incomplete knowledge and skills regarding sexual health and safety.