Christopher R. Harper

High School Students' Self-Reported Use of School Clinics and Nurses.

Access to school health clinics and nurses has been linked with improved student achievement and health. Unfortunately, no studies have examined how many students report using school clinics or nurses and for which services. This study addressed this gap with data from a nationally representative sample of 15- to 25-year-olds. Respondents who reported being in high school were provided a list of services and asked whether they had gone to a school nurse or clinic for any of the listed services. Nearly 90% reported having access to a school clinic or nurse. Among students with access, 65.6% reported using at least one service. Non-White students and younger students were more likely to report having access to a clinic or nurse. These results show many students have access to clinics or nurses and are using these services, although not uniformly for all services.

Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students

PURPOSE Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students. METHODS Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students. RESULTS Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses. CONCLUSIONS With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students.

Changes in the Distribution of Sex Partners in the United States: 2002 to 2011–2013

Objective The purpose of the current analysis is to examine subgroup differences in the distribution of opposite-sex sex partners in the United States across an approximate 10-year period to identify patterns that may inform sexually transmitted infection research and prevention. Methods Data were drawn from the 2002 and 2011–2013 National Survey of Family Growth, a US probability-based household survey focusing on sexual and reproductive health. The measures included in this analysis were lifetime opposite-sex sex partners and opposite-sex sex partners in the past year. Analyses were conducted separately for men and women. All analyses were conducted in R and R-studio with the “survey” package, focusing on medians, the 80th, and 95th quartile. Results In 2002, there were significant differences between men and women in median number of lifetime sex partners with men reporting more lifetime partners. However, in the 2011–2013 data, these differences are no longer significant. Still, the findings suggest that the top 20% and top 5% of men are reporting significantly more lifetime partners than their female counterparts. In comparison, partners in the past year remain relatively unchanged for both men and women. Conclusions These findings suggest that there were important changes in the distribution of sex partners between 2002 and 2011–2013 that have implications for sexually transmitted infection prevention. Median lifetime partners are no longer different for women and men: however, the distribution of lifetime partners among men is becoming even more skewed.

Health risks among discordant heterosexual high school students

ABSTRACT Limited information exists on heterosexual youth with sexual contact with same-sex partners in the United States (i.e., discordant heterosexual). We compared the prevalence of health risks between discordant heterosexual, heterosexual with only opposite-sex sexual contact, lesbian/gay, and bisexual students using the 2015 national Youth Risk Behavior Survey (YRBS). Nationwide, 3.2% of students were identified as discordant heterosexuals. The prevalence of several risk behaviors was significantly higher among discordant heterosexual students than their heterosexual peers with only opposite-sex sexual contact. Clinicians should consider sexual identity and sex of sexual partners when conducting risk-assessments to ensure they appropriately target populations for intervention.

School Environment Is Related to Lower Health and Safety Risks Among Sexual Minority Middle and High School Students

PURPOSE The objective of this study was to examine the relationship between school involvement and connectedness with measures of sexual risk, substance use, and experience of violence among students who had sexual contact with the same sex or with both sexes. METHODS A sample of middle school and high school students who participated in a study conducted in a large urban school district were selected based on their reported experience of having initiated sexual activity with same-sex partners. In classroom-based surveys, we assessed self-reported involvement in school-based activities and feelings of school connectedness, as well as self-reported sexual risk, substance use, and experience of violence. RESULTS Significant protective associations were found between school involvement and lifetime alcohol and marijuana use, and between school connectedness and ever having been in a fight, feeling safe at school, and drug use other than marijuana (all p < .05). CONCLUSIONS Findings suggest that efforts to increase school involvement and connectedness provide a starting point for addressing significant health and safety concerns among students with same-sex sexual activity.