People who engage in unprotected sexual intercourse or use injection drugs are at
increased risk for HIV infection and sexually transmitted diseases (STDs). Monitoring
changes in behaviors over time can provide information about the effectiveness of
new policies and programs.
To measure trends in HIV- and STD-related risk behaviors among high school students
in the U.S. during 1991–2009.
Nationally representative data from the 1991–2009 biennial national Youth Risk Behavior
Surveys were analyzed to describe trends in HIV- and STD-related risk behaviors. For
each cross-sectional national survey, students completed anonymous, self-administered
questionnaires assessing risk behavior participation. This study was approved by the
CDC IRB, and parental permission was obtained. To assess the significance of time
trends for each behavior, logistic regression analyses were conducted that controlled
for gender, grade, and race/ethnicity and simultaneously assessed linear and quadratic
effects. Data were analyzed in 2010.
During 1991–2009, decreases were observed in the percentage of U.S. high school students
who ever had sexual intercourse, had multiple sex partners, and who were currently
sexually active. The prevalence of condom use increased during 1991–2003 and then
leveled off during 2003–2009. However, these changes in risk behaviors were not observed
in some gender and racial/ethnic subgroups.
Additional efforts to reduce HIV- and STD-related risk behaviors, particularly among
black and Hispanic students, must be implemented to decrease rates of HIV infection