Associations of Body Mass Index with Sexual Risk-Taking and Injection Drug Use among US High School Students

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.

[1]  J. Skelton,et al.  Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. , 2014, JAMA pediatrics.

[2]  Reena Mahajan,et al.  Sexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2008 , 2013, Sexually transmitted diseases.

[3]  G. Ryan,et al.  Substance Use and Other Risk Factors for Unprotected Sex: Results from an Event-Based Study of Homeless Youth , 2012, AIDS and Behavior.

[4]  E. Saewyc,et al.  The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[5]  Connie Lim,et al.  Youth risk behavior surveillance - United States, 2011. , 2012, Morbidity and mortality weekly report. Surveillance summaries.

[6]  C. Currie,et al.  Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[7]  M. Marcus,et al.  Psychiatric comorbidity of childhood obesity , 2012, International review of psychiatry.

[8]  E. Demerath,et al.  Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults , 2012, International Journal of Obesity.

[9]  Daniel P. Miller,et al.  A longitudinal examination of childhood maltreatment and adolescent obesity: results from the National Longitudinal Study of Adolescent Health (AddHealth) Study. , 2012, Child abuse & neglect.

[10]  K. Flegal,et al.  Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. , 2012, JAMA.

[11]  Ricardo Tavares Pinheiro,et al.  Risco de suicídio e comportamentos de risco à saúde em jovens de 18 a 24 anos: um estudo descritivo , 2012 .

[12]  J. Noll,et al.  Risk-Taking Behaviors of Adolescents With Extreme Obesity: Normative or Not? , 2011, Pediatrics.

[13]  K. Matthews,et al.  Interpersonal violence in childhood as a risk factor for obesity: a systematic review of the literature and proposed pathways , 2011, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[14]  A. Madkour,et al.  Early adolescent sexual initiation as a problem behavior: a comparative study of five nations. , 2010, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[15]  David R. Williams,et al.  Childhood adversities as risk factors for onset and persistence of suicidal behaviour , 2010, British Journal of Psychiatry.

[16]  N. Reichman,et al.  Effects of Overweight on Risky Sexual Behavior of Adolescent Girls , 2010 .

[17]  Nancy S. Landale,et al.  Teen overweight, weight stigma, and intimate relationship development from adolescence to young adulthood , 2010 .

[18]  K. Flegal,et al.  Prevalence of high body mass index in US children and adolescents, 2007-2008. , 2010, JAMA.

[19]  Hyun-Sun Kim,et al.  Early Initiation of Alcohol Drinking, Cigarette Smoking, and Sexual Intercourse Linked to Suicidal Ideation and Attempts: Findings from the 2006 Korean Youth Risk Behavior Survey , 2009, Yonsei medical journal.

[20]  Judy C. Chang,et al.  Exploring the Relationship Among Weight, Race, and Sexual Behaviors Among Girls , 2009, Pediatrics.

[21]  R. Maniglio,et al.  The impact of child sexual abuse on health: a systematic review of reviews. , 2009, Clinical psychology review.

[22]  M. Zeller,et al.  Negative Peer Perceptions of Obese Children in the Classroom Environment , 2008, Obesity.

[23]  S. Barlow,et al.  Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. , 2007, Pediatrics.

[24]  S. Gortmaker,et al.  Depressive Symptoms as a Longitudinal Predictor of Sexual Risk Behaviors Among US Middle and High School Students , 2006, Pediatrics.

[25]  D. Neumark-Sztainer,et al.  Weight-Related Issues and High-Risk Sexual Behaviors Among College Students , 2005, Journal of American college health : J of ACH.

[26]  D. Galuska,et al.  Associations of body mass index and perceived weight with suicide ideation and suicide attempts among US high school students. , 2005, Archives of pediatrics & adolescent medicine.

[27]  E. Gouws,et al.  Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk? , 2005, Sexually Transmitted Infections.

[28]  Laura Kann,et al.  Methodology of the youth risk behavior surveillance system. , 2004, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[29]  D. Sarwer,et al.  Childhood sexual abuse and obesity , 2004, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[30]  H. Pollack,et al.  Social marginalization of overweight children. , 2003, Archives of pediatrics & adolescent medicine.

[31]  Youfa Wang.  Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. , 2002, Pediatrics.

[32]  Laura Kann,et al.  Reliability of the 1999 youth risk behavior survey questionnaire. , 2002, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[33]  M. Prinstein,et al.  Adolescent obesity, overt and relational peer victimization, and romantic relationships. , 2002, Obesity research.

[34]  Beth E. Molnar,et al.  Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. , 2001, American journal of public health.

[35]  J. Silverman,et al.  The Relationship Between Sexual Abuse and Sexual Risk Among High School Students: Findings from the 1997 Massachusetts Youth Risk Behavior Survey , 2000, Maternal and Child Health Journal.

[36]  R. Strauss.  Childhood Obesity and Self-Esteem , 1999, Pediatrics.

[37]  W. Dietz,et al.  The Relation of Overweight to Cardiovascular Risk Factors Among Children and Adolescents: The Bogalusa Heart Study , 1999, Pediatrics.

[38]  W. Dietz.  Health consequences of obesity in youth: childhood predictors of adult disease. , 1998, Pediatrics.

[39]  Laura Kann,et al.  Youth Risk Behavior Surveillance--United States, 1993. CDC Surveillance Summaries. , 1995 .

[40]  A. Amialchuk,et al.  Racial differences in the influence of female adolescents' body size on dating and sex. , 2014, Economics and human biology.

[41]  L. Kann,et al.  Suicidal thoughts and attempts among u.s. High school students: trends and associated health-risk behaviors, 1991-2011. , 2014, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[42]  L. Kann,et al.  Methodology of the Youth Risk Behavior Surveillance System--2013. , 2013, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[43]  L. Quevedo,et al.  [Suicide risk and health risk behavior among youth between the ages of 18 and 24 years: a descriptive study]. , 2012, Cadernos de saude publica.

[44]  Laura Kann,et al.  Vital signs: HIV infection, testing, and risk behaviors among youths - United States. , 2012, MMWR. Morbidity and mortality weekly report.

[45]  Thomas R. Frieden,et al.  School health guidelines to promote healthy eating and physical activity. , 2011, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[46]  D. Wilson.  Health consequences of childhood sexual abuse. , 2010, Perspectives in psychiatric care.

[47]  J. Santelli,et al.  Long-term health correlates of timing of sexual debut: results from a national US study. , 2008, American journal of public health.

[48]  D. Neumark-Sztainer,et al.  Social, educational, and psychological correlates of weight status in adolescents. , 2001, Obesity research.

[49]  J. Udry,et al.  Effects of body fat on weight concerns, dating, and sexual activity: a longitudinal analysis of black and white adolescent girls. , 1999, Developmental psychology.