Abstract

BACKGROUND: Young people who are same-sex attracted report higher rates of substance use, sexual risk behaviour, and mental health problems. Numerous studies have shown that sexual identity, sexual behaviour and sexual attraction do not always correspond, particularly among young people. We describe sexual identity, sexual partners, and associations between sexual identity and risk in a community-based sample of young people. METHODS: From 2011 to 2013, young people (16-29 years) were recruited at a music festival in Melbourne, Australia to self-complete a questionnaire. We describe sexual identity and gender of anal/vaginal sex partners in the past year. Secondly, we assess associations between risk behaviours, health outcomes and gay/lesbian/bisexual/queer/questioning (GLBQQ)-identity using multivariable logistic regression. RESULTS: Among 3793 (91%) participants with complete data, 115 (9%) males and 266 (11%) females were GLBQQ-identifying. Among GLBQQ-identifying males, 23% reported only same-sex partners, 34% reported both sex partners, 26% reported only opposite-sex partners, 5% reported no sex partners in the past year, and 12% had never had sex. Among GLBQQ-identifying females, 10% reported only same-sex partners, 22% reported both sex partners, 48% reported only opposite-sex partners, 3% reported no sex partners in the past year, and 17% had never had sex. Controlling for age and sex, significant (p<0.05) associations with GLBQQ-identity included: recent drug use (adjusted odds ratio [AOR] 1.7, 95%CI 1.3-2.2); ever injected drugs (AOR 5.7, 95%CI 3.3-9.7); young age at first sex (AOR 1.8, 95%CI 1.3-2.3); >/=11 lifetime sex partners (AOR 1.5, 95%CI 1.1-2.0); multiple sex partners in the past year (AOR 1.9, 95%CI 1.5-2.5); and rating mental health as fair/poor (AOR 3.0, 95%CI 1.9-4.6). CONCLUSION: Young people with GLBQQ-identity commonly engage in high risk behaviours and are more at risk relative to their heterosexual-identifying peers. Targeted interventions to promote the health and wellbeing of this group should account for the complexities of identity and behaviour.

This project has been greatly assisted by the Victorian AIDS Council (VAC), Marie Stopes International, Beyond Blue, Hepatitis C Victoria, Family Planning Victoria, Cadbury Schweppes, The Department of Health and Ageing, Third Drawer Down, Step Back Think and the staff at the Melbourne Big Day Out. The authors gratefully acknowledge the financial contributions received for this work from the Victorian Department of Health and Victorian Law Enforcement Drug Fund (VLEDF), and from the Victorian Operational Infrastructure Support Program received by the Burnet Institute. The National Drug and Alcohol Research Centre at the University of NSW is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund. ALB is supported by an Australian Postgraduate Award, LD is support by a National Health and Medical Research Council (NHMRC) Principal Research Fellowship, MH is supported by a NHMRC Senior Research Fellowship, and MSCL is supported by NHMRC Sidney Sax Fellowship.

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