HIV and Young Men Who Have Sex With Men

Establish Safe and Supportive School Environments

HIV prevention activities are more likely to have an impact if they take into account the context in which risk behaviors occur. For YMSM and other sexual minority students, this means addressing the challenges these young people face at school. A survey using a convenience sample of more than 7,000 middle and high school students across the United States found that, in the past year,

• Eight in 10 lesbian, gay, bisexual, or transgender students had been verbally harassed at school because of their sexual orientation.
• Six in 10 felt unsafe at school because of their sexual orientation.
• Almost a third skipped a day of school in the past month because they felt unsafe.¹⁴

For youth to thrive in their schools and communities, they need to feel socially, emotionally, and physically safe and supported. A positive school climate has been associated with decreased depression, suicidal feelings, substance use, and unexcused school absences among lesbian, gay, bisexual, and transgender students.^15,16

Gay-straight alliances (GSAs) are one approach being used to create safe and welcoming school environments. Research has shown that in schools with support groups such as GSAs, lesbian, gay, and bisexual students were less likely to experience threats of violence, miss school because they felt unsafe, or attempt suicide than those in schools without such groups.¹

Provide Professional Development for School Staff

School health professionals can benefit from training to help them understand the needs of lesbian, gay, and bisexual youth and shape behavioral health messages accordingly. During 2006-2011, CDC funded the American Psychological Association (APA) Healthy Lesbian, Gay, and Bisexual Students Project to help schools and youth-serving organizations improve health and mental health outcomes for sexual minority youth. APA created a training manual and offered science-based workshops for school counselors, nurses, psychologists, and social workers on how to effectively reach sexual minority students with HIV prevention messages and other health information. Many education agencies funded by CDC have formed their own training cadres to offer the workshop locally.

Implement School-Based HIV Prevention Policies, Practices, and Interventions

CDC funds state, territorial, tribal, and local education agencies to help schools implement policies and practices to reduce sexual risk behaviors. Recognizing that YMSM are a major risk group for HIV infection, a number of these agencies are taking action to address the needs of sexual minority youth. Examples of program activities include:

• Ensuring that health education curricula include prevention information relevant to sexual minority students.
• Providing training for district and school staff to help them understand the special concerns and needs of this population.
• Supporting schools in establishing GSAs or similar groups.
• Linking schools to community organizations that provide health and mental health services for lesbian, gay, and bisexual youth.

Specific program activities are described at www.cdc.gov/lgbthealth/youth.htm.

In 2011, CDC awarded funds to the Gay, Lesbian, and Straight Education Network (GLSEN) and the Gay-Straight Alliance Network (GSAN) to assist CDC-funded public health and education agencies and community-based organizations in establishing policy and environmental changes to help schools and communities meet the health and mental health needs of lesbian, gay, bisexual, and transgender youth.

CDC also funds health departments and community organizations to promote the use of evidence-based HIV prevention interventions, many of which are geared toward YMSM and young people of color. Information about these interventions is available at www.cdc.gov/hiv/topics/research/prs/evidence-based-interventions.htm.

* In the 37 states and five U.S. dependent areas with confidential name-based reporting since at least January 2005.

** The Youth Risk Behavior Surveillance System (YRBSS) monitors health risk behaviors and the prevalence of obesity and asthma among youth and young adults. YRBSS includes a national school-based survey conducted by CDC and surveys conducted by state, territorial, and local education and health agencies and tribal governments. Information is available at www.cdc.gov/yrbs.

† Sexual minority students are defined as students who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or who have had sexual contact with persons of the same sex or with both males and females.

References

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14. GLSEN. The 2009 National School Climate Survey. New York: Gay, Lesbian, and Straight Education Network; 2010.
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