Medicine and Education Lag in the Delivery of Services to Enhance Health of Sexually Active Adolescent Gay-Identified Men

Health care providers working with young gay men of color should begin routine testing for HIV and other sexually transmitted infections at earlier ages, say Rutgers researchers

Young gay sexual minority men – especially Black and Latino youth – have their first sexual experiences at younger ages, emphasizing a need for comprehensive and inclusive sex education, according to Rutgers researchers.

The study, published in the Journal of Sex Research, examined consensual sex behaviors to better understand same-sex sexual debut, or the age at which people first engage in sexual behaviors.

The researchers, part of the Rutgers School of Public Health’s Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), found that 19 percent of participants had their first sexual experience before the age of 13.

The researchers also found that same-sex sexual encounters first happen, on average, at 14.5 years, with Hispanic/Latinx and Black non-Hispanic participants reporting a younger age for their first time performing oral sex or engaging in anal sex, compared to their peers.

Earlier age of sexual debut among sexual minority men is associated with a range of sexual and health risk behaviors, including increased likelihood of condomless sex; tobacco, alcohol, and other substance use; psychological distress; suicidality; and earlier age of HIV diagnosis.

According to the researchers, health care providers, including pediatricians and behavioral health therapists, can help reduce potential harms of these behaviors by having candid conversations about sex; not assuming the sexual identities or behaviors of their young patients; actively inquiring about sexual behaviors with partners of all genders; providing appropriate counseling about all sexual behaviors and their associated risks for HIV and other STIs; and speaking with adolescent patients in private – without parents/guardians present – whenever legally and ethically possible.

Providers working with young gay men of all ages should also consider beginning routine testing for HIV and other sexually transmitted diseases at earlier ages than previously indicated, particularly among youth of color.

“Our results suggest that health care providers can play an active role in mitigating sexual and health behaviors that are associated with the early onset of same-sex sexual behaviors; to date the medical profession is ill equipped to address the needs of LGBTQ+ people,” said Perry N. Halkitis, dean of the Rutgers School of Public Health.

Comprehensive sexuality education, which is inclusive of sexual and gender minority populations and all types of sexual behaviors, may not only empower sexual and gender minority youth to make informed choices about their sexual health and behavior, but may also improve school climate through educating non-LGBTQ peers.

“As many schools are forced to redesign their classrooms and curricula to accommodate socially distanced or remote learning for COVID-19, this may be the perfect time to consider implementing comprehensive sex education programming to provide age-appropriate sexual health education for people of all genders and sexual orientations,” said Caleb LoSchiavo, doctoral student at the Rutgers School of Public Health and co-author.