Substance Use and Sexual Risk Behaviors Among American Indian and Alaska Native High School Students

Abstract
BACKGROUND We describe the prevalence of behaviors that put American Indian and Alaska Native (AI/AN) high school students at risk for teen pregnancy and sexually transmitted infections (STIs) and the relationships among race/ethnicity and these behaviors. METHODS We analyzed merged 2007 and 2009 data from the national Youth Risk Behavior Survey, a biennial, self‐administered, school‐based survey of US students in grades 9‐12 (N = 27,912). Prevalence estimates and logistic regression, controlling for sex and grade, were used to examine the associations between race/ethnicity, and substance use, and sexual risk behaviors. RESULTS Of the 26 variables studied, the adjusted odds ratios (AOR) were higher among AI/AN than White students for 18 variables (ranging from 1.4 to 2.3), higher among AI/AN than Black students for 13 variables (ranging from 1.4 to 4.2), and higher among AI/AN than Hispanic students for 5 variables (ranging from 1.4 to 1.5). Odds were lower among AI/AN than Black students for many of the sexual risk‐related behaviors. CONCLUSIONS The data suggest it is necessary to develop targeted, adolescent‐specific interventions aimed at reducing behaviors that put AI/AN high school students at risk for teen pregnancy, STI/HIV, and other health conditions.