High school sexual minorities—those who identify as non-heterosexuals or report same-sex sexual partners—engage in a higher rate of sexual risk behaviors than their nonsexual-minority peers. That is according to the Centers for Disease Control and Prevention’s (CDC) first-ever analysis comparing sexual risk behaviors among teenagers according to subgroups based on sexual orientation and also the sex of young people’s partners.

Publishing their findings in the Morbidity and Mortality Weekly Report, researchers pooled data on 30,389 teenagers from the 2015 and 2017 cycles of the nationally representative Youth Risk Behavior Survey, a cross-sectional, school-based survey assessing health behaviors among U.S. students in grades nine through 12.

Participants were categorized according to sexual orientation (if they stated they were heterosexual, gay or lesbian, bisexual or not sure about their sexual orientation), and also according to the sex of their sexual partners (no sexual contact, females, males, or females and males).

For the analysis, early sexual debut was defined as having sex for the first time before the age of 13. Not using a condom meant not using a condom for the last sexual intercourse. Not using pregnancy prevention meant not using any method to prevent pregnancy during the last intercourse. Alcohol or drug use prior to sex also referred to the last sexual intercourse.

The study’s models controlled for race and grade in school, and with the exception of the model predicting if young people had ever had intercourse, were limited to those who had ever had intercourse.

Across the sexual orientation subgroups, among females, a low of 26.9 percent of the “not sure” group and a high of 51.4 percent of the bisexual group reported ever having intercourse; and among males, a low of 33.9 percent of the not sure group and a high of 47.8 percent of the gay males reported ever having intercourse.

Members of sexual-orientation-based sexual minority subgroups were more likely than heterosexual young people to engage in sexual risk behaviors. Compared with heterosexual females, bisexual females were 1.41 times more likely to report having had intercourse, 2.43 times more likely to report early sexual debut, 1.69 times more likely to report at least four sexual partners in their lifetime, 1.17 times more likely to report no condom use, 1.49 times more likely to report no pregnancy prevention method use and 1.36 times more likely to report alcohol or drug use before sex.

Compared with heterosexual males, males who were not sure about their sexual orientation were 2.33 times more likely to report early sexual debut, 1.47 times more likely to report four or more sexual partners, 2.03 times more likely to report no pregnancy prevention method use and 1.73 times more likely to report alcohol or drug use before sex.

Lesbian or bisexual females were more likely than females unsure about their sexual orientation to report having had sexual intercourse, no condom use and no pregnancy prevention method use. Gay or bisexual males were more likely than were males who were unsure of their sexual orientation to report having had sexual intercourse and not using pregnancy prevention.

Unsurprisingly, gays and lesbians were more likely than were bisexuals to report not using pregnancy prevention and, among females, not using condoms.

As for sexual-behavior-based subgroups, among females, a low of 66.2 percent of those reporting only same-sex sex and a high of 77.7 percent of those reporting only opposite-sex sex reported ever having intercourse; among males a low of 77.3 percent of those reporting sex with both sexes and a high of 83.3 percent of those reporting sex with females only reported ever having intercourse.

Compared with those students who reported only opposite-sex sexual contact, those who reported sexual contact with both sexes were, among females and males, a respective 3.05 and 2.64 times more likely to report early sexual debut, a respective 2.48 and 1.48 times more likely to report four or more sexual partners, a respective 1.3 and 1.34 times more likely to report no condom use, a respective 1.52 and 2.12 times more likely to report not using pregnancy protection and a respective 1.94 and 1.45 times more likely to report drug or alcohol use before intercourse.

Compared with students reporting only opposite-sex sexual contact, those reporting only same-sex sexual contact were, among females and males, a respective 2.97 and 1.96 times more likely to report early sexual debut and among males 1.67 times more likely to report no condom use.

To read the CDC report, click here.