School-Based Protective Factors for HIV Prevention in the United States: Secondary Analysis of the Youth Risk Behavior Survey 2015-2019

David R Garcia; Jason Fletcher; Lloyd Goldsamt; David L Bell; Yaguang Zheng; Ann-Margaret Dunn Navarra

doi:10.1097/JNC.0000000000000501

School-Based Protective Factors for HIV Prevention in the United States: Secondary Analysis of the Youth Risk Behavior Survey 2015-2019

J Assoc Nurses AIDS Care. 2024 Sep 12. doi: 10.1097/JNC.0000000000000501. Online ahead of print.

Authors

David R Garcia^{1

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6}, Jason Fletcher^{1

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6}, Lloyd Goldsamt^{1

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6}, David L Bell^{1

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6}, Yaguang Zheng^{1

2

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6}, Ann-Margaret Dunn Navarra^{1

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6}

Affiliations

¹ David R. Garcia, PhD, FNP-BC, NP-C, is an Assistant Professor and Provost's Postdoctoral Fellow, Rory Meyers College of Nursing, New York University, New York, New York, USA.
² Jason Fletcher, PhD, is a Senior Biostatistician, Rory Meyers College of Nursing, New York University, New York, New York, USA.
³ Lloyd Goldsamt, PhD, is a Senior Research Scientist, Rory Meyers College of Nursing, New York University, New York, New York, USA.
⁴ David L. Bell, MD, MPH, is a Professor, Population and Family Health and Pediatrics, Columbia University Medical Center, New York, New York, USA.
⁵ Yaguang Zheng, PhD, RN, is an Assistant Professor, Rory Meyers College of Nursing, New York University, New York, New York, USA.
⁶ Ann-Margaret Dunn Navarra, PhD, CPNP-PC, FAAN, is an Associate Professor, Associate Dean of Nursing Research and Innovation, and Chair of the Department of Doctor of Philosophy in Nursing Studies, Stony Brook University School of Nursing, Stony Brook, New York, USA.

PMID: 39259519
DOI: 10.1097/JNC.0000000000000501

Abstract

This secondary analysis of the National Youth Risk Behavior Survey (years 2015-2019) examines associations between school-based protective factors (i.e., safe school environments and academic achievement) and HIV risk behaviors among sexually experienced adolescent gay and bisexual men ( n = 644), a population with the highest prevalence of undiagnosed HIV infections. Demographics included Hispanics/Latinos (25%, n = 158), Other race/ethnicity (14%, n = 88), and non-Hispanic Blacks/African Americans (13%, n = 81). Adjusted models showed that protective factors reduced odds for early sexual debut, multiple sexual partners, sex under the influence of drugs/alcohol, and condomless sex, with an additive effect demonstrated when two protective factors were present. Hispanics/Latinos had greater odds of reporting multiple sexual partners and HIV testing, indicating opportunities for school-based HIV prevention and further research. Our findings provide support for school-based programs that aim to improve social and structural determinants of health and ultimately reduce adolescent HIV burdens.