P3A049: Exploring Comprehensive Impacts for Sexual Minority Youth: A Cross-sectional Assessment of a School District-wide Inclusive Sex Education Intervention

Background: Repeated studies have shown that sexual minority youth (SMY) report increased higher-risk sexual behaviors compared to their heterosexual peers, and researchers have correlated these disparities to non-inclusive sex education. Traditional school-based sex education has typically centered on abstinence or cisgender heterosexual sex, leaving out relevant information for SMY youth. In the context of growing state, national and international attention to comprehensive and SMY-inclusive sex education, Oakland Unified School District (OUSD) implemented a new week-long comprehensive and SMY-inclusive sex education curriculum in 2015 for all ninth-grade students in the district’s 17 high schools. This study proposes a novel utilization of district-level Youth Risk Behavior Survey (YRBS) data to evaluate the curriculum's success through analyzing students' reported sexual, mental, and behavioral health outcomes.

Methods: This repeated cross-sectional study is a secondary survey analysis of biennial YRBS data collected from a representative sample of OUSD high school students. Respondents who reported SMY identity during the 2015, 2017 and 2019 YRBS cycles for OUSD were divided into two cohorts based on grade level and survey year to determine who was expected to have received the intervention. A logistic regression model including adjustment for survey year, grade level and age was used to assess for significant differences among SMY respondents on questions regarding sexual health, exposure to violence, mental health and substance use based on whether they received the intervention of the new sex education curriculum.

Results: Among the 4571 respondents within OUSD to the 2015-2019 YRBS cycles, 657 reported SMY identity, of which 403 received the intervention. There were no significant differences between SMY who did and did not receive the intervention based on reported race, binary sex, or sexual identity. SMY who received the intervention were significantly less likely to report being bullied due to suspected SMY identity in the previous year (OR 0.43, CI 0.19-0.97). No other significant associations were noted among SMY regarding sexual and mental health, experienced violence, and substance use.

Conclusion: A significant association was only found between reduction of experienced bullying based on perceived sexual minority identity and receipt of the SMY-inclusive comprehensive sex education curriculum among SMY. Other larger studies have found correlation between SMY-inclusive comprehensive sex education and reduced homophobic bullying as well as intimate partner violence prevention and improved sexual risk behaviors. This model of using publicly available data for program evaluation may spur further experimental or qualitative studies to better understand the impact of the SMY-inclusive comprehensive sex education curriculum on high school students within OUSD or other districts.