School-Level Poverty and Rurality Associated With Differences in Sexual Risk Behaviors Among US Public High School Students

Results: Compared to students attending low-poverty schools, high-poverty school students were significantly more likely to be currently sexually active (adjusted prevalence ratio = 1.4 [95% confidence interval = 1.1-1.8]) and have four or more lifetime sexual partners (1.6 [1.0-2.5]), but were significantly less likely to have drank alcohol or used drugs before the last sexual intercourse (.7 [.5-.9]) and have used hormonal birth control during the last sexual intercourse (.7 [.6-1.0]). Compared to students attending rural schools, urban school students were significantly less likely to be currently sexually active (.8 [.7-.9]) and have four or more lifetime sexual partners (.7 [.5-.9]). Conclusions: School-level socioeconomic status and metropolitan status were associated with differential risk in sexual behaviors. (c) 2021 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.