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

Background: American Indians/Alaska Natives (AI/AN) have disproportionately high rates of STDs and teen pregnancy. There is limited information describing the associated risk behaviors among AI/AN adolescents.

Objectives: To examine the prevalence of behaviors that put AI/AN students at risk for teen pregnancy and STDs and how those rates differ from students of other race/ethnicities.

Methods: We analyzed data from CDC’s 2007 and 2009 national Youth Risk Behavior Survey (YRBS), a biennial, self-administered, school-based survey of U.S. students in grades 9-12 (N=27,912).

Results: Many AI/AN (14.2%), white (8.2%), black (14.2%), and Hispanic (10.9%) students experienced dating violence; the odds was higher among AI/AN than white students (adjusted odds rate [AOR]=1.9). Many AI/AN (43.9%), white (36.8%), black (40.5%), and Hispanic (39.1%) students had used marijuana; the odds was higher among AI/AN than white students (AOR=1.5). Many AI/AN (48.9%), white (42.8%), black (65.9%), and Hispanic (50.3%) students had sexual intercourse; the odds was higher among AI/AN than white students (AOR=1.5), but lower among AI/AN than black students (AOR=0.5).

Conclusions: Although the odds of engaging in many risk behaviors examined was higher among AI/AN than among students of other race/ethnicities, all race/ethnicities had high prevalences that put them at risk for serious immediate and long-term health consequences.

Implications for Programs, Policy, and Research: These data support the need to develop effective, culturally relevant prevention interventions for AI/AN youth and to increase resources for this at-risk, under-served population.