Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9–12 — United States and Selected Sites, 2015

Introduction

Sexual identity and sex of sexual contacts can both be used to identify sexual minority youth. Sexual minority youth include those who identify as gay, lesbian, and bisexual and those who are not sure about their sexual identity as well as those who have sexual contact with only the same sex or with both sexes. Dissonance between sexual identity and sex of sexual contact occurs, particularly among youth (1–7). Some youth who identify as heterosexual, gay, lesbian, or bisexual and some youth who are not sure of their sexual identity might not have had any sexual contact. Some youth who have had sexual contact with only the same sex or with both sexes might identify as heterosexual and some youth who have had sexual contact with only the opposite sex might identify as gay, lesbian, or bisexual or be not sure of their sexual identity. Sexual identity and sex of sexual contacts can change throughout the life span.

Significant health disparities exist between sexual minority and nonsexual minority youth (7,8). More specifically, violence, human immunodeficiency virus (HIV) infection, sexually transmitted infections, and pregnancy occur more frequently among sexual minority youth than nonsexual minority youth. In addition, some sexual minority youth struggle with stigma, discrimination, family disapproval, and social rejection. However, not enough is known about health-related behaviors that contribute to negative health outcomes among sexual minority youth and how the prevalence of these health-related behaviors compare with the prevalence of health-related behaviors among nonsexual minority youth (8).

CDC developed the Youth Risk Behavior Surveillance System (YRBSS) to monitor six categories of priority health-related behaviors that contribute to the leading causes of mortality and morbidity among youth and adults in the United States: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including HIV infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. These behaviors frequently are interrelated and are established during childhood and adolescence and extend into adulthood. YRBSS also monitors obesity, overweight, asthma, and other priority health-related behaviors. YRBSS includes school-based national, state, and large urban school district Youth Risk Behavior Surveys (YRBS) conducted among representative samples of students in grades 9–12. Additional information about the YRBSS is available at http://www.cdc.gov/yrbs.

Since 1995, the need for data on the priority health-related behaviors of high school students by sexual minority subgroup has been recognized by an increasing number of states and large urban school districts (Table 1). With CDC support, these states and large urban school districts began adding at least one of two questions to their YRBS questionnaire to ascertain sexual identity and/or sex of sexual contacts and to generate estimates of priority health-related behaviors by sexual identity and sex of sexual contacts. For the 1997 YRBSS cycle, a question on sexual identity and a question on sex of sexual contacts were placed on the YRBS Optional Question List for the first time indicating CDC’s support for the use of these questions. Results from seven states and six large urban school districts that used these questions during 2001–2009 were then summarized in a previous MMWR Surveillance Summary (9). For the 2015 YRBSS cycle, on the basis of substantial support from the state and large urban school district YRBS coordinators, the two questions ascertaining sexual minority status were added for the first time to the standard YRBS questionnaire used by the states and large urban school districts as a starting point for their YRBS questionnaires. The two questions also were added to the national YRBS questionnaire for the first time.

This report provides the first national estimates of the percentage of high school students who are gay, lesbian, and bisexual or are not sure of their sexual identity and the percentage of high school students who have had sexual contact with only the same sex or with both sexes. In addition, this report summarizes results for 118 health-related behaviors plus obesity, overweight, and asthma from the 2015 national YRBS by sexual identity and sex of sexual contacts. Results from 25 state and 19 large urban school district surveys that added at least one of the questions to ascertain sexual minority status and had weighted data for the 2015 YRBSS cycle also are included in this report. However, seven states (Colorado, Georgia, Iowa, New Jersey, Ohio, Texas, and Wisconsin) and two large urban school districts (Chicago and Shelby County) that added at least one of the questions to ascertain sexual minority status, but had unweighted data, are not included in this report. Among the 25 states and 19 large urban school districts included in this report, two state and one large urban school district surveys were conducted during fall 2014; the national survey, 22 state, and 16 large urban school district surveys were conducted during spring 2015; and one state and two large urban school district surveys were conducted during fall 2015.

Methods

Detailed information about the methodology of the national, state, and large urban school district YRBSs has been described elsewhere (10). Information also is available at http://www.cdc.gov/yrbs.

Sampling

National Youth Risk Behavior Survey

The sampling frame for the 2015 national YRBS consisted of all regular public* and private^† schools with students in at least one of grades 9–12 in the 50 states and the District of Columbia. The sampling frame was based on the Market Data Retrieval (MDR) database (11), which includes information on both public and private schools, and the most recent data from the Common Core of Data from the National Center for Education Statistics (12). A three-stage cluster sample design produced a nationally representative sample of students in grades 9–12 who attend public and private schools. The first-stage sampling frame consisted of 1,259 primary sampling units (PSUs), consisting of counties, subareas of large counties, or groups of smaller, adjacent counties. The 1,259 PSUs were categorized into 16 strata according to their metropolitan statistical area (MSA) status (e.g., urban city) and the percentages of black and Hispanic students in the PSUs. From the 1,259 PSUs, 54 were sampled with probability proportional to overall school enrollment size for the PSU.

In the second stage of sampling, 180 schools with any of grades 9–12 were sampled with probability proportional to school enrollment size from within the 54 PSUs. The third stage of sampling consisted of random sampling in each of grades 9–12, one or two classrooms from either a required subject (e.g., English or social studies) or a required period (e.g., homeroom or second period). All students in sampled classes were eligible to participate. Schools, classes, and students that refused to participate were not replaced.

State and Large Urban School District Youth Risk Behavior Surveys

In 2015, a two-stage cluster sample design was used to produce a representative sample of public^§ school students in grades 9–12 in the 25 states and 19 large urban school districts that asked at least one of two questions to ascertain sexual minority status. In the first sampling stage, schools with any of grades 9–12 were sampled with probability proportional to school enrollment size in 23 states and three large urban school districts; all schools with any of grades 9–12 were invited to participate in two states and 16 large urban school districts. In the second sampling stage, intact classes from either a required subject (e.g., English or social studies) or a required period (e.g., homeroom or second period) were sampled randomly in 24 states and 18 large urban school districts, and all students in the sampled classes were eligible to participate. In one state and one large urban school district, all students in sampled schools were eligible to participate.

Data Collection Procedures and Questionnaires

Survey procedures for the national, state, and large urban school district surveys were designed to protect students’ privacy by allowing for anonymous and voluntary participation. Before survey administration, local parental permission procedures were followed. Students completed the self-administered questionnaire during one class period and recorded their responses directly on a computer-scannable booklet or answer sheet. CDC’s Institutional Review Board approved the protocol for the national YRBS.

The 2015 standard YRBS questionnaire contained 89 questions. This questionnaire was used as the starting point for the state and large urban school district questionnaires. States and large urban school districts could add and/or delete questions from the standard questionnaire. Only two states and three large urban school districts used the 2015 YRBS standard questionnaire without modifications. This report presents state and large urban school district results only from selected questions on the 2015 standard questionnaire.

The 2015 national YRBS questionnaire contained 99 questions including all 89 questions on the standard questionnaire. This report presents national results (along with state and large urban school district results) for selected questions on the 2015 standard questionnaire, plus national only results from eight additional questions measuring usual method of marijuana use, ever use of hallucinogenic drugs, consumption of sports drinks, consumption of water, muscle strengthening exercises, indoor tanning device use, having had a sunburn, and avoidance of foods because eating the food could cause an allergic reaction.

Two questions on the standard questionnaire and national questionnaire measured sexual minority status. Sexual identity was ascertained with the following question: “Which of the following best describes you?” Response options were “heterosexual (straight),” “gay or lesbian,” “bisexual,” and “not sure.” All 25 states and 19 large urban school districts included this question. Sex of sexual contacts was ascertained with: “During your life, with whom have you had sexual contact?” Response options were “I have never had sexual contact,” “females,” “males,” and “females and males.” No definition was provided for sexual contact. All but two (Arizona and North Dakota) of the 25 states and all 19 large urban school districts included this question.

Except for six demographic questions (sex, grade in school, age, Hispanic ethnicity, race, and sexual identity) and three questions assessing height, weight, and asthma, all the remaining questions on the standard questionnaire and the national questionnaire measured behaviors practiced or experienced by the students (referred to as “behaviors”). Skip patterns, which occur when a particular response to one question indicates to the respondents that they should not answer one or more subsequent questions, were not included in any YRBS questionnaire to protect students’ privacy by ensuring all students took about the same amount of time to complete the questionnaire. All questions (except for two questions assessing height and weight and the race question) were multiple choice with a maximum of eight mutually exclusive response options and only one possible answer per respondent. Information about the reliability of the standard questionnaire has been published elsewhere (13). The wording of each question, including recall periods, response options, and operational definitions are available in the 2015 standard and national YRBS questionnaires at http://www.cdc.gov/yrbs.

Data Processing Procedures and Response Rates

For the 2015 national YRBS, 15,713 questionnaires were completed in 125 public and private schools. The national data set was cleaned and edited for inconsistencies. Missing data were not statistically imputed. Among the 15,713 completed questionnaires, 89 failed quality control^¶ and were excluded from analysis, resulting in 15,624 usable questionnaires (Table 2). The school response rate was 69%, the students response rate was 86%, and the overall response rate was 60%**.

Data from each state and large urban school district survey were cleaned and edited for inconsistencies with the same procedures used for the national data set. The percentage of completed questionnaires that failed quality control checks and were excluded from analysis ranged from 0.2% to 5.3% (median: 0.8%) across the 25 states and from 0.3% to 6.4% (median: 1.6%) across the 19 large urban school districts. The student sample sizes ranged from 1,452 to 55,596 (median: 2,899) across the states and from 1,052 to 10,419 (median: 2,181) across the large urban school districts (Table 2). Among the states, the school response rates ranged from 70% to 100%, student response rates ranged from 66% to 90%, and overall response rates ranged from 60% to 82%. Among the large urban school districts, the school response rates ranged from 90% to 100%, student response rates ranged from 66% to 88%, and overall response rates ranged from 64% to 88%.

To obtain a sufficient sample size for analyses of health-related behaviors by sexual identity subgroups, students who selected “gay or lesbian” or “bisexual” were combined into a single subgroup and are referred to as “gay, lesbian, and bisexual students” as appropriate. Students who selected “heterosexual (straight)” are referred to as “heterosexual students” and students who selected “not sure” are referred to as “not sure students.” Sex of sexual contact was computed from “During your life, with whom have you had sexual contact?” and “What is your sex?” (response options were “female” and “male”). To obtain a sufficient sample size for analyses of health-related behaviors by sex of sexual contact subgroups, students who had sexual contact with only the same sex or with both sexes were combined into a single subgroup and are referred to as “students who had sexual contact with only the same sex or with both sexes.” Students who had sexual contact with only the opposite sex are referred to as “students who had sexual contact with only the opposite sex.” Students who selected “I have never had sexual contact” are referred to as “students who had no sexual contact.” Students who had no sexual contact were excluded from analyses on sexual behaviors, female students who had sexual contact with only females were excluded from analyses on condom use and birth control use, and male students who had sexual contact with only males were excluded from analyses on birth control use.

Race/ethnicity was computed from two questions: 1) “Are you Hispanic or Latino?” (response options were “yes” and “no”), and 2) “What is your race?” (response options were “American Indian or Alaska Native,” “Asian,” “black or African American,” “Native Hawaiian or other Pacific Islander,” and “white”). For the second question, students could select more than one response option. For this report, students were classified as “Hispanic/ Latino” and are referred to as “Hispanic” if they answered “yes” to the first question, regardless of how they answered the second question. Students who answered “no” to the first question and selected only “black or African American” to the second question were classified as “black or African American” and are referred to as “black.” Students who answered “no” to the first question and selected only “white” to the second question were classified, and are referred to, as “white.” Race/ethnicity was classified as missing for students who did not answer the first question and for students who answered “no” to the first question but did not answer the second question.

Students were classified as having obesity or being overweight based on their body mass index (kg/m²) (BMI), which was calculated from self-reported height and weight. The BMI values were compared with sex- and age-specific reference data from the 2000 CDC growth charts (14). Obesity was defined as a BMI of ≥95th percentile for age and sex. Overweight was defined as a BMI of ≥85th percentile and <95th percentile for age and sex. These classifications are not intended to diagnose obesity or overweight in individual students, but to provide population-level estimates of obesity and overweight.

Weighting

For the national YRBS, a weight based on student sex, race/ethnicity, and grade was applied to each record to adjust for school and student nonresponse and oversampling of black and Hispanic students. The overall weights were scaled so that the weighted count of students equals the total sample size, and the weighted proportions of students in each grade match the national population proportions. Therefore, weighted estimates are representative of all students in grades 9–12 attending public and private schools in the United States.

Data from states and large urban school districts that had a representative sample of students, appropriate documentation, and an overall response rate of ≥60% were weighted. A weight was applied to each record to adjust for school and student nonresponse and the distribution of students by grade, sex, and race/ethnicity in each jurisdiction, such that the weighted count of students equals the student population in each jurisdiction. Data from 25 states and 19 large urban school districts were weighted. The weighted prevalence estimates are representative of all students in grades 9–12 attending public schools in each jurisdiction.

Analytic Methods

Statistical analyses were conducted on weighted data using SAS (15) and SUDAAN (16) software to account for the complex sampling designs. Prevalence estimates and confidence intervals were computed for all variables and all data sets. In addition, for the national YRBS data, t tests (17) were used to determine pairwise differences between sexual identity and sex of sexual contact subgroups. Differences between prevalence estimates were considered statistically significant if the t test p value was <0.05 for main effects (sexual identity and sex of sexual contacts) and for interactions (sex by sexual identity, sexual identity by sex, sex by sex of sexual contacts, and sex of sexual contacts by sex). In the results section, only statistically significant differences in national YRBS prevalence estimates are reported in the following order: sexual identity, sex by sexual identity, sexual identity by sex, sex of sexual contacts, sex by sex of sexual contacts, and sex of sexual contacts by sex.

Results

Nationwide, 88.8% of students identified as heterosexual, 2.0% identified as gay or lesbian, 6.0% identified as bisexual, and 3.2% were not sure of their sexual identity (Table 3). Across 25 states, from 84.4% to 91.1% (median: 87.4%) of students identified as heterosexual, from 0.8% to 4.4% (median: 2.7%) identified as gay or lesbian, from 4.8% to 8.1% (median 6.4%) identified as bisexual, and from 2.8% to 4.9% (median: 4.0%) were not sure of their sexual identity. Across 19 large urban school districts, from 77.6% to 89.7% (median: 86.0%) of students identified as heterosexual, from 1.4% to 7.6% (median: 3.1%) identified as gay or lesbian, from 4.3% to 10.8% (median: 6.5%) identified as bisexual, and from 3.2% to 5.8% (median: 4.5%) were not sure of their sexual identity.

Nationwide, 48.0% of students had had sexual contact with only the opposite sex, 1.7% had had sexual contact with only the same sex, 4.6% had had sexual contact with both sexes, and 45.7% had had no sexual contact (Table 4). Across 23 states, from 36.8% to 51.5% (median: 45.7%) of students had had sexual contact with only the opposite sex, from 1.0% to 3.9% (median: 2.9%) had had sexual contact with only the same sex, from 3.2% to 6.1% (median: 4.7%) had had sexual contact with both sexes, and from 39.1% to 56.8% (median: 46.9%) had had no sexual contact. Across 19 large urban school districts, from 30.2% to 53.4% (median: 45.7%) of students had had sexual contact with only the opposite sex, from 1.8% to 8.2% (median: 3.8%) had had sexual contact with only the same sex, from 2.7% to 9.0% (median: 5.3%) had had sexual contact with both sexes, and from 33.5% to 64.3% (median: 44.1%) had had no sexual contact.

Nationwide, among students who had sexual contact with only the opposite sex, 95.7% identified as heterosexual; 2.8% identified as gay, lesbian, or bisexual; and 1.5% were not sure of their sexual identity (Table 5). Across 23 states, among students who had sexual contact with only the opposite sex, from 91.7% to 96.2% (median: 94.2%) identified as heterosexual; from 2.1% to 5.9% (median: 4.0%) identified as gay, lesbian, or bisexual; and from 1.0% to 3.5% (median: 2.1%) were not sure of their sexual identity. Across 19 large urban school districts, among students who had sexual contact with only the opposite sex, from 90.6% to 96.0% (median: 93.0%) identified as heterosexual; from 2.3% to 6.8% (median: 4.4%) identified as gay, lesbian, or bisexual; and from 1.3% to 3.9% (median: 2.4%) were not sure of their sexual identity.

Nationwide, among students who had sexual contact with only the same sex or with both sexes, 25.0% identified as heterosexual; 61.4% identified as gay, lesbian, or bisexual; and 13.6% were not sure of their sexual identity. Across 23 states, among students who had sexual contact with only the same sex or with both sexes, from 12.9% to 43.9% (median: 28.2%) identified as heterosexual; from 45.6% to 72.4% (median: 62.1%) identified as gay, lesbian, or bisexual; and from 6.9% to 15.8% (median: 11.2%) were not sure of their sexual identity. Across 19 large urban school districts, among students who had sexual contact with only the same sex or with both sexes, from 9.9% to 47.1% (median: 34.1%) identified as heterosexual; from 45.8% to 81.2% (median: 55.0%) identified as gay, lesbian, or bisexual; and from 5.1% to 18.2% (median: 9.1%) were not sure of their sexual identity.

Nationwide, among students who had no sexual contact, 90.8% identified as heterosexual; 5.8% identified as gay, lesbian, or bisexual; and 3.3% were not sure of their sexual identity. Across 23 states, among students who had no sexual contact, from 88.4% to 94.8% (median: 90.5%) identified as heterosexual; from 2.3% to 7.1% (median: 5.3%) identified as gay, lesbian, or bisexual; and from 1.7% to 5.3% (median: 4.1%) were not sure of their sexual identity. Across 19 large urban school districts, among students who had no sexual contact, from 84.5% to 92.9% (median: 88.8%) identified as heterosexual; from 3.3% to 10.2% (median: 5.9%) identified as gay, lesbian, or bisexual; and from 3.1% to 6.6% (median: 4.7%) were not sure of their sexual identity.

Behaviors that Contribute to Unintentional Injuries

Rarely or Never Wore a Bicycle Helmet

Among the students nationwide who had ridden a bicycle during the 12 months before the survey, 81.4% of all those students; 81.2% of the heterosexual students; 80.9% of the gay, lesbian, and bisexual students; and 77.5% of the not sure students had rarely or never worn a bicycle helmet (Table 6). The prevalence was higher among heterosexual male (82.6%) than heterosexual female (79.5%) students.

Across 16 states, the prevalence of having rarely or never worn a bicycle helmet ranged from 53.0% to 92.7% (median: 85.0%) among heterosexual students; from 60.5% to 93.8% (median: 87.0%) among gay, lesbian, and bisexual students; and from 41.4% to 92.4% (median: 78.0%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 54.7% to 97.2% (median: 88.4%) among heterosexual students; from 64.9% to 92.1% (median: 84.6%) among gay, lesbian, and bisexual students; and from 40.1% to 94.6% (median: 79.5%) among not sure students.

Among the students nationwide who had ridden a bicycle during the 12 months before the survey, 89.1% of the students who had sexual contact with only the opposite sex, 87.9% of the students who had sexual contact with only the same sex or with both sexes, and 72.3% of the students who had no sexual contact had rarely or never worn a bicycle helmet. The prevalence of having rarely or never worn a bicycle helmet was higher among students who had sexual contact with only the opposite sex (89.1%) and students who had sexual contact with only the same sex or with both sexes (87.9%) than students who had no sexual contact (72.3%). Among female students, the prevalence was higher among those who had sexual contact with only males (87.0%) and those who had sexual contact with only females or with both sexes (90.3%) than those who had no sexual contact (72.2%). Among male students, the prevalence was higher among those who had sexual contact with only females (90.3%) than those who had no sexual contact (72.4%). The prevalence also was higher among male students who had sexual contact with only females (90.3%) than female students who had sexual contact with only males (87.0%).

Across 16 states, the prevalence of having rarely or never worn a bicycle helmet ranged from 62.5% to 96.0% (median: 90.7%) among students who had sexual contact with only the opposite sex, from 68.0% to 95.9% (median: 86.9%) among students who had sexual contact with only the same sex or with both sexes, and from 40.8% to 88.2% (median: 78.2%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 72.2% to 97.4% (median: 92.1%) among students who had sexual contact with only the opposite sex, from 59.2% to 96.2% (median: 85.0%) among students who had sexual contact with only the same sex or with both sexes, and from 40.3% to 97.4% (median: 84.2%) among students who had no sexual contact.

Rarely or Never Wore a Seatbelt

Nationwide, 6.1% of all students; 5.5% of heterosexual students; 8.7% of gay, lesbian, and bisexual students; and 10.2% of not sure students rarely or never wore a seatbelt when riding in a car driven by someone else (Table 7). The prevalence of having rarely or never worn a seatbelt was higher among gay, lesbian, and bisexual students (8.7%) and not sure students (10.2%) than heterosexual students (5.5%). Among female students, the prevalence was higher among lesbian and bisexual students (8.4%) than heterosexual students (4.3%) and not sure students (4.9%). Among male students, the prevalence was higher among not sure students (15.1%) than heterosexual students (6.6%). The prevalence also was higher among heterosexual male students (6.6%) than heterosexual female students (4.3%) and higher among not sure male students (15.1%) than not sure female students (4.9%).

Across 20 states, the prevalence of having rarely or never worn a seatbelt ranged from 3.2% to 10.5% (median: 6.1%) among heterosexual students; from 4.4% to 19.5% (median: 10.4%) among gay, lesbian, and bisexual students; and from 4.4% to 27.3% (median: 10.9%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 4.0% to 20.4% (median: 7.0%) among heterosexual students; from 4.0% to 29.6% (median: 13.2%) among gay, lesbian, and bisexual students; and from 6.8% to 31.1% (median: 12.4%) among not sure students.

Nationwide, 7.3% of students who had sexual contact with only the opposite sex, 12.5% of students who had sexual contact with only the same sex or with both sexes, and 3.0% of students who had no sexual contact rarely or never wore a seatbelt. The prevalence of having rarely or never worn a seatbelt was higher among students who had sexual contact with only the same sex or with both sexes (12.5%) than students who had sexual contact with only the opposite sex (7.3%) and students who had no sexual contact (3.0%) and higher among students who had sexual contact with only the opposite sex (7.3%) than students who had no sexual contact (3.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (10.7%) than those who had sexual contact with only males (5.9%) and those who had no sexual contact (2.4%) and higher among those who had sexual contact with only males (5.9%) than those who had no sexual contact (2.4%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (18.1%) than those who had sexual contact with only females (8.4%) and those who had no sexual contact (3.7%) and higher among those who had sexual contact with only females (8.4%) than those who had no sexual contact (3.7%). The prevalence also was higher among male students who had sexual contact with only females (8.4%) than female students who had sexual contact with only males (5.9%) and higher among male students who had sexual contact with only males or with both sexes (18.1%) than female students who had sexual contact with only females or with both sexes (10.7%).

Across 18 states, the prevalence of having rarely or never worn a seatbelt ranged from 4.1% to 14.4% (median: 8.3%) among students who had sexual contact with only the opposite sex, from 7.8% to 23.3% (median: 13.8%) among students who had sexual contact with only the same sex or with both sexes, and from 2.0% to 6.9% (median: 3.5%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 4.4% to 22.9% (median: 8.4%) among students who had sexual contact with only the opposite sex, from 4.2% to 28.3% (median: 12.9%) among students who had sexual contact with only the same sex or with both sexes, and from 3.1% to 16.1% (median: 4.9%) among students who had no sexual contact.

Rode with a Driver Who Had Been Drinking Alcohol

Nationwide, 20.0% of all students; 20.0% of heterosexual students; 20.5% of gay, lesbian, and bisexual students; and 21.5% of not sure students had ridden in a car or other vehicle one or more times during the 30 days before the survey with a driver who had been drinking alcohol (Table 8). The prevalence of having ridden with a driver who had been drinking alcohol did not vary significantly by sexual identity subgroup.

Across 21 states, the prevalence of having ridden with a driver who had been drinking alcohol ranged from 13.4% to 21.0% (median: 17.2%) among heterosexual students; from 18.3% to 32.2% (median: 24.9%) among gay, lesbian, and bisexual students; and from 14.1% to 49.2% (median: 25.8%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 13.0% to 30.7% (median: 20.6%) among heterosexual students; from 14.9% to 39.5% (median: 26.4%) among gay, lesbian, and bisexual students; and from 17.9% to 41.0% (median: 28.4%) among not sure students.

Nationwide, 25.4% of students who had sexual contact with only the opposite sex, 28.1% of students who had sexual contact with only the same sex or with both sexes, and 13.1% of students who had no sexual contact had ridden with a driver who had been drinking alcohol. The prevalence of having ridden with a driver who had been drinking alcohol was higher among students who had sexual contact with only the opposite sex (25.4%) and students who had sexual contact with only the same sex or with both sexes (28.1%) than students who had no sexual contact (13.1%). Among female students, the prevalence was higher among those who had sexual contact with only males (25.4%) and those who had sexual contact with only females or with both sexes (27.2%) than those who had no sexual contact (14.4%). Among male students, the prevalence was higher among those who had sexual contact with only females (25.5%) and those who had sexual contact with only males or with both sexes (30.8%) than those who had no sexual contact (11.7%). The prevalence also was higher among female students who had no sexual contact (14.4%) than male students who had no sexual contact (11.7%).

Across 20 states, the prevalence of having ridden with a driver who had been drinking alcohol ranged from 19.0% to 27.4% (median: 22.9%) among students who had sexual contact with only the opposite sex, from 18.1% to 40.0% (median: 30.0%) among students who had sexual contact with only the same sex or with both sexes, and from 6.2% to 15.1% (median: 11.7%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 20.5% to 34.3% (median: 27.3%) among students who had sexual contact with only the opposite sex, from 17.8% to 45.8% (median: 32.5%) among students who had sexual contact with only the same sex or with both sexes, and from 8.5% to 19.3% (median: 14.5%) among students who had no sexual contact.

Drove When Drinking Alcohol

Among the students nationwide who drove a car or other vehicle during the 30 days before the survey, 7.8% of all those students; 7.4% of the heterosexual students; 7.8% of the gay, lesbian, and bisexual students; and 16.7% of the not sure students had driven a car or other vehicle one or more times when they had been drinking alcohol during the 30 days before the survey (Table 9). The prevalence of having driven a car or other vehicle when they had been drinking alcohol was higher among not sure students (16.7%) than heterosexual students (7.4%) and gay, lesbian, and bisexual students (7.8%). Among female students, the prevalence was higher among not sure students (14.5%) than heterosexual students (5.6%) and lesbian and bisexual students (6.1%). Among male students, the prevalence was higher among not sure students (17.4%) than heterosexual students (9.0%). The prevalence also was higher among heterosexual male students (9.0%) than heterosexual female students (5.6%).

Across 23 states, the prevalence of having driven a car or other vehicle when they had been drinking alcohol ranged from 3.6% to 9.3% (median: 6.4%) among heterosexual students; from 2.3% to 21.9% (median: 11.1%) among gay, lesbian, and bisexual students; and from 6.8% to 26.7% (median: 15.8%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 2.4% to 9.9% (median: 5.9%) among heterosexual students; from 2.4% to 21.7% (median: 10.1%) among gay, lesbian, and bisexual students; and from 6.8% to 35.6% (median: 15.3%) among not sure students.

Among the students nationwide who drove a car or other vehicle during the 30 days before the survey, 11.0% of the students who had sexual contact with only the opposite sex, 13.9% of the students who had sexual contact with only the same sex or with both sexes, and 2.1% of the students who had no sexual contact had driven a car or other vehicle when they had been drinking alcohol. The prevalence of having driven a car or other vehicle when they had been drinking alcohol was higher among students who had sexual contact with only the opposite sex (11.0%) and students who had sexual contact with only the same sex or with both sexes (13.9%) than students who had no sexual contact (1.5%). Among female students, the prevalence was higher among those who had sexual contact with only males (8.5%) and those who had sexual contact with only females or with both sexes (11.1%) than those who had no sexual contact (1.5%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (21.9%) than those who had sexual contact with only females (12.8%) and those who had no sexual contact (2.7%) and higher among those who had sexual contact with only females (12.8%) than those who had no sexual contact (2.7%). The prevalence also was higher among male students who had sexual contact with only females (12.8%) than female students who had sexual contact with only males (8.5%).

Across 21 states, the prevalence of having driven a car or other vehicle when they had been drinking alcohol ranged from 5.0% to 13.7% (median: 9.4%) among students who had sexual contact with only the opposite sex, from 7.6% to 28.0% (median: 16.7%) among students who had sexual contact with only the same sex or with both sexes, and from 0.4% to 3.0% (median: 1.3%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 3.7% to 16.0% (median: 8.6%) among students who had sexual contact with only the opposite sex, from 7.6% to 29.8% (median: 14.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 2.4% (median: 1.4%) among students who had no sexual contact.

Texted or E-Mailed While Driving

Among the students nationwide who drove a car or other vehicle during the 30 days before the survey, 41.5% of all those students; 42.6% of the heterosexual students; 30.3% of the gay, lesbian, and bisexual students; and 40.3% of the not sure students had texted or e-mailed while driving a car or other vehicle on at least 1 day during the 30 days before the survey (Table 10). The prevalence of having texted or e-mailed while driving was higher among heterosexual students (42.6%) than gay, lesbian, or bisexual students (30.3%). Among female students, the prevalence was higher among heterosexual students (41.7%) than lesbian or bisexual students (30.4%). Among male students, the prevalence was higher among heterosexual students (43.2%) than gay and bisexual students (30.3%).

Across 23 states, the prevalence of having texted or e-mailed while driving ranged from 25.2% to 58.3% (median: 37.2%) among heterosexual students; from 22.7% to 54.1% (median: 36.9%) among gay, lesbian, and bisexual students; and from 26.9% to 55.5% (median: 40.9%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 13.0% to 38.9% (median: 31.1%) among heterosexual students; from 17.1% to 45.2% (median: 32.2%) among gay, lesbian, and bisexual students; and from 18.0% to 48.0% (median: 31.7%) among not sure students.

Among the students nationwide who drove a car or other vehicle during the 30 days before the survey, 53.7% of the students who had sexual contact with only the opposite sex, 43.5% of the students who had sexual contact with only the same sex or with both sexes, and 24.0% of the students who had no sexual contact had texted or e-mailed while driving. The prevalence was higher among students who had sexual contact with only the opposite sex (53.7%) than students who had sexual contact with only the same sex or with both sexes (43.5%) and students who had no sexual contact (24.0%) and higher among students who had sexual contact with only the same sex or with both sexes (43.5%) than students who had no sexual contact (24.0%). Among female students, the prevalence was higher among those who had sexual contact with only males (55.3%) than those who had sexual contact with only females or with both sexes (42.0%) and those who had no sexual contact (22.3%) and higher among those who had sexual contact with only females or with both sexes (42.0%) than those who had no sexual contact (22.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (52.5%) and those who had sexual contact with only males and with both sexes (47.3%) than those who had no sexual contact (25.7%).

Across 22 states, the prevalence of having texted or e-mailed while driving ranged from 33.5% to 65.4% (median: 48.3%) among students who had sexual contact with only the opposite sex, from 30.9% to 61.8% (median: 46.9%) among students who had sexual contact with only the same sex or with both sexes, and from 11.9% to 34.6% (median: 20.5%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 18.2% to 48.5% (median: 35.6%) among students who had sexual contact with only the opposite sex, from 23.7% to 56.3% (median: 41.0%) among students who had sexual contact with only the same sex or with both sexes, and from 4.6% to 25.0% (median: 15.7%) among students who had no sexual contact.

Behaviors that Contribute to Violence

Carried a Weapon

Nationwide, 16.2% of all students; 16.0% of heterosexual students; 18.9% of gay, lesbian, and bisexual students; and 14.7% of not sure students had carried a weapon (e.g., gun, knife, or club) on at least 1 day during the 30 days before the survey (Table 11). Among female students, the prevalence of having carried a weapon was higher among lesbian and bisexual students (16.0%) than heterosexual students (6.2%). The prevalence also was higher among heterosexual male students (24.5%) than heterosexual female students (6.2%) and higher among not sure male students (20.0%) than not sure female students (10.9%).

Across 20 states, the prevalence of having carried a weapon ranged from 9.0% to 28.5% (median: 17.1%) among heterosexual students; from 8.1% to 39.6% (median: 21.7%) among gay, lesbian, and bisexual students; and from 8.3% to 36.3% (median: 21.2%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 7.0% to 19.5% (median: 11.4%) among heterosexual students; from 6.1% to 31.6% (median: 19.5%) among gay, lesbian, and bisexual students; and from 9.4% to 36.2% (median: 17.9%) among not sure students.

Nationwide, 20.8% of students who had sexual contact with only the opposite sex, 18.8% of students who had sexual contact with only the same sex or with both sexes, and 10.7% of students who had no sexual contact had carried a weapon. The prevalence of having carried a weapon was higher among students who had sexual contact with only the opposite sex (20.8%) and students who had sexual contact with only the same sex or with both sexes (18.8%) than students who had no sexual contact (10.7%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (17.9%) than those who had sexual contact with only males (8.7%) and those who had no sexual contact (4.2%) and higher among those who had sexual contact with only males (8.7%) than those who had no sexual contact (4.2%). Among male students, the prevalence was higher among those who had sexual contact with only females (30.4%) than those who had sexual contact with only males and with both sexes (21.5%) and those who had no sexual contact (17.6%). The prevalence also was higher among male students who had sexual contact with only females (30.4%) than female students who had sexual contact with only males (8.7%) and higher among male students who had no sexual contact (17.6%) than female students who had no sexual contact (4.2%).

Across 19 states, the prevalence of having carried a weapon ranged from 12.9% to 32.0% (median: 21.7%) among students who had sexual contact with only the opposite sex, from 14.2% to 39.2% (median: 26.2%) among students who had sexual contact with only the same sex or with both sexes, and from 5.6% to 25.8% (median: 10.8%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 11.5% to 27.0% (median 17.6%) among students who had sexual contact with only the opposite sex, from 7.7% to 31.8% (median: 21.9%) among students who had sexual contact with only the same sex or with both sexes, and from 3.2% to 9.2% (median: 5.3%) among students who had no sexual contact.

Carried a Gun

Nationwide, 5.3% of all students; 5.2% of heterosexual students; 4.1% of gay, lesbian, and bisexual students; and 4.6% of not sure students had carried a gun on at least 1 day during the 30 days before the survey (Table 12). Among female students, the prevalence of having carried a gun was higher among lesbian and bisexual students (3.1%) than heterosexual students (1.3%). Among male students, the prevalence was higher among heterosexual students (8.5%) than gay and bisexual students (4.8%). The prevalence also was higher among heterosexual male students (8.5%) than heterosexual female students (1.3%) and higher among not sure male students (8.0%) than not sure female students (1.7%).

Across 15 states, the prevalence of having carried a gun ranged from 2.6% to 11.2% (median: 5.3%) among heterosexual students; from 1.5% to 13.2% (median: 6.2%) among gay, lesbian, and bisexual students; and from 2.1% to 16.6% (median: 6.6%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 1.9% to 5.7% (median: 3.9%) among heterosexual students; from 1.9% to 9.9% (median: 4.6%) among gay, lesbian, and bisexual students; and from 0.4% to 21.5% (median: 6.7%) among not sure students.

Nationwide, 6.7% of students who had sexual contact with only the opposite sex, 6.8% of students who had sexual contact with only the same sex or with both sexes, and 3.0% of students who had no sexual contact had carried a gun. The prevalence of having carried a gun was higher among students who had sexual contact with only the opposite sex (6.7%) and students who had sexual contact with only the same sex or with both sexes (6.8%) than students who had no sexual contact (3.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (5.5%) than those who had sexual contact with only males (1.4%) and those who had no sexual contact (0.7%). Among male students, the prevalence was higher among those who had sexual contact with only females (10.9%) and those who had sexual contact with only males or with both sexes (11.2%) than those who had no sexual contact (5.4%). The prevalence also was higher among male students who had sexual contact with only females (10.9%) than female students who had sexual contact with only males (1.4%), higher among male students who had sexual contact with only males or with both sexes (11.2%) than female students who had sexual contact with only females or with both sexes (5.5%), and higher among male students who had no sexual contact (5.4%) than female students who had no sexual contact (0.7%).

Across 14 states, the prevalence of having carried a gun ranged from 3.5% to 11.8% (median: 7.6%) among students who had sexual contact with only the opposite sex, from 4.2% to 20.9% (median: 10.8%) among students who had sexual contact with only the same sex or with both sexes, and from 1.0% to 10.4% (median: 3.2%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 2.8% to 10.4% (median: 6.0%) among students who had sexual contact with only the opposite sex, from 4.7% to 11.9% (median: 6.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.4% to 1.7% (median: 1.0%) among students who had no sexual contact.

Carried a Weapon on School Property

Nationwide, 4.1% of all students; 3.7% of heterosexual students; 6.2% of gay, lesbian, and bisexual students; and 7.1% of not sure students had carried a weapon (e.g., gun, knife, or club) on school property on at least 1 day during the 30 days before the survey (Table 13). The prevalence of having carried a weapon on school property was higher among gay, lesbian, and bisexual students (6.2%) than heterosexual students (3.7%). Among female students, the prevalence was higher among lesbian and bisexual students (5.5%) and not sure students (4.4%) than heterosexual students (1.4%). The prevalence also was higher among heterosexual male students (5.7%) than heterosexual female students (1.4%) and higher among not sure male students (10.1%) than not sure female students (4.4%).

Across 23 states, the prevalence of having carried a weapon on school property ranged from 1.5% to 10.1% (median: 3.8%) among heterosexual students; from 1.3% to 15.9% (median: 7.6%) among gay, lesbian, and bisexual students; and from 0.2% to 16.6% (median: 9.5%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 1.8% to 8.0% (median: 2.7%) among heterosexual students; from 1.3% to 17.3% (median: 7.6%) among gay, lesbian, and bisexual students; and from 2.1% to 17.0% (median: 8.1%) among not sure students.

Nationwide, 5.5% of students who had sexual contact with only the opposite sex, 8.1% of students who had sexual contact with only the same sex or with both sexes, and 1.7% of students who had no sexual contact had carried a weapon on school property. The prevalence of having carried a weapon on school property was higher among students who had sexual contact with only the opposite sex (5.5%) and students who had sexual contact with only the same sex or with both sexes (8.1%) than students who had no sexual contact (1.7%). Among female students, the prevalence was higher among those who had sexual contact with only females and with both sexes (6.5%) than those who had sexual contact with only males (2.2%) and those who had no sexual contact (0.8%) and higher among those who had sexual contact with only males (2.2%) than those who had no sexual contact (0.8%). Among male students, the prevalence was higher among those who had sexual contact with only females (8.1%) and those who had sexual contact with only males or with both sexes (12.8%) than those who had no sexual contact (2.5%). The prevalence also was higher among male students who had sexual contact with only females (8.1%) than female students who had sexual contact with only males (2.2%), higher among male students who had sexual contact with only males or with both sexes (12.8%) than female students who had sexual contact with only females or with both sexes (6.5%), and higher among male students who had no sexual contact (2.5%) than female students who had no sexual contact (0.8%).

Across 21 states, the prevalence of having carried a weapon on school property ranged from 2.6% to 14.5% (median: 5.6%) among students who had sexual contact with only the opposite sex, from 2.5% to 18.6% (median: 11.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.6% to 5.7% (median: 1.4%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 2.4% to 10.1% (median: 4.3%) among students who had sexual contact with only the opposite sex, from 1.7% to 21.6% (median: 9.4%) among students who had sexual contact with only the same sex or with both sexes, and from 0.5% to 3.6% (median: 1.0%) among students who had no sexual contact.

Threatened or Injured with a Weapon on School Property

Nationwide, 6.0% of all students; 5.1% of heterosexual students; 10.0% of gay, lesbian, and bisexual students; and 12.6% of not sure students had been threatened or injured with a weapon (e.g., a gun, knife, or club) on school property one or more times during the 12 months before the survey (Table 14). The prevalence of having been threatened or injured with a weapon on school property was higher among gay, lesbian, and bisexual students (10.0%) and not sure students (12.6%) than heterosexual students (5.1%). Among female students, the prevalence was higher among lesbian and bisexual students (9.1%) than heterosexual students (3.8%). Among male students, the prevalence was higher among gay and bisexual students (11.6%) and not sure students (17.2%) than heterosexual students (6.2%). The prevalence also was higher among heterosexual male students (6.2%) than heterosexual female students (3.8%).

Across 21 states, the prevalence of having been threatened or injured with a weapon on school property ranged from 3.5% to 8.4% (median: 5.3%) among heterosexual students; from 6.7% to 23.1% (median: 13.3%) among gay, lesbian, and bisexual students; and from 4.0% to 18.9% (median: 11.8%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 3.5% to 12.6% (median: 5.8%) among heterosexual students; from 6.7% to 20.6% (median: 11.5%) among gay, lesbian, and bisexual students; and from 3.6% to 31.4% (median: 13.5%) among not sure students.

Nationwide, 7.2% of students who had sexual contact with only the opposite sex, 13.0% of students who had sexual contact with only the same sex or with both sexes, and 2.9% of students who had no sexual contact had been threatened or injured with a weapon on school property. The prevalence of having been threatened or injured with a weapon on school property was higher among students who had sexual contact with only the same sex or with both sexes (13.0%) than students who had sexual contact with only the opposite sex (7.2%) and students who had no sexual contact (2.9%) and higher among students who had sexual contact with only the opposite sex (7.2%) than students who had no sexual contact (2.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (10.6%) than those who had sexual contact with only males (4.9%) and those who had no sexual contact (2.8%) and higher among those who had sexual contact with only males (4.9%) than those who had no sexual contact (2.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.4%) than those who had sexual contact with only females (8.9%) and those who had no sexual contact (3.1%) and higher among those who had sexual contact with only females (8.9%) than those who had no sexual contact (3.1%). The prevalence also was higher among male students who had sexual contact with only females (8.9%) than female students who had sexual contact with only males (4.9%) and higher among male students who had sexual contact with only males or with both sexes (20.4%) than female students who had sexual contact with only females or with both sexes (10.6%).

Across 20 states, the prevalence of having been threatened or injured with a weapon on school property ranged from 5.0% to 10.7% (median: 7.3%) among students who had sexual contact with only the opposite sex, from 6.2% to 25.0% (median: 15.7%) among students who had sexual contact with only the same sex or with both sexes, and from 1.5% to 4.3% (median: 2.8%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 4.2% to 10.6% (median: 8.3%) among students who had sexual contact with only the opposite sex, from 9.8% to 22.2% (median: 14.2%) among students who had sexual contact with only the same sex or with both sexes, and from 1.8% to 5.6% (median: 2.8%) among students who had no sexual contact.

In a Physical Fight

Nationwide, 22.6% of all students; 21.7% of heterosexual students; 28.4% of gay, lesbian, and bisexual students; and 34.5% of not sure students had been in a physical fight one or more times during the 12 months before the survey (Table 15). The prevalence of having been in a physical fight was higher among gay, lesbian, and bisexual students (28.4%) and not sure students (34.5%) than heterosexual students (21.7%). Among female students, the prevalence was higher among lesbian and bisexual students (30.0%) and not sure students (26.1%) than heterosexual students (14.2%). Among male students, the prevalence was higher among not sure students (44.2%) than heterosexual students (28.3%). The prevalence also was higher among heterosexual male students (28.3%) than heterosexual female students (14.2%) and higher among not sure male students (44.2%) than not sure female students (26.1%).

Across 22 states, the prevalence of physical fighting ranged from 13.0% to 24.1% (median: 18.6%) among heterosexual students; from 19.9% to 39.4% (median: 29.9%) among gay, lesbian, and bisexual students; and from 15.7% to 32.9% (median: 22.7%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 13.3% to 37.0% (median: 21.4%) among heterosexual students; from 20.3% to 53.5% (median: 34.1%) among gay, lesbian, and bisexual students; and from 14.1% to 55.5% (median: 26.6%) among not sure students.

Nationwide, 30.1% of students who had sexual contact with only the opposite sex, 37.0% of students who had sexual contact with only the same sex or with both sexes, and 12.9% of students who had no sexual contact had been in a physical fight. The prevalence of having been in a physical fight was higher among students who had sexual contact with only the same sex or with both sexes (37.0%) than students who had sexual contact with only the opposite sex (30.1%) and students who had no sexual contact (12.9%) and higher among students who had sexual contact with only the opposite sex (30.1%) than students who had no sexual contact (12.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (36.3%) than those who had sexual contact with only males (20.5%) and those who had no sexual contact (9.1%) and higher among those who had sexual contact with only males (20.5%) than those who had no sexual contact (9.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (37.7%) and those who had sexual contact with only males or with both sexes (39.4%) than those who had no sexual contact (17.0%). The prevalence also was higher among male students who had sexual contact with only females (37.7%) than female students who had sexual contact with only males (20.5%) and higher among male students who had no sexual contact (17.0%) than female students who had no sexual contact (9.1%).

Across 21 states, the prevalence of physical fighting ranged from 19.1% to 32.9% (median: 25.8%) among students who had sexual contact with only the opposite sex, from 26.1% to 44.9% (median: 36.1%) among students who had sexual contact with only the same sex or with both sexes, and from 6.9% to 16.4% (median: 10.5%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 23.8% to 44.0% (median: 31.3%) among students who had sexual contact with only the opposite sex, from 28.1% to 56.6% (median: 35.8%) among students who had sexual contact with only the same sex or with both sexes, and from 6.9% to 27.1% (median: 11.9%) among students who had no sexual contact.

Injured in a Physical Fight

Nationwide, 2.9% of all students; 2.5% of heterosexual students; 4.9% of gay, lesbian, and bisexual students; and 8.7% of not sure students nationwide had been in a physical fight one or more times during the 12 months before the survey in which they were injured and had to be treated by a doctor or nurse (Table 16). The prevalence of having been injured in a physical fight was higher among gay, lesbian, and bisexual students (4.9%) and not sure students (8.7%) than heterosexual students (2.5%). Among female students, the prevalence was higher among lesbian and bisexual students (4.6%) than heterosexual students (1.3%). Among male students, the prevalence was higher among not sure students (13.8%) than heterosexual students (3.4%). The prevalence also was higher among heterosexual male students (3.4%) than heterosexual female students (1.3%) and higher among not sure male students (13.8%) than not sure female students (3.1%).

Across 17 states, the prevalence of having been injured in a physical fight ranged from 1.4% to 3.0% (median: 2.2%) among heterosexual students; from 1.7% to 8.9% (median: 6.9%) among gay, lesbian, and bisexual students; and from 0.6% to 10.4% (median: 4.8%) among not sure students. Across 14 large urban school districts, the prevalence ranged from 1.7% to 9.0% (median: 2.9%) among heterosexual students; from 2.5% to 14.1% (median: 6.4%) among gay, lesbian, and bisexual students; and from 1.7% to 21.8% (median: 4.3%) among not sure students.

Nationwide, 3.7% of students who had sexual contact with only the opposite sex, 8.6% of students who had sexual contact with only the same sex or with both sexes, and 1.1% of students who had no sexual contact had been injured in a physical fight. The prevalence of having been injured in a physical fight was higher among students who had sexual contact with only the same sex or with both sexes (8.6%) than students who had sexual contact with only the opposite sex (3.7%) and students who had no sexual contact (1.1%) and higher among students who had sexual contact with only the opposite sex (3.7%) than students who had no sexual contact (1.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (7.5%) than those who had sexual contact with only males (1.7%) and those who had no sexual contact (0.7%) and higher among those who had sexual contact with only males (1.7%) than those who had no sexual contact (0.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (11.9%) than those who had sexual contact with only females (5.2%) and those who had no sexual contact (1.4%) and higher among those who had sexual contact with only females (5.2%) than those who had no sexual contact (1.4%). The prevalence also was higher among male students who had sexual contact with only females (5.2%) than female students who had sexual contact with only males (1.7%) and higher among male students who had no sexual contact (1.4%) than female students who had no sexual contact (0.7%).

Across 17 states, the prevalence of having been injured in a physical fight ranged from 2.0% to 4.9% (median: 3.1%) among students who had sexual contact with only the opposite sex, from 3.3% to 13.6% (median: 8.3%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 1.5% (median: 1.0%) among students who had no sexual contact. Across 14 large urban school districts, the prevalence ranged from 2.7% to 7.8% (median: 4.2%) among students who had sexual contact with only the opposite sex, from 4.0% to 14.7% (median: 8.1%) among students who had sexual contact with only the same sex or with both sexes, and from 0.3% to 3.8% (median: 0.9%) among students who had no sexual contact.

In a Physical Fight on School Property

Nationwide, 7.8% of all students; 7.1% of heterosexual students; 11.2% of gay, lesbian, and bisexual students; and 14.6% of not sure students had been in a physical fight on school property one or more times during the 12 months before the survey (Table 17). The prevalence of having been in a physical fight on school property was higher among gay, lesbian, and bisexual students (11.2%) and not sure students (14.6%) than heterosexual students (7.1%). Among female students, the prevalence was higher among lesbian and bisexual students (10.4%) and not sure students (9.5%) than heterosexual students (4.0%). Among male students, the prevalence was higher among not sure students (19.1%) than heterosexual students (9.7%). The prevalence also was higher among heterosexual male students (9.7%) than heterosexual female students (4.0%) and higher among not sure male students (19.1%) than not sure female students (9.5%).

Across 22 states, the prevalence of having been in a physical fight on school property ranged from 4.2% to 10.2% (median: 6.6%) among heterosexual students; from 5.4% to 22.5% (median: 12.0%) among gay, lesbian, and bisexual students; and from 3.9% to 20.2% (median: 9.5%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 5.1% to 16.5% (median: 7.1%) among heterosexual students; from 8.7% to 23.1% (median: 13.6%) among gay, lesbian, and bisexual students; and from 2.7% to 24.3% (median: 10.3%) among not sure students.

Nationwide, 9.6% of students who had sexual contact with only the opposite sex, 15.6% of students who had sexual contact with only the same sex or with both sexes, and 4.1% of students who had no sexual contact had been in a physical fight on school property. The prevalence of having been in a physical fight on school property was higher among students who had sexual contact with only the same sex or with both sexes (15.6%) than students who had sexual contact with only the opposite sex (9.6%) and students who had no sexual contact (4.1%) and higher among students who had sexual contact with only the opposite sex (9.6%) than students who had no sexual contact (4.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (13.4%) than those who had sexual contact with only males (5.9%) and those who had no sexual contact (2.3%) and higher among those who had sexual contact with only males (5.9%) than those who had no sexual contact (2.3%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (22.2%) than those who had sexual contact with only females (12.5%) and those who had no sexual contact (6.0%) and higher among those who had sexual contact with only females (12.5%) than those who had no sexual contact (6.0%). The prevalence also was higher among male students who had sexual contact with only females (12.5%) than female students who had sexual contact with only males (5.9%), higher among male students who had sexual contact with only males or with both sexes (22.2%) than female students who had sexual contact with only females or with both sexes (13.4%), and higher among male students who had no sexual contact (6.0%) than female students who had no sexual contact (2.3%).

Across 20 states, the prevalence of having been in a physical fight on school property ranged from 5.6% to 13.9% (median: 9.2%) among students who had sexual contact with only the opposite sex, from 9.7% to 25.5% (median: 14.2%) among students who had sexual contact with only the same sex or with both sexes, and from 2.1% to 5.3% (median: 3.4%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 7.2% to 18.7% (median: 10.6%) among students who had sexual contact with only the opposite sex, from 11.0% to 21.6% (median: 16.8%) among students who had sexual contact with only the same sex or with both sexes, and from 2.4% to 9.0% (median: 3.8%) among students who had no sexual contact.

Did Not Go to School Because of Safety Concerns

Nationwide, 5.6% of all students; 4.6% of heterosexual students; 12.5% of gay, lesbian, and bisexual students; and 10.8% of not sure students had not gone to school on at least 1 day during the 30 days before the survey because they felt they would be unsafe at school or on their way to or from school (i.e., did not go to school because of safety concerns) (Table 18). The prevalence of not having gone to school because of safety concerns was higher among gay, lesbian, and bisexual students (12.5%) and not sure students (10.8%) than heterosexual students (4.6%). Among female students, the prevalence was higher among lesbian and bisexual students (10.8%) and not sure students (11.1%) than heterosexual students (5.1%). Among male students, the prevalence was higher among gay and bisexual students (15.5%) than heterosexual students (4.1%). The prevalence also was higher among heterosexual female students (5.1%) than heterosexual male students (4.1%).

Across 24 states, the prevalence of not having gone to school because of safety concerns ranged from 3.5% to 7.2% (median: 5.0%) among heterosexual students; from 6.5% to 23.6% (median: 13.8%) among gay, lesbian, and bisexual students; and from 6.7% to 21.3% (median: 13.6%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 3.5% to 10.0% (median: 7.4%) among heterosexual students; from 8.2% to 22.8% (median: 15.2%) among gay, lesbian, and bisexual students; and from 5.3% to 30.8% (median: 17.5%) among not sure students.

Nationwide, 5.8% of students who had sexual contact with only the opposite sex, 11.9% of students who had sexual contact with only the same sex or with both sexes, and 3.4% of students who had no sexual contact had not gone to school because of safety concerns. The prevalence of not having gone to school because of safety concerns was higher among students who had sexual contact with only the same sex or with both sexes (11.9%) than students who had sexual contact with only the opposite sex (5.8%) and students who had no sexual contact (3.4%) and higher among students who had sexual contact with only the opposite sex (5.8%) than students who had no sexual contact (3.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (11.5%) than those who had sexual contact with only males (6.0%) and those who had no sexual contact (4.5%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (13.2%) than those who had sexual contact with only females (5.7%) and those who had no sexual contact (2.3%) and higher among those who had sexual contact with only females (5.7%) than those who had no sexual contact (2.3%). The prevalence also was higher among female students who had no sexual contact (4.5%) than male students who had no sexual contact (2.3%).

Across 23 states, the prevalence of not having gone to school because of safety concerns ranged from 3.1% to 9.1% (median: 6.6%) among students who had sexual contact with only the opposite sex, from 8.8% to 25.0% (median: 14.7%) among students who had sexual contact with only the same sex or with both sexes, and from 2.1% to 6.5% (median: 3.6%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 4.2% to 12.2% (median: 8.4%) among students who had sexual contact with only the opposite sex, from 6.2% to 24.1% (median: 16.0%) among students who had sexual contact with only the same sex or with both sexes, and from 2.6% to 8.1% (median: 5.2%) among students who had no sexual contact.

Electronically Bullied

Nationwide, 15.5% of all students; 14.2% of heterosexual students; 28.0% of gay, lesbian, and bisexual students; and 22.5% of not sure students had been electronically bullied, counting being bullied through e-mail, chat rooms, instant messaging, websites, or texting, during the 12 months before the survey (Table 19). The prevalence of having been electronically bullied was higher among gay, lesbian, and bisexual students (28.0%) and not sure students (22.5%) than heterosexual students (14.2%). Among female students, the prevalence was higher among lesbian and bisexual students (30.5%) than heterosexual students (20.6%) and not sure students (20.4%). Among male students, the prevalence was higher among gay and bisexual students (22.4%) and not sure students (22.3%) than heterosexual students (8.7%). The prevalence also was higher among heterosexual female students (20.6%) than heterosexual male students (8.7%) and higher among lesbian and bisexual female students (30.5%) than gay and bisexual male students (22.4%).

Across 24 states, the prevalence of having been electronically bullied ranged from 9.6% to 17.8% (median: 12.8%) among heterosexual students; from 22.6% to 46.1% (median: 27.1%) among gay, lesbian, and bisexual students; and from 16.2% to 37.3% (median: 23.5%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 6.4% to 14.8% (median: 9.4%) among heterosexual students; from 12.0% to 28.7% (median: 20.8%) among gay, lesbian, and bisexual students; and from 8.5% to 30.1% (median: 20.6%) among not sure students.

Nationwide, 17.4% of students who had sexual contact with only the opposite sex, 31.9% of students who had sexual contact with only the same sex or with both sexes, and 11.5% of students who had no sexual contact had been electronically bullied. The prevalence of having been electronically bullied was higher among students who had sexual contact with only the same sex or with both sexes (31.9%) than students who had sexual contact with only the opposite sex (17.4%) and students who had no sexual contact (11.5%) and higher among students who had sexual contact with only the opposite sex (17.4%) than students who had no sexual contact (11.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (32.2%) than those who had sexual contact with only males (26.3%) and those who had no sexual contact (15.7%) and higher among those who sexual contact with only males (26.3%) than those who had no sexual contact (15.7%). Among male students, the prevalence was higher among those who had sexual contact with only males and with both sexes (31.1%) than those who had sexual contact with only females (10.6%) and those who had no sexual contact (7.1%) and higher among those who had sexual contact with only females (10.6%) than those who had no sexual contact (7.1%). The prevalence also was higher among female students who had sexual contact with only males (26.3%) than male students who had sexual contact with only females (10.6%) and higher among female students who had no sexual contact (15.7%) than male students who had no sexual contact (7.1%).

Across 23 states, the prevalence of having been electronically bullied ranged from 12.1% to 23.0% (median: 16.4%) among students who had sexual contact with only the opposite sex, from 24.5% to 48.0% (median: 30.9%) among students who had sexual contact with only the same sex or with both sexes, and from 7.1% to 14.8% (median: 10.0%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 6.8% to 15.5% (median: 11.3%) among students who had sexual contact with only the opposite sex, from 11.7% to 33.4% (median: 21.5%) among students who had sexual contact with only the same sex or with both sexes, and from 4.5% to 9.9% (median: 8.0%) among students who had no sexual contact.

Bullied on School Property

Nationwide, 20.2% of all students; 18.8% of heterosexual students; 34.2% of gay, lesbian, and bisexual students; and 24.9% of not sure students had been bullied on school property during the 12 months before the survey (Table 20). The prevalence of having been bullied on school property was higher among gay, lesbian, and bisexual students (34.2%) then heterosexual students (18.8%) and not sure students (24.9%) and higher among not sure students (24.9%) than heterosexual students (18.8%). Among female students, the prevalence was higher among lesbian and bisexual students (37.2%) than heterosexual students (23.2%) and not sure students (19.1%). Among male students, the prevalence was higher among gay and bisexual students (26.3%) and not sure students (31.7%) than heterosexual students (15.0%). The prevalence also was higher among heterosexual female students (23.2%) than heterosexual male students (15.0%), higher among lesbian and bisexual female students (37.2%) than gay and bisexual male students (26.3%), and higher among not sure male students (31.7%) than not sure female students (19.1%).

Across 23 states, the prevalence of having been bullied on school property ranged from 12.4% to 23.4% (median: 17.0%) among heterosexual students; from 25.0% to 48.8% (median: 34.3%) among gay, lesbian, and bisexual students; and from 14.0% to 45.4% (median: 30.1%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 9.3% to 16.7% (median: 13.0%) among heterosexual students; from 13.8% to 37.6% (median: 23.2%) among gay, lesbian, and bisexual students; and from 17.4% to 35.0% (median: 25.4%) among not sure students.

Nationwide, 21.2% of students who had sexual contact with only the opposite sex, 34.1% of students who had sexual contact with only the same sex or with both sexes, and 17.4% of students who had no sexual contact had been bullied on school property. The prevalence of having been bullied on school property was higher among students who had sexual contact with only the same sex or with both sexes (34.1%) than students who had sexual contact with only the opposite sex (21.2%) and students who had no sexual contact (17.4%) and higher among students who had sexual contact with only the opposite sex (21.2%) than students who had no sexual contact (17.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (34.0%) than those who had sexual contact with only males (27.3%) and those who had no sexual contact (20.7%) and higher among those who had sexual contact with only males (27.3%) than those who had no sexual contact (20.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (34.4%) than those who had sexual contact with only females (16.5%) and those who had no sexual contact (13.9%). The prevalence also was higher among female students who had sexual contact with only males (27.3%) than male students who had sexual contact with only females (16.5%) and higher among female students who had no sexual contact (20.7%) than male students who had no sexual contact (13.9%).

Across 22 states, the prevalence of having been bullied on school property ranged from 12.9% to 27.6% (median: 18.5%) among students who had sexual contact with only the opposite sex, from 28.2% to 51.5% (median: 34.5%) among students who had sexual contact with only the same sex or with both sexes, and from 12.2% to 21.3% (median: 16.4%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 9.0% to 17.9% (median: 13.7%) among students who had sexual contact with only the opposite sex, from 17.5% to 33.6% (median: 24.0%) among students who had sexual contact with only the same sex or with both sexes, and from 8.8% to 16.0% (median: 12.7%) among students who had no sexual contact.

Forced to Have Sexual Intercourse

Nationwide, 6.7% of all students; 5.4% of heterosexual students; 17.8% of gay, lesbian, and bisexual students; and 12.6% of not sure students had ever been physically forced to have sexual intercourse when they did not want to (Table 21). The prevalence of having ever been forced to have sexual intercourse was higher among gay, lesbian, and bisexual students (17.8%) and not sure students (12.6%) than heterosexual students (5.4%) and higher among not sure students (12.6%) than heterosexual students (5.4%). Among female students, the prevalence was higher among lesbian and bisexual students (21.1%) than heterosexual students (8.8%) and not sure students (9.8%). Among male students, the prevalence was higher among gay and bisexual students (8.0%) and not sure students (13.5%) than heterosexual students (2.5%). The prevalence also was higher among heterosexual female students (8.8%) than heterosexual male students (2.5%) and higher among lesbian and bisexual female students (21.1%) than gay and bisexual male students (8.0%).

Across 24 states, the prevalence of having ever been forced to have sexual intercourse ranged from 4.5% to 8.6% (median: 6.2%) among heterosexual students; from 9.9% to 34.0% (median: 19.7%) among gay, lesbian, and bisexual students; and from 6.7% to 23.0% (median: 15.7%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 4.4% to 10.4% (median: 7.0%) among heterosexual students; from 12.5% to 26.7% (median: 18.4%) among gay, lesbian, and bisexual students; and from 2.6% to 22.1% (median: 14.2%) among not sure students.

Nationwide, 9.0% of students who had sexual contact with only the opposite sex, 25.2% of students who had sexual contact with only the same sex or with both sexes, and 1.4% of students who had no sexual contact had ever been physically forced to have sexual intercourse. The prevalence of having ever been forced to have sexual intercourse was higher among students who had sexual contact with only the same sex or with both sexes (25.2%) than students who had sexual contact with only the opposite sex (9.0%) and students who had no sexual contact (1.4%) and higher among students who had sexual contact with only the opposite sex (9.0%) than students who had no sexual contact (1.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (28.1%) than those who had sexual contact with only males (15.8%) and those who had no sexual contact (1.8%) and higher among those who had sexual contact with only males (15.8%) than those who had no sexual contact (1.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (16.0%) than those who had sexual contact with only females (3.7%) and those who had no sexual contact (1.0%) and higher among those who had sexual contact with only females (3.7%) than those who had no sexual contact (1.0%). The prevalence also was higher among female students who had sexual contact with only males (15.8%) than male students who had sexual contact with only females (3.7%), higher among female students who had sexual contact with only females or with both sexes (28.1%) than male students who had sexual contact with only males or with both sexes (16.0%), and higher among female students who had no sexual contact (1.8%) than male students who had no sexual contact (1.0%).

Across 22 states, the prevalence of having ever been forced to have sexual intercourse ranged from 7.2% to 13.0% (median: 9.8%) among students who had sexual contact with only the opposite sex, from 19.7% to 39.1% (median: 27.0%) among students who had sexual contact with only the same sex or with both sexes, and from 0.7% to 4.9% (median: 2.6%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 7.4% to 13.1% (median: 10.2%) among students who had sexual contact with only the opposite sex, from 14.4% to 29.4% (median: 20.6%) among students who had sexual contact with only the same sex or with both sexes, and from 1.9% to 6.7% (median: 3.6%) among students who had no sexual contact.

Physical Dating Violence

Among the students nationwide who dated or went out with someone during the 12 months before the survey, 9.6% of all those students; 8.3% of the heterosexual students; 17.5% of the gay, lesbian, and bisexual students; and 24.5% of the not sure students had been physically hurt on purpose (counting being hit, slammed into something, or injured with an object or weapon) by someone they were dating or going out with one or more times during the 12 months before the survey (i.e., physical dating violence) (Table 22). The prevalence of physical dating violence was higher among gay, lesbian, and bisexual students (17.5%) and not sure students (24.5%) than heterosexual students (8.3%). Among female students, the prevalence was higher among lesbian and bisexual students (16.9%) than heterosexual students (10.7%). Among male students, the prevalence was higher among gay and bisexual students (19.9%) and not sure students (30.5%) than heterosexual students (6.2%). The prevalence also was higher among heterosexual female students (10.7%) than heterosexual male students (6.2%).

Across 24 states, the prevalence of physical dating violence ranged from 5.6% to 12.4% (median: 7.2%) among heterosexual students; from 11.2% to 31.8% (median: 20.6%) among gay, lesbian, and bisexual students; and from 6.0% to 32.2% (median: 21.1%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 5.0% to 10.0% (median: 7.5%) among heterosexual students; from 11.8% to 26.1% (median: 20.8%) among gay, lesbian, and bisexual students; and from 3.0% to 35.2% (median: 16.9%) among not sure students.

Among the students nationwide who dated or went out with someone during the 12 months before the survey, 10.8% of the students who had sexual contact with only the opposite sex, 23.5% of the students who had sexual contact with only the same sex or with both sexes, and 3.0% of the students who had no sexual contact had experienced physical dating violence. The prevalence of physical dating violence was higher among students who had sexual contact with only the same sex or with both sexes (23.5%) than students who had sexual contact with only the opposite sex (10.8%) and students who had no sexual contact (3.0%) and higher among students who had sexual contact with only the opposite sex (10.8%) than those who had no sexual contact (3.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (21.4%) than those who had sexual contact with only males (14.1%) and those who had no sexual contact (4.1%) and higher among those who had sexual contact with only males (14.1%) than those who had no sexual contact (4.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (31.9%) than those who had sexual contact with only females (8.2%) and those who had no sexual contact (1.9%) and higher among those who had sexual contact with only females (8.2%) than those who had no sexual contact (1.9%). The prevalence also was higher among female students who had sexual contact with only males (14.1%) than male students who had sexual contact with only females (8.2%), higher among male students who had sexual contact with only males or with both sexes (31.9%) than female students who had sexual contact with only females or with both sexes (21.4%), and higher among female students who had no sexual contact (4.1%) than male students who had no sexual contact (1.9%).

Across 23 states, the prevalence of physical dating violence ranged from 7.1% to 15.7% (median: 10.2%) among students who had sexual contact with only the opposite sex, from 12.6% to 41.2% (median: 24.5%) among students who had sexual contact with only the same sex or with both sexes, and from 1.2% to 3.8% (median: 2.7%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 5.9% to 12.6% (median: 9.4%) among students who had sexual contact with only the opposite sex, from 10.4% to 27.4% (median: 21.9%) among students who had sexual contact with only the same sex or with both sexes, and from 1.0% to 6.6% (median: 3.9%) among students who had no sexual contact.

Sexual Dating Violence

Among the students nationwide who dated or went out with someone during the 12 months before the survey, 10.6% of all those students; 9.1% of the heterosexual students; 22.7% of the gay, lesbian, and bisexual students; and 23.8% of the not sure students had been forced to do sexual things (counting being kissed, touched, or physically forced to have sexual intercourse) they did not want to do by someone they were dating or going out with one or more times during the 12 months before the survey (i.e., sexual dating violence) (Table 23). The prevalence of sexual dating violence was higher among gay, lesbian, and bisexual students (22.7%) and not sure students (23.8%) than heterosexual students (9.1%). Among female students, the prevalence was higher among lesbian and bisexual students (22.6%) then heterosexual students (14.5%). Among male students, the prevalence was higher among gay and bisexual students (20.9%) and not sure students (21.7%) than heterosexual students (4.3%). The prevalence also was higher among heterosexual female students (14.5%) than heterosexual male students (4.3%).

Across 21 states, the prevalence of sexual dating violence ranged from 6.2% to 11.3% (median: 8.5%) among heterosexual students; from 13.7% to 31.8% (median: 20.6%) among gay, lesbian, and bisexual students; and from 11.7% to 39.3% (median: 23.7%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 5.8% to 11.7% (median: 7.8%) among heterosexual students; from 11.6% to 33.3% (median: 20.2%) among gay, lesbian, and bisexual students; and from 16.7% to 45.6% (median: 23.1%) among not sure students.

Among the students nationwide who dated or went out with someone during the 12 months before the survey, 10.5% of the students who had sexual contact with only the opposite sex, 27.0% of the students who had sexual contact with only the same sex or with both sexes, and 5.9% of the students who had no sexual contact experienced sexual dating violence. The prevalence of sexual dating violence was higher among students who had sexual contact with only the same sex or with both sexes (27.0%) than students who had sexual contact with only the opposite sex (10.5%) and students who had no sexual contact (5.9%) and higher among students who had sexual contact with only the opposite sex (10.5%) than students who had no sexual contact (5.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (28.4%) than those who had sexual contact with only males (16.5%) and those who had no sexual contact (9.7%) and higher among those who had sexual contact with only males (16.5%) than those who had no sexual contact (9.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (21.2%) than those who had sexual contact with only females (5.6%) and those who had no sexual contact (1.9%) and higher among those who had sexual contact with only females (5.6%) than those who had no sexual contact (1.9%). The prevalence also was higher among female students who had sexual contact with only males (16.5%) than male students who had sexual contact with only females (5.6%) and higher among female students who had no sexual contact (9.7%) than male students who had no sexual contact (1.9%).

Across 21 states, the prevalence of sexual dating violence ranged from 7.6% to 15.1% (median: 10.2%) among students who had sexual contact with only the opposite sex, from 15.8% to 36.1% (median: 26.3%) among students who had sexual contact with only the same sex or with both sexes, and from 1.9% to 7.4% (median: 4.2%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 6.1% to 13.3% (median: 9.7%) among students who had sexual contact with only the opposite sex, from 10.8% to 36.0% (median: 22.5%) among students who had sexual contact with only the same sex or with both sexes, and from 2.0% to 8.1% (median: 4.4%) among students who had no sexual contact.

Felt Sad or Hopeless

During the 12 months before the survey, 29.9% of all students; 26.4% of heterosexual students; 60.4% of gay, lesbian, and bisexual students; and 46.5% of not sure students nationwide had felt so sad or helpless almost every day for 2 or more weeks in a row that they stopped doing some usual activities (Table 24). The prevalence of having felt sad or hopeless was higher among gay, lesbian, and bisexual students (60.4%) than heterosexual students (26.4%) and not sure students (46.5%) and higher among not sure students (46.5%) than heterosexual students (26.4%). Among female students, the prevalence was higher among lesbian and bisexual students (66.5%) than heterosexual students (35.5%) and not sure students (49.7%) and higher among not sure students (49.7%) than heterosexual students (35.5%). Among male students, the prevalence was higher among gay and bisexual students (43.9%) and not sure students (40.5%) than heterosexual students (18.6%). The prevalence also was higher among heterosexual female students (35.5%) than heterosexual male students (18.6%) and higher among lesbian and bisexual female students (66.5%) than gay and bisexual male students (43.9%).

Across 25 states, the prevalence of having felt sad or hopeless ranged from 20.5% to 29.6% (median: 24.7%) among heterosexual students; from 47.0% to 71.3% (median: 59.8%) among gay, lesbian, and bisexual students; and from 28.0% to 61.8% (median: 44.6%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 22.5% to 31.0% (median: 26.1%) among heterosexual students; from 44.2% to 65.0% (median: 52.9%) among gay, lesbian, and bisexual students; and from 27.7% to 56.5% (median: 44.5%) among not sure students.

Nationwide, 32.9% of students who had sexual contact with only the opposite sex, 62.7% of students who had sexual contact with only the same sex or with both sexes, and 22.3% of students who had no sexual contact had felt sad or hopeless. The prevalence of having felt sad or hopeless was higher among students who had sexual contact with only the same sex or with both sexes (62.7%) than students who had sexual contact with only the opposite sex (32.9%) and students who had no sexual contact (22.3%) and higher among students who had sexual contact with only the opposite sex (32.9%) than students who had no sexual contact (22.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (66.3%) than those who had sexual contact with only males (44.3%) and those who had no sexual contact (30.7%) and higher among those who had sexual contact with only males (44.3%) than those who had no sexual contact (30.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (51.6%) than those who had sexual contact with only females (24.1%) and those who had no sexual contact (13.4%) and higher among those who had sexual contact with only females (24.1%) than those who had no sexual contact (13.4%). The prevalence also was higher among female students who had sexual contact with only males (44.3%) than male students who had sexual contact with only females (24.1%), higher among female students who had sexual contact with only females or with both sexes (66.3%) than male students who had sexual contact with only males or with both sexes (51.6%), and higher among female students who had no sexual contact (30.7%) than male students who had no sexual contact (13.4%).

Across 23 states, the prevalence of having felt sad or hopeless ranged from 25.8% to 36.1% (median: 31.8%) among students who had sexual contact with only the opposite sex, from 40.8% to 72.0% (median: 58.9%) among students who had sexual contact with only the same sex or with both sexes, and from 17.1% to 26.3% (median: 21.2%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 25.7% to 32.8% (median: 31.0%) among students who had sexual contact with only the opposite sex, from 44.8% to 65.7% (median: 50.7%) among students who had sexual contact with only the same sex or with both sexes, and from 18.9% to 29.9% (median: 23.9%) among students who had no sexual contact.

Seriously Considered Attempting Suicide

Nationwide, 17.7% of all students; 14.8% of heterosexual students; 42.8% of gay, lesbian, or bisexual students; and 31.9% of not sure students had seriously considered attempting suicide during the 12 months before the survey (Table 25). The prevalence of having seriously considered attempting suicide was higher among gay, lesbian, and bisexual students (42.8%) than heterosexual students (14.8%) and not sure students (31.9%) and higher among not sure students (31.9%) than heterosexual students (14.8%). Among female students, the prevalence was higher among lesbian and bisexual students (46.6%) than heterosexual students (19.6%) and not sure students (32.6%) and higher among not sure students (32.6%) than heterosexual students (19.6%). Among male students, the prevalence was higher among gay and bisexual students (32.7%) and not sure students (30.9%) than heterosexual students (10.6%). The prevalence also was higher among heterosexual female students (19.6%) than heterosexual male students (10.6%) and higher among lesbian and bisexual female students (46.6%) than gay and bisexual male students (32.7%).

Across 24 states, the prevalence of having seriously considered attempting suicide ranged from 10.4% to 16.5% (median: 12.8%) among heterosexual students; from 32.6% to 55.4% (median: 42.1%) among gay, lesbian, and bisexual students; and from 23.3% to 44.0% (median: 30.8%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 8.4% to 15.4% (median: 11.6%) among heterosexual students; from 27.0% to 43.4% (median: 38.4%) among gay, lesbian, and bisexual students; and from 17.5% to 39.9% (median: 29.2%) among not sure students.

Nationwide, 19.7% of students who had sexual contact with only the opposite sex, 44.5% of students who had sexual contact with only the same sex or with both sexes, and 12.0% of students who had no sexual contact had seriously considered attempting suicide. The prevalence of having seriously considered attempting suicide was higher among students who had sexual contact with only the same sex or with both sexes (44.5%) than students who had sexual contact with only the opposite sex (19.7%) and students who had no sexual contact (12.0%) and higher among students who had sexual contact with only the opposite sex (19.7%) than students who had no sexual contact (12.0%). Among female students, the prevalence was higher among those who had sexual contact with only females and with both sexes (45.6%) than those who had sexual contact with only males (26.2%) and those who had no sexual contact (16.5%) and higher among those who had sexual contact with only males (26.2%) than those who had no sexual contact (16.5%). Among male students, the prevalence was higher among those who had sexual contact with only males and with both sexes (41.2%) than those who had sexual contact with only females (14.6%) and those who had no sexual contact (7.3%) and higher among those who had sexual contact with only females (14.6%) than those who had no sexual contact (7.3%). The prevalence also was higher among female students who had sexual contact with only males (26.2%) than male students who had sexual contact with only females (14.6%) and higher among female students who had no sexual contact (16.5%) than male students who had no sexual contact (7.3%).

Across 22 states, the prevalence of having seriously considered attempting suicide ranged from 14.3% to 23.3% (median: 17.0%) among students who had sexual contact with only the opposite sex, from 32.0% to 55.0% (median: 41.5%) among students who had sexual contact with only the same sex or with both sexes, and from 7.5% to 14.7% (median: 10.2%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 10.5% to 19.5% (median: 15.2%) among students who had sexual contact with only the opposite sex, from 25.8% to 44.6% (median: 35.0%) among students who had sexual contact with only the same sex or with both sexes, and from 5.7% to 14.6% (median: 10.8%) among students who had no sexual contact.

Made a Suicide Plan

During the 12 months before the survey, 14.6% of all students; 11.9% of heterosexual students; 38.2% of gay, lesbian, and bisexual students; and 27.9% of not sure students had made a plan about how they would attempt suicide (Table 26). The prevalence of having made a suicide plan was higher among gay, lesbian, and bisexual students (38.2%) than heterosexual students (11.9%) and not sure students (27.9%) and higher among not sure students (27.9%) than heterosexual students (11.9%). Among female students, the prevalence was higher among lesbian and bisexual students (42.0%) than heterosexual students (15.7%) and not sure students (29.3%) and higher among not sure students (29.3%) than heterosexual students (15.7%). Among male students, the prevalence was higher among gay and bisexual students (27.0%) and not sure students (23.6%) than heterosexual students (8.6%). The prevalence also was higher among heterosexual female students (15.7%) than heterosexual male students (8.6%) and higher among lesbian and bisexual female students (42.0%) than gay and bisexual male students (27.0%).

Across 23 states, the prevalence of having made a suicide plan ranged from 8.3% to 15.4% (median: 11.3%) among heterosexual students; from 29.0% to 51.9% (median: 37.4%) among gay, lesbian, and bisexual students; and from 18.8% to 40.8% (median: 27.7%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 6.8% to 15.4% (median: 11.0%) among heterosexual students; from 25.3% to 44.3% (median: 31.8%) among gay, lesbian, and bisexual students; and from 8.5% to 39.0% (median: 26.3%) among not sure students.

Nationwide, 15.6% of students who had sexual contact with only the opposite sex, 39.6% of students who had sexual contact with only the same sex or with both sexes, and 10.1% of students who had no sexual contact had made a suicide plan. The prevalence of having made a suicide plan was higher among students who had sexual contact with only the same sex or with both sexes (39.6%) than students who had sexual contact with only the opposite sex (15.6%) and students who had no sexual contact (10.1%) and higher among students who had sexual contact with only the opposite sex (15.6%) than students who had no sexual contact (10.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (41.5%) than those who had sexual contact with only males (21.2%) and those who had no sexual contact (13.7%) and higher among those who had sexual contact with only males (21.2%) than those who had no sexual contact (13.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (33.8%) than those who had sexual contact with only females (11.2%) and those who had no sexual contact (6.3%) and higher among those who had sexual contact with only females (11.2%) than those who had no sexual contact (6.3%). The prevalence also was higher among female students who had sexual contact with only males (21.2%) than male students who had sexual contact with only females (11.2%) and higher among female students who had no sexual contact (13.7%) than male students who had no sexual contact (6.3%).

Across 21 states, the prevalence of having made a suicide plan ranged from 11.7% to 19.8% (median: 15.0%) among students who had sexual contact with only the opposite sex, from 24.9% to 44.4% (median: 35.7%) among students who had sexual contact with only the same sex or with both sexes, and from 6.6% to 12.8% (median: 9.0%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 9.5% to 18.9% (median: 13.3%) among students who had sexual contact with only the opposite sex, from 18.2% to 37.6% (median: 30.9%) among students who had sexual contact with only the same sex or with both sexes, and from 4.6% to 12.9% (median: 9.8%) among students who had no sexual contact.

Attempted Suicide

Nationwide, 8.6% of all students; 6.4% of heterosexual students; 29.4% of gay, lesbian, and bisexual students; and 13.7% of not sure students had attempted suicide one or more times during the 12 months before the survey (Table 27). The prevalence of having attempted suicide was higher among gay, lesbian, and bisexual students (29.4%) than heterosexual students (6.4%) and not sure students (13.7%) and higher among not sure students (13.7%) than heterosexual students (6.4%). Among female students, the prevalence was higher among lesbian and bisexual students (32.8%) than heterosexual students (8.4%) and not sure students (11.7%). Among male students, the prevalence was higher among gay and bisexual students (19.4%) and not sure students (16.0%) than heterosexual students (4.5%). The prevalence also was higher among heterosexual female students (8.4%) than heterosexual male students (4.5%) and higher among lesbian and bisexual female students (32.8%) than gay and bisexual male students (19.4%).

Across 23 states, the prevalence of having attempted suicide ranged from 3.8% to 9.5% (median: 6.8%) among heterosexual students; from 19.7% to 37.4% (median: 26.5%) among gay, lesbian, and bisexual students; and from 9.4% to 27.8% (median: 18.0%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 4.3% to 15.9% (median: 7.1%) among heterosexual students; from 20.7% to 37.8% (median: 26.1%) among gay, lesbian, and bisexual students; and from 11.8% to 40.8% (median: 19.3%) among not sure students.

Nationwide, 9.7% of students who had sexual contact with only the opposite sex, 27.6% of students who had sexual contact with only the same sex or with both sexes, and 4.2% of students who had no sexual contact had attempted suicide. The prevalence of having attempted suicide was higher among students who had sexual contact with only the same sex or with both sexes (27.6%) than students who had sexual contact with only the opposite sex (9.7%) and students who had no sexual contact (4.2%) and higher among students who had sexual contact with only the opposite sex (9.7%) than students who had no sexual contact (4.2%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (31.0%) than those who had sexual contact with only males (13.1%) and those who had no sexual contact (6.1%) and higher among those who had sexual contact with only males (13.1%) than those who had no sexual contact (6.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (17.0%) than those who had sexual contact with only females (6.9%) and those who had no sexual contact (2.3%) and higher among those who had sexual contact with only females (6.9%) than those who had no sexual contact (2.3%). The prevalence also was higher among female students who had sexual contact with only males (13.1%) than male students who had sexual contact with only females (6.9%), higher among female students who had sexual contact with only females or with both sexes (31.0%) than male students who had sexual contact with only males or with both sexes (17.0%), and higher among female students who had no sexual contact (6.1%) than male students who had no sexual contact (2.3%).

Across 21 states, the prevalence of having attempted suicide ranged from 6.2% to 13.5% (median: 9.7%) among students who had sexual contact with only the opposite sex, from 18.9% to 40.3% (median: 28.7%) among students who had sexual contact with only the same sex or with both sexes, and from 2.3% to 6.2% (median: 4.2%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 7.4% to 18.9% (median: 9.7%) among students who had sexual contact with only the opposite sex, from 19.8% to 42.6% (median: 28.6%) among students who had sexual contact with only the same sex or with both sexes, and from 1.9% to 12.5% (median: 5.6%) among students who had no sexual contact.

Suicide Attempt Treated by a Doctor or Nurse

Nationwide, 2.8% of all students; 2.0% of heterosexual students; 9.4% of gay, lesbian, and bisexual students; and 4.7% of not sure students nationwide had made a suicide attempt during the 12 months before the survey that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse (Table 28). The prevalence of having made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse was higher among gay, lesbian, and bisexual students (9.4%) than heterosexual students (2.0%) and not sure students (4.7%) and higher among not sure students (4.7%) than heterosexual students (2.0%). Among female students, the prevalence was higher among lesbian and bisexual students (10.3%) than heterosexual students (2.6%) and not sure students (3.8%). Among male students, the prevalence was higher among gay and bisexual students (7.0%) than heterosexual students (1.5%). The prevalence also was higher among heterosexual female students (2.6%) than heterosexual male students (1.5%).

Across 21 states, the prevalence of having made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse ranged from 1.1% to 9.0% (median: 2.3%) among heterosexual students; from 5.8% to 15.5% (median: 9.3%) among gay, lesbian, and bisexual students; and from 1.6% to 12.3% (median: 7.5%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 1.3% to 6.1% (median: 2.5%) among heterosexual students; from 4.1% to 15.9% (median: 11.2%) among gay, lesbian, and bisexual students; and from 0.0% to 19.5% (median: 8.7%) among not sure students.

Nationwide, 3.4% of students who had sexual contact with only the opposite sex, 11.0% of students who had sexual contact with only the same sex or with both sexes, and 0.9% of students who had no sexual contact nationwide had made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse. The prevalence of having made a suicide attempt that resulted in an injury, poisoning, or over dose that had to be treated by a doctor or nurse was higher among students who had sexual contact with only the same sex or with both sexes (11.0%) than students who had sexual contact with only the opposite sex (3.4%) and students who had no sexual contact (0.9%) and higher among students who had sexual contact with only the opposite sex (3.4%) than students who had no sexual contact (0.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (12.4%) than those who had sexual contact with only males (4.2%) and those who had no sexual contact (1.3%) and higher among those who had sexual contact with only males (4.2%) than those who had no sexual contact (1.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (2.8%) and those who had sexual contact with only males or with both sexes (6.5%) than those who had no sexual contact (0.4%). The prevalence also was higher among female students who had sexual contact with only females or with both sexes (12.4%) than male students who had sexual contact with only males or with both sexes (6.5%) and higher among female students who had no sexual contact (1.3%) than male students who had no sexual contact (0.4%).

Across 20 states, the prevalence of having made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse ranged from 2.1% to 10.3% (median: 3.3%) among students who had sexual contact with only the opposite sex, from 6.1% to 19.6% (median: 12.7%) among students who had sexual contact with only the same sex or with both sexes, and from 0.4% to 6.2% (median: 1.1%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 2.2% to 6.4% (median: 3.4%) among students who had sexual contact with only the opposite sex, from 3.8% to 17.4% (median: 11.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.2% to 3.4% (median: 1.5%) among students who had no sexual contact.

Tobacco Use

Ever Tried Cigarette Smoking

Nationwide, 32.3% of all students; 30.5% of heterosexual students; 50.4% of gay, lesbian, and bisexual students; and 39.5% of not sure students had ever tried cigarette smoking (even one or two puffs) (i.e., ever tried cigarette smoking) (Table 29). The prevalence of having ever tried cigarette smoking was higher among gay, lesbian, and bisexual students (50.4%) than heterosexual students (30.5%) and not sure students (39.5%) and higher among not sure students (39.5%) than heterosexual students (30.5%). Among female students, the prevalence was higher among lesbian and bisexual students (53.3%) than heterosexual students (27.1%) and not sure students (40.5%) and higher among not sure students (40.5%) than heterosexual students (27.1%). Among male students, the prevalence was higher among gay and bisexual students (43.0%) than heterosexual students (33.5%). The prevalence also was higher among heterosexual male students (33.5%) than heterosexual female students (27.1%) and higher among lesbian and bisexual female students (53.3%) than gay and bisexual male students (43.0%).

Across 20 states, the prevalence of having ever tried cigarette smoking ranged from 19.8% to 45.8% (median: 32.3%) among heterosexual students; from 36.0% to 64.5% (median: 56.2%) among gay, lesbian, and bisexual students; and from 22.0% to 56.7% (median: 37.7%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 19.2% to 32.1% (median: 24.2%) among heterosexual students; from 28.7% to 53.3% (median: 42.8%) among gay, lesbian, and bisexual students; and from 20.4% to 46.8% (median: 31.6%) among not sure students.

Nationwide, 46.0% of students who had sexual contact with only the opposite sex, 63.2% of students who had sexual contact with only the same sex or with both sexes, and 14.6% of students who had no sexual contact had ever tried cigarette smoking. The prevalence of having ever tried cigarette smoking was higher among students who had sexual contact with only the same sex or with both sexes (63.2%) than students who had sexual contact with only the opposite sex (46.0%) and students who had no sexual contact (14.6%) and higher among students who had sexual contact with only the opposite sex (46.0%) than students who had no sexual contact (14.6%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (63.7%) than those who had sexual contact with only males (43.0%) and those who had no sexual contact (14.2%) and higher among those who had sexual contact with only males (43.0%) than those who had no sexual contact (14.2%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (61.6%) than those who had sexual contact with only females (48.3%) and those who had no sexual contact (14.9%) and higher among those who had sexual contact with only females (48.3%) than those who had no sexual contact (14.9%). The prevalence also was higher among male students who had sexual contact with only females (43.0%) than female students who had sexual contact with only males (43.0%).

Across 18 states, the prevalence of having ever tried cigarette smoking ranged from 30.6% to 59.8% (median: 46.4%) among students who had sexual contact with only the opposite sex, from 51.6% to 76.6% (median: 66.1%) among students who had sexual contact with only the same sex or with both sexes, and from 8.4% to 23.8% (median: 15.1%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 27.9% to 47.9% (median: 35.5%) among students who had sexual contact with only the opposite sex, from 37.2% to 61.4% (median: 49.3%) among students who had sexual contact with only the same sex or with both sexes, and from 8.2% to 20.9% (median: 12.1%) among students who had no sexual contact.

Smoked a Whole Cigarette Before Age 13 Years

Nationwide, 6.6% of all students; 5.8% of heterosexual students; 12.8% of gay, lesbian, and bisexual students; and 10.9% of not sure students had smoked a whole cigarette for the first time before age 13 years (Table 30). The prevalence of having smoked a whole cigarette before age 13 years was higher among gay, lesbian, and bisexual students (12.8%) and not sure students (10.9%) than heterosexual students (5.8%). Among female students, the prevalence was higher among lesbian and bisexual students (12.8%) and not sure students (8.9%) than heterosexual students (3.7%). The prevalence also was higher among heterosexual male students (7.7%) than heterosexual female students (3.7%).

Across 23 states, the prevalence of having smoked a whole cigarette before age 13 years ranged from 3.7% to 11.4% (median: 6.1%) among heterosexual students; from 8.3% to 28.8% (median: 14.7%) among gay, lesbian, and bisexual students; and from 5.5% to 27.6% (median: 12.9%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 2.7% to 11.9% (median: 4.8%) among heterosexual students; from 7.8% to 24.5% (median: 11.3%) among gay, lesbian, and bisexual students; and from 4.3% to 21.5% (median: 10.4%) among not sure students.

Nationwide, 9.0% of students who had sexual contact with only the opposite sex, 16.4% of students who had sexual contact with only the same sex or with both sexes, and 2.3% of students who had no sexual contact had smoked a whole cigarette before age 13 years. The prevalence having smoked a whole cigarette before age 13 years was higher among students who had sexual contact with only the same sex or with both sexes (16.4%) than students who had sexual contact with only the opposite sex (9.0%) and students who had no sexual contact (2.3%) and higher among students who had sexual contact with only the opposite sex (9.0%) than students who had no sexual contact (2.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (15.2%) than those who had sexual contact with only males (6.1%) and those who had no sexual contact (1.9%) and higher among those who had sexual contact with only males (6.1%) than those who had no sexual contact (1.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.0%) than those who had sexual contact with only females (11.3%) and those who had no sexual contact (2.7%) and higher among those who had sexual contact with only females (11.3%) than those who had no sexual contact (2.7%). The prevalence also was higher among male students who had sexual contact with only females (11.3%) than female students who had sexual contact with only males (6.1%).

Across 21 states, the prevalence of having smoked a whole cigarette before age 13 years ranged from 5.7% to 17.0% (median: 9.2%) among students who had sexual contact with only the opposite sex, from 11.5% to 34.6% (median: 21.7%) among students who had sexual contact with only the same sex or with both sexes, and from 1.0% to 4.9% (median: 2.3%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 4.6% to 12.5% (median: 8.0%) among students who had sexual contact with only the opposite sex, from 8.9% to 21.7% (median: 14.5%) among students who had sexual contact with only the same sex or with both sexes, and from 0.7% to 5.1% (median: 1.9%) among students who had no sexual contact.

Current Cigarette Use

Nationwide, 10.8% of all students; 9.8% of heterosexual students; 19.2% of gay, lesbian, and bisexual students; and 14.7% of not sure students had smoked cigarettes on at least 1 day during the 30 days before the survey (i.e., current cigarette use) (Table 31). The prevalence of current cigarette use was higher among gay, lesbian, and bisexual students (19.2%) than heterosexual students (9.8%). Among female students, the prevalence was higher among lesbian and bisexual students (20.7%) than heterosexual students (7.9%) and not sure students (10.5%). The prevalence also was higher among heterosexual male students (11.5%) than heterosexual female students (7.9%).

Across 25 states, the prevalence of current cigarette use ranged from 3.5% to 16.3% (median: 9.1%) among heterosexual students; from 14.3% to 34.2% (median: 20.8%) among gay, lesbian, and bisexual students; and from 0.7% to 34.7% (median: 14.9%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 3.2% to 8.8% (median: 4.8%) among heterosexual students; from 8.6% to 24.5% (median: 12.7%) among gay, lesbian, and bisexual students; and from 6.4% to 19.8% (median: 11.4%) among not sure students.

Nationwide, the prevalence of current cigarette use was 16.3% among students who had sexual contact with only the opposite sex, 26.6% among students who had sexual contact with only the same sex or with both sexes, and 3.3% among students who had no sexual contact. The prevalence of current cigarette use was higher among students who had sexual contact with only the same sex or with both sexes (26.6%) than students who had sexual contact with only the opposite sex (16.3%) and students who had no sexual contact (3.3%) and higher among students who had sexual contact with only the opposite sex (16.3%) than students who had no sexual contact (3.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (24.4%) than those who had sexual contact with only males (14.4%) and those who had no sexual contact (2.9%) and higher among those who had sexual contact with only males (14.4%) than those who had no sexual contact (2.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (33.3%) than those who had sexual contact with only females (17.8%) and those who had no sexual contact (3.7%) and higher among those who had sexual contact with only females (17.8%) than those who had no sexual contact (3.7%). The prevalence also was higher among male students who had sexual contact with only females (17.8%) than female students who had sexual contact with only male students (14.4%) and higher among male students who had sexual contact with only male students or with both sexes (33.3%) than female students who had sexual contact with only female students or with both sexes (24.4%).

Across 23 states, the prevalence of current cigarette use ranged from 5.8% to 25.9% (median: 15.3%) among students who had sexual contact with only the opposite sex, from 23.2% to 47.2% (median: 30.6%) among students who had sexual contact with only the same sex or with both sexes, and from 0.7% to 5.2% (median: 2.5%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 5.0% to 15.7% (median: 8.1%) among students who had sexual contact with only the opposite sex, from 10.9% to 23.9% (median: 16.7%) among students who had sexual contact with only the same sex or with both sexes, and from 0.6% to 2.8% (median: 1.4%) among students who had no sexual contact.

Current Frequent Cigarette Use

Nationwide, 3.4% of all students; 2.7% of heterosexual students; 7.3% of gay, lesbian, and bisexual students; and 8.2% of not sure students had smoked cigarettes 20 or more days during the 30 days before the survey (i.e., current frequent cigarette use) (Table 32). The prevalence of current frequent cigarette use was higher among gay, lesbian, and bisexual students (7.3%) and not sure students (8.2%) than heterosexual students (2.7%). Among female students, the prevalence was higher among lesbian and bisexual students (7.7%) than heterosexual students (2.4%). Among male students, the prevalence was higher among not sure students (13.2%) than heterosexual students (3.0%). The prevalence also was higher among not sure male students (13.2%) than not sure female students (4.3%).

Across 25 states, the prevalence of current frequent cigarette use ranged from 1.0% to 6.5% (median: 2.4%) among heterosexual students; from 0.9% to 13.4% (median: 6.4%) among gay, lesbian, and bisexual students; and from 0.2% to 19.1% (median: 6.1%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 0.4% to 1.6% (median: 1.0%) among heterosexual students; from 0.0% to 7.8% (median: 2.6%) among gay, lesbian, and bisexual students; and from 1.2% to 12.4% (median: 3.6%) among not sure students.

Nationwide, the prevalence of current frequent cigarette use was 5.0% among students who had sexual contact with only the opposite sex, 14.1% among students who had sexual contact with only the same sex or with both sexes, and 0.3% among students who had no sexual contact. The prevalence of current frequent cigarette use was higher among students who had sexual contact with only the same sex or with both sexes (14.1%) than students who had sexual contact with only the opposite sex (5.0%) and students who had no sexual contact (0.3%) and higher among students who had sexual contact with only the opposite sex (5.0%) than students who had no sexual contact (0.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (11.6%) than those who had sexual contact with only males (4.6%) and those who had no sexual contact (0.4%) and higher among those who had sexual contact with only males (4.6%) than those who had no sexual contact (0.4%). Among male students, the prevalence was higher among those who had sexual contact with only males (21.9%) than those who had sexual contact with only females (5.2%) and those who had no sexual contact (0.2%) and higher among those who had sexual contact with only females (5.2%) than those who had no sexual contact (0.2%). The prevalence also was higher among male students who had sexual contact with only males or with both sexes (21.9%) than female students who had sexual contact with only females or with both sexes (11.6%).

Across 23 states, the prevalence of current frequent cigarette use ranged from 1.4% to 10.2% (median: 4.3%) among students who had sexual contact with only the opposite sex, from 5.9% to 18.9% (median: 12.0%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 1.3% (median: 0.5%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 0.8% to 3.0% (median: 1.9%) among students who had sexual contact with only the opposite sex, from 0.5% to 7.6% (median: 5.5%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.5% (median: 0.1%) among students who had no sexual contact.

Smoked More Than 10 Cigarettes per Day

Among the students nationwide who currently smoked cigarettes, 7.9% of all those students; 6.3% of the heterosexual students; 7.7% of the gay, lesbian, and bisexual students; and 27.7% of the not sure students had smoked more than 10 cigarettes per day on the days they smoked during the 30 days before the survey (Table 33). The prevalence of having smoked more than 10 cigarettes per day was higher among not sure students (27.7%) than heterosexual students (6.3%) and gay, lesbian, and bisexual students (7.7%).

Across 19 states, the prevalence of having smoked more than 10 cigarettes per day on the days they smoked ranged from 1.2% to 14.6% (median: 7.1%) among heterosexual students; from 5.7% to 17.0% (median: 8.6%) among gay, lesbian, and bisexual students; and from 15.6% to 32.8% (median: 28.9%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 0.0% to 12.8% (median: 6.2%) among heterosexual students. The range and median are not available for gay, lesbian, and bisexual students and not sure students because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Among the students nationwide who currently smoked cigarettes, 6.5% of the students who had sexual contact with only the opposite sex, 17.1% of the students who had sexual contact with only the same sex or with both sexes, and 1.9% of the students who had no sexual contact had smoked more than 10 cigarettes per day on the days they smoked. The prevalence of having smoked more than 10 cigarettes per day was higher among students who had sexual contact with only the same sex or with both sexes (17.1%) than students who had sexual contact with only the opposite sex (6.5%) and students who had no sexual contact (1.9%) and higher among students who had sexual contact with only the opposite sex (6.5%) than students who had no sexual contact (1.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (12.0%) than those who had sexual contact with only males (4.1%) and those who had no sexual contact (1.4%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (29.5%) than those who had sexual contact with only females (8.0%) and those who had no sexual contact (2.2%) and higher among those who had sexual contact with only females (8.0%) than those who had no sexual contact (2.2%). The prevalence also was higher among male students who had sexual contact with only males or with both sexes (29.5%) than female students who had sexual contact with only females or with both sexes (12.0%).

Across 18 states, the prevalence of having smoked more than 10 cigarettes per day on the days they smoked ranged from 0.9% to 12.7% (median: 7.2%) among students who had sexual contact with only the opposite sex, from 7.4% to 24.5% (median: 16.6%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 13.3% (median: 3.5%) among students who had no sexual contact. Across 13 large urban school districts, the prevalence ranged from 0.5% to 14.6% (median: 4.8%) among students who had sexual contact with only the opposite sex. The range and median are not available for students who had sexual contact with only the same sex or with both sexes and students who had no sexual contact because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Currently Smoked Cigarettes Daily

Nationwide, 2.3% of all students; 1.9% of heterosexual students; 4.0% of gay, lesbian, and bisexual students; and 7.0% of not sure students had smoked cigarettes on all 30 days during the 30 days before the survey (i.e., currently smoked cigarettes daily) (Table 34). The prevalence of having currently smoked cigarettes daily was higher among gay, lesbian, and bisexual students (4.0%) and not sure students (7.0%) than heterosexual students (1.9%). Among female students, the prevalence was higher among lesbian and bisexual students (4.2%) than heterosexual students (1.7%). Among male students, the prevalence was higher among not sure students (12.2%) than heterosexual students (2.0%) and gay and bisexual students (3.5%). The prevalence also was higher among not sure male students (12.2%) than not sure female students (3.4%).

Across 25 states, the prevalence of having currently smoked cigarettes daily ranged from 0.8% to 4.5% (median: 1.8%) among heterosexual students; from 0.9% to 10.7% (median: 4.6%) among gay, lesbian, and bisexual students; and from 0.2% to 13.8% (median: 5.5%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 0.3% to 1.2% (median: 0.7%) among heterosexual students; from 0.0% to 6.0% (median: 1.7%) among gay, lesbian, and bisexual students; and from 0.7% to 12.0% (median: 3.1%) among not sure students.

Nationwide, 3.4% of students who had sexual contact with only the opposite sex, 9.6% of students who had sexual contact with only the same sex or with both sexes, and 0.1% of students who had no sexual contact currently smoked cigarettes daily. The prevalence of having currently smoked cigarettes daily was higher among students who had sexual contact with only the same sex or with both sexes (9.6%) than students who had sexual contact with only the opposite sex (3.4%) and students who had no sexual contact (0.1%) and higher among students who had sexual contact with only the opposite sex (3.4%) than students who had no sexual contact (0.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (7.3%) than those students who had sexual contact with only males (3.1%) and those who had no sexual contact (0.2%) and higher among those who had sexual contact with only males (3.1%) than those who had no sexual contact (0.2%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (16.9%) than those who had sexual contact with only females (3.5%) and those who had no sexual contact (0.1%) and higher among those who had sexual contact with only females (3.5%) than those who had no sexual contact (0.1%). The prevalence also was higher among male students who had sexual contact with only males or with both sexes (16.9%) than female students who had sexual contact with only females or with both sexes (7.3%).

Across 23 states, the prevalence of having smoked cigarettes daily ranged from 0.9% to 7.9% (median: 3.3%) among students who had sexual contact with only the opposite sex, from 4.3% to 16.1% (median: 8.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.7% (median: 0.3%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 0.5% to 2.1% (median: 1.3%) among students who had sexual contact with only the opposite sex, from 0.5% to 7.6% (median: 3.9%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.5% (median: 0.1%) among students who had no sexual contact.

Bought Cigarettes in a Store or Gas Station

Among the students nationwide who currently smoked cigarettes and were aged <18 years, 12.6% of all those students; 13.6% of the heterosexual students; 5.5% of the gay, lesbian, and bisexual students; and 21.0% of the not sure students had usually obtained their own cigarettes by buying them in a store (e.g., convenience store, supermarket, or discount store) or gas station during the 30 days before the survey (Table 35). The prevalence of usually obtaining their own cigarettes by buying them in a store or gas station was higher among heterosexual students (13.6%) and not sure students (21.0%) than gay, lesbian, and bisexual students (5.5%). The prevalence also was higher among heterosexual male students (16.5%) than heterosexual female students (8.6%).

Across 18 states, the prevalence of usually obtaining their own cigarettes by buying them in a store or gas station ranged from 2.3% to 27.0% (median: 13.7%) among heterosexual students and from 0.0% to 17.7% (median: 5.5%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five states had enough students in this subgroup for this variable to produce stable estimates. Across 10 large urban school districts, the prevalence ranged from 13.6% to 68.9% (median: 24.7%) among heterosexual students. The range and median are not available for gay, lesbian, and bisexual students and not sure students because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Among the students nationwide who currently smoked cigarettes and were aged <18 years, 13.9% of the students who had sexual contact with only the opposite sex, 11.7% of the students who had sexual contact with only the same sex or with both sexes, and 7.7% of the students who had no sexual contact had usually obtained their own cigarettes by buying them in a store or gas station. The prevalence of usually obtaining their own cigarettes by buying them in a store or gas station was higher among students who had sexual contact with only the opposite sex (13.9%) than students who had no sexual contact (7.7%). The prevalence also was higher among male students who had sexual contact with only females (17.8%) than female students who had sexual contact with only males (8.1%).

Across 16 states, the prevalence of usually obtaining their own cigarettes by buying them in a store or gas station ranged from 4.0% to 23.7% (median: 13.9%) among students who had sexual contact with only the opposite sex and from 2.6% to 20.6% (median: 8.0%) among students who had sexual contact with only the same sex or with both sexes. The range and median are not available for students who had no sexual contact because less than five states had enough students in this subgroup for this variable to produce stable estimates. Across nine large urban school districts, the prevalence ranged from 14.9% to 36.6% (median: 24.2%) among students who had sexual contact with only the opposite sex. The range and median are not available for students who had sexual contact with only the same sex or with both sexes and students who had no sexual contact because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Bought Cigarettes on the Internet

Among the students nationwide who currently smoked cigarettes and were aged <18 years, 1.0% of all those students; 1.0% of the heterosexual students; 0.3% of the gay, lesbian, and bisexual students; and 1.3% of the not sure students had usually obtained their own cigarettes by buying them on the Internet during the 30 days before the survey (Table 36). The prevalence of usually obtaining their own cigarettes by buying them on the Internet did not vary significantly by sexual identity subgroup.

Across 18 states, the prevalence of usually obtaining their own cigarettes by buying them on the Internet ranged from 0.0% to 3.8% (median: 0.7%) among heterosexual students and from 0.0% to 8.2% (median: 0.9%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five states had enough students in this subgroup for this variable to produce stable estimates. Across 10 large urban school districts, the prevalence ranged from 0.0% to 3.5% (median: 1.7%) among heterosexual students. The range and median are not available for gay, lesbian, and bisexual students and not sure students because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Among the students nationwide who currently smoked cigarettes and were aged <18 years, 1.3% of the students who had sexual contact with only the opposite sex, 0.1% of the students who had sexual contact with only the same sex or with both sexes, and 0.0% of the students who had no sexual contact had usually obtained their own cigarettes by buying them on the Internet. The prevalence of usually obtaining their own cigarettes by buying them on the Internet was higher among students who had sexual contact with only the opposite sex (1.3%) than students who had no sexual contact (0.0%).

Across 16 states, the prevalence of usually obtaining their own cigarettes by buying them on the Internet ranged from 0.0% to 3.7% (median: 0.7%) among students who had sexual contact with only the opposite sex and from 0.0% to 15.7% (median: 2.3%) among students who had sexual contact with only the same sex or with both sexes. The range and median are not available for students who had no sexual contact because less than five states had enough students in this subgroup to produce stable estimates. Across 9 large urban school districts, the prevalence ranged from 0.0% to 3.4% (median: 2.4%) among students who had sexual contact with only the opposite sex. The range and median are not available for students who had sexual contact with only the same sex or with both sexes and students who had no sexual contact because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Tried to Quit Smoking Cigarettes

Among the students nationwide who currently smoked cigarettes, 45.4% of all those students; 44.6% of the heterosexual students; 52.7% of the gay, lesbian, and bisexual students; and 41.0% of the not sure students had tried to quit smoking cigarettes during the 12 months before the survey (Table 37). The prevalence of having tried to quit smoking cigarettes was higher among heterosexual female students (51.0%) than heterosexual male students (40.9%) and higher among lesbian and bisexual female students (60.2%) than gay and bisexual male students (24.8%).

Across 18 states, the prevalence of having tried to quit smoking cigarettes ranged from 33.9% to 59.2% (median: 47.9%) among heterosexual students and from 45.1% to 75.2% (median: 50.8%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five states had enough students in this subgroup for this variable to produce stable estimates. Across 14 large urban school districts, the prevalence ranged from 33.7% to 83.9% (median: 49.8%) among heterosexual students. The range and median are not available for gay, lesbian, and bisexual students and not sure students because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Among the students nationwide who currently smoked cigarettes, 44.8% of the students who had sexual contact with only the opposite sex, 45.9% of the students who had sexual contact with only the same sex or with both sexes, and 51.8% of the students who had no sexual contact had tried to quit smoking cigarettes. The prevalence of having tried to quit smoking cigarettes was higher among female students who had sexual contact with only male students (52.3%) than male students who had sexual contact with only female students (40.1%), higher among female students who had sexual contact with only females or with both sexes (52.8%) than male students who had sexual contact with only males or with both sexes (30.8%), and higher among female students who had no sexual contact (63.0%) than male students who had no sexual contact (42.8%).

Across 16 states, the prevalence of having tried to quit smoking cigarettes ranged from 33.8% to 61.0% (median: 50.5%) among students who had sexual contact with only the opposite sex, from 41.2% to 68.5% (median: 52.3%) among students who had sexual contact with only the same sex or with both sexes, and from 36.9% to 63.1% (median: 51.4%) among students who had no sexual contact. Across 13 large urban school districts, the prevalence ranged from 35.1% to 70.6% (median: 48.4%) among students who had sexual contact with only the opposite sex. The range and median are not available for students who had sexual contact with only the same sex or with both sexes and students who had no sexual contact because less than five large urban school districts had enough students in these subgroups for this variable to produce stable estimates.

Current Smokeless Tobacco Use

Nationwide, 7.3% of all students; 7.2% of heterosexual students; 6.1% of gay, lesbian, and bisexual students; and 10.0% of not sure students had used smokeless tobacco (e.g., chewing tobacco, snuff, or dip) on at least 1 day during the 30 days before the survey (i.e., current smokeless tobacco use) (Table 38). The prevalence of current smokeless tobacco use was higher among heterosexual male students (11.6%) than heterosexual female students (1.9%), higher among gay and bisexual male students (12.1%) than lesbian and bisexual female students (3.3%), and higher among not sure male students (18.0%) than not sure female students (3.7%).

Across 22 states, the prevalence of current smokeless tobacco use ranged from 3.0% to 12.9% (median: 6.3%) among heterosexual students; from 0.0% to 21.0% (median: 9.5%) among gay, lesbian, and bisexual students; and from 2.2% to 17.0% (median: 9.6%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 1.8% to 5.3% (median: 3.1%) among heterosexual students; from 2.9% to 18.6% (median: 10.6%) among gay, lesbian, and bisexual students; and from 3.0% to 28.7% (median: 10.1%) among not sure students.

Nationwide, the prevalence of current smokeless tobacco use was 11.3% among students who had sexual contact with only the opposite sex, 8.7% among students who had sexual contact with only the same sex or with both sexes; and 2.1% among students who had no sexual contact. The prevalence of smokeless tobacco use was higher among students who had sexual contact with only the opposite sex (11.3%) and students who had sexual contact with only the same sex or with both sexes (8.7%) than students who had no sexual contact (2.1%). Among female students, the prevalence was higher among those who had sexual contact with only males (3.4%) and those who had sexual contact with only females or with both sexes (4.9%) than those who had no sexual contact (0.4%). Among male students, the prevalence was higher among those who had sexual contact with only females (17.4%) and those who had sexual contact with only males or with both sexes (20.2%) than those who had no sexual contact (3.9%). The prevalence also was higher among male students who had sexual contact with only females (17.4%) than female students who had sexual contact with only males (3.4%), higher among male students who had sexual contact with only males or with both sexes (20.2%) than female students who had sexual contact with only females or with both sexes (4.9%), and higher among male students who had no sexual contact (3.9%) than female students who had no sexual contact (0.4%).

Across 20 states, the prevalence of current smokeless tobacco use ranged from 4.1% to 19.5% (median: 10.0%) among students who had sexual contact with only the opposite sex, from 4.5% to 24.8% (median: 12.9%) among students who had sexual contact with only the same sex or with both sexes, and from 0.6% to 4.2% (median: 1.6%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 2.6% to 7.6% (median: 4.2%) among students who had sexual contact with only the opposite sex, from 5.5% to 22.0% (median: 11.9%) among students who had sexual contact with only the same sex or with both sexes, and from 0.1% to 1.2% (median: 0.5%) among students who had no sexual contact.

Current Cigar Use

Nationwide, 10.3% of all students; 9.8% of heterosexual students; 13.4% of gay, lesbian, and bisexual students; and 16.7% of not sure students had smoked cigars, cigarillos, or little cigars on at least 1 day during the 30 days before the survey (i.e., current cigar use) (Table 39). The prevalence of current cigar use was higher among gay, lesbian, and bisexual students (13.4%) and not sure students (16.7%) than heterosexual students (9.8%). Among female students, the prevalence was higher among lesbian and bisexual students (11.2%) than heterosexual students (5.4%). Among male students, the prevalence was higher among not sure students (25.1%) than heterosexual students (13.5%). The prevalence also was higher among heterosexual male students (13.5%) than heterosexual female students (5.4%) and higher among not sure male students (25.1%) than not sure female students (10.2%).

Across 21 states, the prevalence of current cigar use ranged from 5.7% to 12.4% (median: 9.8%) among heterosexual students; from 6.6% to 28.5% (median: 16.1%) among gay, lesbian, and bisexual students; and from 3.2% to 26.9% (median: 15.3%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 2.9% to 11.1% (median: 6.8%) among heterosexual students; from 7.8% to 28.5% (median: 17.3%) among gay, lesbian, and bisexual students; and from 4.8% to 25.1% (median: 14.9%) among not sure students.

Nationwide, the prevalence of current cigar use was 15.5% among students who had sexual contact with only the opposite sex (15.5%), 19.4% among students who had sexual contact with only the same sex or with both sexes, and 3.0% among students who had no sexual contact. The prevalence of current cigar use was higher among students who had sexual contact with only the same sex or with both sexes (19.4%) than students who had sexual contact with only the opposite sex (15.5%) and students who had no sexual contact (3.0%) and higher among students who had sexual contact with only the opposite sex (15.5%) than students who had no sexual contact (3.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (16.4%) than those who had sexual contact with only males (9.2%) and those who had no sexual contact (1.5%) and higher among those who had sexual contact with only males (9.2%) than those who had no sexual contact (1.5%). Among male students, the prevalence was higher among those who had sexual contact with only females (20.4%) and those who had sexual contact with only males or with both sexes (28.5%) than those who had no sexual contact (4.5%). The prevalence also was higher among male students who had sexual contact with only female students (20.4%) than female students who had sexual contact with only male students (9.2%), higher among male students who had sexual contact with only males or with both sexes (28.5%) than female students who had sexual contact with only females or with both sexes (16.4%) and higher among male students who had no sexual contact (4.5%) than female students who had no sexual contact (1.5%).

Across 19 states, the prevalence of current cigar use ranged from 9.2% to 19.7% (median: 15.0%) among students who had sexual contact with only the opposite sex, from 16.0% to 35.1% (median: 23.9%) among students who had sexual contact with only the same sex or with both sexes, and from 1.4% to 4.5% (median: 2.5%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 5.3% to 18.9% (median: 11.7%) among students who had sexual contact with only the opposite sex, from 13.4% to 30.4% (median: 22.6%) among students who had sexual contact with only the same sex or with both sexes, and from 1.0% to 3.9% (median: 1.7%) among students who had no sexual contact.

Ever Used Electronic Vapor Products

Nationwide, 44.9% of all students; 44.2% of heterosexual students; 53.5% of gay, lesbian, and bisexual students; and 43.6% of not sure students had ever used electronic vapor products (including e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens) (i.e., ever used electronic vapor products) (Table 40). The prevalence of having ever used electronic vapor products was higher among gay, lesbian, and bisexual students (53.5%) than heterosexual students (44.2%) and not sure students (43.6%). Among female students, the prevalence was higher among lesbian and bisexual students (58.9%) than heterosexual students (41.4%) and not sure students (46.4%). The prevalence also was higher among heterosexual male students (46.5%) than heterosexual female students (41.4%) and higher among lesbian and bisexual female students (58.9%) than gay and bisexual male students (40.1%).

Across 21 states, the prevalence of having ever used electronic vapor products ranged from 30.0% to 53.0% (median: 44.6%) among heterosexual students; from 38.3% to 70.2% (median: 52.3%) among gay, lesbian, and bisexual students; and from 23.6% to 66.1% (median: 40.1%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 28.7% to 48.4% (median: 39.0%) among heterosexual students; from 41.5% to 65.5% (median: 53.7%) among gay, lesbian, and bisexual students; and from 25.5% to 47.3% (median: 35.6%) among not sure students.

Nationwide, the prevalence of having ever used electronic vapor products was 62.0% among students who had sexual contact with only the opposite sex, 67.8% among students who had sexual contact with only the same sex or with both sexes, and 24.1% among students who had no sexual contact. The prevalence of having ever used electronic vapor products was higher among students who had sexual contact with only the same sex or with both sexes (67.8%) than students who had sexual contact with only the opposite sex (62.0%) and students who had no sexual contact (24.1%) and higher among students who had sexual contact with only the opposite sex (62.0%) than students who had no sexual contact (24.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (70.0%) than those who had sexual contact with only males (60.4%) and those who had no sexual contact (24.1%) and higher among those who had sexual contact with only males (60.4%) than those who had no sexual contact (24.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (63.2%) and those who had sexual contact with only males or with both sexes (61.4%) than those who had no sexual contact (24.2%).

Across 19 states, the prevalence of having ever used electronic vapor products ranged from 44.3% to 71.8% (median: 61.3%) among students who had sexual contact with only the opposite sex, from 53.8% to 79.2% (median: 67.8%) among students who had sexual contact with only the same sex or with both sexes, and from 11.4% to 36.2% (median: 24.0%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 36.2% to 66.5% (median: 56.1%) among students who had sexual contact with only the opposite sex, from 46.8% to 72.0% (median: 61.3%) among students who had sexual contact with only the same sex or with both sexes, and from 17.9% to 30.1% (median: 23.0%) among students who had no sexual contact.

Current Electronic Vapor Product Use

Nationwide, 24.1% of all students; 23.4% of heterosexual students; 29.2% of gay, lesbian, and bisexual students; and 26.8% of not sure students had used electronic vapor products (including e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens) on at least 1 day during the 30 days before the survey (i.e., current electronic vapor product use) (Table 41). The prevalence of current electronic vapor product use was higher among gay, lesbian, and bisexual students (29.2%) than heterosexual students (23.4%). Among female students, the prevalence was higher among lesbian and bisexual students (31.5%) than heterosexual students (21.0%) and not sure students (22.9%). The prevalence also was higher among heterosexual male students (25.4%) than heterosexual female students (21.0%) and higher among lesbian and bisexual female students (31.5%) than gay and bisexual male students (23.2%).

Across 23 states, the prevalence of current electronic vapor product use ranged from 14.8% to 29.4% (median: 23.3%) among heterosexual students; from 20.9% to 49.5% (median: 35.9%) among gay, lesbian, and bisexual students; and from 11.8% to 43.4% (median: 22.4%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 10.4% to 24.6% (median: 15.8%) among heterosexual students; from 19.7% to 49.0% (median: 26.9%) among gay, lesbian, and bisexual students; and from 9.2% to 32.6% (median: 18.9%) among not sure students.

Nationwide, the prevalence of current electronic vapor product use was 34.8% among students who had sexual contact with only the opposite sex, 40.1% among students who had sexual contact with only the same sex or with both sexes, and 10.8% among students who had no sexual contact. The prevalence of current electronic vapor product use was higher among students who had sexual contact with only the same sex or with both sexes (40.1%) than students who had sexual contact with only the opposite sex (34.8%) and students who had no sexual contact (10.8%) and higher among students who had sexual contact with only the opposite sex (34.8%) than students who had no sexual contact (10.8%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (38.7%) than those who had sexual contact with only males (32.5%) and those who had no sexual contact (10.8%) and higher among those who had sexual contact with only males (32.5%) than those who had no sexual contact (10.8%). Among male students, the prevalence was higher among those who had sexual contact with only females (36.7%) and those who had sexual contact with only males or with both sexes (44.5%) than those who had no sexual contact (10.7%). The prevalence also was higher among male students who had sexual contact with only females (36.7%) than female students who had sexual contact with only males (32.5%).

Across 21 states, the prevalence of current electronic vapor product use ranged from 22.5% to 42.4% (median: 34.8%) among students who had sexual contact with only the opposite sex, from 31.8% to 59.2% (median: 43.3%) among students who had sexual contact with only the same sex or with both sexes, and from 4.5% to 14.0% (median: 10.2%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 13.3% to 36.4% (median: 24.1%) among students who had sexual contact with only the opposite sex, from 23.0% to 41.7% (median: 34.1%) among students who had sexual contact with only the same sex or with both sexes, and from 4.2% to 13.0% (median: 8.8%) among students who had no sexual contact.

Current Cigarette or Cigar Use

Nationwide, 16.0% of all students; 14.7% of heterosexual students; 24.8% of gay, lesbian, and bisexual students; and 21.1% of not sure students reported current cigarette or cigar use (Table 42). The prevalence of current cigarette or cigar use was higher among gay, lesbian, and bisexual students (24.8%) than heterosexual students (14.7%). Among female students, the prevalence was higher among lesbian and bisexual students (24.3%) than heterosexual students (10.6%) and not sure students (13.5%). Among male students, the prevalence was higher among not sure students (31.5%) than heterosexual students (18.2%). The prevalence also was higher among heterosexual male students (18.2%) than heterosexual female students (10.6%) and higher among not sure male students (31.5%) than not sure female students (13.5%).

Across 21 states, the prevalence of current cigarette or cigar use ranged from 8.8% to 21.5% (median: 13.9%) among heterosexual students; from 21.1% to 43.7% (median: 30.2%) among gay, lesbian, and bisexual students; and from 5.8% to 38.2% (median: 20.7%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 5.0% to 14.7% (median: 9.4%) among heterosexual students; from 13.1% to 34.6% (median: 22.7%) among gay, lesbian, and bisexual students; and from 9.0% to 33.7% (median: 19.1%) among not sure students.

Nationwide, the prevalence of current cigarette or cigar use was 23.9% among students who had sexual contact with only the opposite sex, 32.1% among students who had sexual contact with only the same sex or with both sexes, and 4.9% among students who had no sexual contact. The prevalence of current cigarette or cigar use was higher among students who had sexual contact with only the same sex or with both sexes (32.1%) than students who had sexual contact with only the opposite sex (23.9%) and students who had no sexual contact (4.9%) and higher among students who had sexual contact with only the opposite sex (23.9%) than students who had no sexual contact (4.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (28.9%) than those who had sexual contact with only males (19.1%) and those who had no sexual contact (3.8%) and higher among those who had sexual contact with only males (19.1%) than those who had no sexual contact (3.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (41.8%) than those who had sexual contact with only females (27.6%) and those who had no sexual contact (6.2%) and higher among those who had sexual contact with only females (27.6%) than those who had no sexual contact (6.2%). The prevalence also was higher among male students who had sexual contact with only females (27.6%) than female students who had sexual contact with only males (19.1%), higher among male students who had sexual contact with only males or with both sexes (41.8%) than female students who had sexual contact with only females or with both sexes (28.9%) and higher among male students who had no sexual contact (6.2%) than female students who had no sexual contact (3.8%).

Across 19 states, the prevalence of current cigarette or cigar use ranged from 14.5% to 34.2% (median: 23.2%) among students who had sexual contact with only the opposite sex, from 24.7% to 53.8% (median: 41.7%) among students who had sexual contact with only the same sex or with both sexes, and from 2.3% to 7.3% (median: 4.0%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 8.9% to 25.3% (median: 14.5%) among students who had sexual contact with only the opposite sex, from 19.8% to 40.7% (median: 29.7%) among students who had sexual contact with only the same sex or with both sexes, and from 1.2% to 5.5% (median: 2.7%) among students who had no sexual contact.

Current Cigarette, Cigar, or Smokeless Tobacco Use

Nationwide, 18.5% of all students; 17.5% of heterosexual students; 25.7% of gay, lesbian, and bisexual students; and 22.7% of not sure students reported current cigarette, cigar, or smokeless tobacco use (Table 43). The prevalence of current cigarette, cigar, or smokeless tobacco use was higher among gay, lesbian, and bisexual students (25.7%) than heterosexual students (17.5%). Among female students, the prevalence was higher among lesbian and bisexual students (24.9%) than heterosexual students (11.4%) and not sure students (13.7%). Among male students the prevalence was higher among not sure students (35.0%) than heterosexual students (22.8%). The prevalence also was higher among heterosexual male students (22.8%) than heterosexual female students (11.4%) and higher among not sure male students (35.0%) than not sure female students (13.7%).

Across 21 states, the prevalence of current cigarette, cigar, or smokeless tobacco use ranged from 10.8% to 26.9% (median: 16.5%) among heterosexual students; from 22.7% to 48.2% (median: 32.7%) among gay, lesbian, and bisexual students; and from 6.6% to 43.1% (median: 23.6%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 5.8% to 16.0% (median: 10.4%) among heterosexual students; from 13.9% to 37.4% (median: 23.8%) among gay, lesbian, and bisexual students; and from 9.0% to 33.9% (median: 20.3%) among not sure students.

Nationwide, the prevalence of current cigarette, cigar, or smokeless tobacco use was 28.1% among students who had sexual contact with only the opposite sex, 32.9% among students who had sexual contact with only the same sex or with both sexes, and 6.0% among students who had no sexual contact. The prevalence of current cigarette, cigar, or smokeless tobacco use was higher among students who had sexual contact with only the opposite sex (28.1%) and students who had sexual contact with only the same sex or with both sexes (32.9%) than students who had no sexual contact (6.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (29.3%) than those who had sexual contact with only males (20.3%) and those who had no sexual contact (4.0%) and higher among those who had sexual contact with only males (20.3%) than those who had no sexual contact (4.0%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (43.9%) than those who had sexual contact with only females (34.1%) and those who had no sexual contact (8.1%) and higher among those who had sexual contact with only females (34.1%) than those who had no sexual contact (8.1%). The prevalence also was higher among male students who had sexual contact with only females (34.1%) than female students who had sexual contact with only males (20.3%), higher among male students who had sexual contact with only males or with both sexes (43.9%) than female students who had sexual contact with only females or with both sexes (29.3%), and higher among male students who had no sexual contact (8.1%) than female students who had no sexual contact (4.0%).

Across 19 states, the prevalence of current cigarette, cigar, or smokeless tobacco use ranged from 17.7% to 41.0% (median: 26.9%) among students who had sexual contact with only the opposite sex, from 25.7% to 56.4% (median: 44.2%) among students who had sexual contact with only the same sex or with both sexes, and from 2.6% to 9.3% (median: 5.1%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 9.9% to 27.4% (median: 16.0%) among students who had sexual contact with only the opposite sex, from 20.8% to 44.4% (median: 31.0%) among students who had sexual contact with only the same sex or with both sexes, and from 1.6% to 5.9% (median: 2.8%) among students who had no sexual contact.

Current Cigarette, Cigar, Smokeless Tobacco, or Electronic Vapor Product Use

Nationwide, 31.4% of all students; 30.3% of heterosexual students; 40.5% of gay, lesbian, and bisexual students; and 33.7% of not sure students reported current cigarette, cigar, smokeless tobacco, or electronic vapor product use (Table 44). The prevalence of current cigarette, cigar, smokeless tobacco, or electronic vapor product use was higher among gay, lesbian, and bisexual students (40.5%) than heterosexual students (30.3%). Among female students, the prevalence was higher among lesbian and bisexual students (41.1%) than heterosexual students (25.5%) and not sure students (27.7%). The prevalence also was higher among heterosexual male students (34.4%) than heterosexual female students (25.5%) and higher among not sure male students (42.1%) than not sure female students (27.7%).

Across 21 states, the prevalence of current cigarette, cigar, smokeless tobacco, or electronic vapor product use ranged from 22.7% to 38.0% (median: 29.3%) among heterosexual students; from 34.4% to 63.5% (median: 45.5%) among gay, lesbian, and bisexual students; and from 17.3% to 55.4% (median: 32.0%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 18.3% to 30.3% (median: 22.3%) among heterosexual students; from 28.2% to 60.8% (median: 42.4%) among gay, lesbian, and bisexual students; and from 13.4% to 38.5% (median: 31.6%) among not sure students.

Nationwide, the prevalence of current cigarette, cigar, smokeless tobacco, or electronic vapor product use was 45.0% among students who had sexual contact with only the opposite sex, 50.6% among students who had sexual contact with only the same sex or with both sexes, and 13.9% among students who had no sexual contact. The prevalence of current cigarette, cigar, smokeless tobacco, or electronic vapor product use was higher among students who had sexual contact with only the opposite sex (45.0%) and students who had sexual contact with only the same sex or with both sexes (50.6%) than students who had no sexual contact (13.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (48.2%) than those who had sexual contact with only males (40.1%) and those who had no sexual contact (12.7%) and higher among those who had sexual contact with only males (40.1%) than those who had no sexual contact (12.7%). Among male students, the prevalence was higher among those who had sexual contact with only the opposite sex (48.9%) and those who had sexual contact with only males or with both sexes (57.9%) than those who had no sexual contact (15.2%). The prevalence also was higher among male students who had sexual contact with only females (48.9%) than female students who had sexual contact with only males (40.1%) and higher among male students who had no sexual contact (15.2%) than female students who had no sexual contact (12.7%).

Across 19 states, the prevalence of current cigarette, cigar, smokeless tobacco, or electronic vapor product use ranged from 34.5% to 54.4% (median: 43.6%) among students who had sexual contact with only the opposite sex, from 49.3% to 71.8% (median: 57.1%) among students who had sexual contact with only the same sex or with both sexes, and from 7.0% to 16.3% (median: 13.1%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 23.0% to 43.8% (median: 31.3%) among students who had sexual contact with only the opposite sex, from 38.5% to 56.5% (median: 48.4%) among students who had sexual contact with only the same sex or with both sexes, and from 9.4% to 14.3% (median: 10.2%) among students who had no sexual contact.

Alcohol and Other Drug Use

Ever Drank Alcohol

Nationwide, 63.2% of all students; 62.5% of heterosexual students; 75.3% of gay, lesbian, and bisexual students; and 62.7% of not sure students had had at least one drink of alcohol on at least 1 day during their life (i.e., ever drank alcohol) (Table 45). The prevalence of having ever drunk alcohol was higher among gay, lesbian, and bisexual students (75.3%) than heterosexual (62.5%) and not sure students (62.7%). Among female students, the prevalence was higher among lesbian and bisexual students (79.4%) than heterosexual students (63.8%) and not sure students (60.6%). The prevalence also was higher among lesbian and bisexual female students (79.4%) than gay and bisexual male students (64.7%).

Across 17 states, the prevalence of having ever drunk alcohol ranged from 50.4% to 64.4% (median: 59.5%) among heterosexual students; from 65.9% to 82.7% (median: 74.4%) among gay, lesbian, and bisexual students; and from 43.1% to 76.2% (median: 55.0%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 43.1% to 62.3% (median: 53.9%) among heterosexual students; from 57.6% to 79.4% (median: 72.5%) among gay, lesbian, and bisexual students; and from 32.1% to 71.5% (median: 54.2%) among not sure students.

Nationwide, 80.7% of students who had sexual contact with only the opposite sex, 86.7% of students who had sexual contact with only the same sex or with both sexes, and 43.2% of students who had no sexual contact ever drank alcohol. The prevalence of having ever drunk alcohol was higher among students who had sexual contact with only the same sex or with both sexes (86.7%) than students who had sexual contact with only the opposite sex (80.7%) and students who had no sexual contact (43.2%) and higher among students who had sexual contact with only the opposite sex (80.7%) than students who had no sexual contact (43.2%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (88.3%) than those who had sexual contact with only males (83.8%) and those who had no sexual contact (45.2%) and higher among those who had sexual contact with only males (83.8%) than those who had no sexual contact (45.2%). Among male students, the prevalence was higher among those who had sexual contact with only females (78.3%) and those who had sexual contact with only males or with both sexes (82.0%) than those who had no sexual contact (41.1%). The prevalence also was higher among female students who had sexual contact with only males (83.8%) than male students who had sexual contact with only females (78.3%).

Across 16 states, the prevalence of having ever drunk alcohol ranged from 69.8% to 84.0% (median: 78.6%) among students who had sexual contact with only the opposite sex, from 79.2% to 91.0% (median: 84.1%) among students who had sexual contact with only the same sex or with both sexes, and from 31.9% to 46.3% (median: 38.8%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 56.6% to 78.9% (median: 71.5%) among students who had sexual contact with only the opposite sex, from 70.3% to 87.2% (median: 80.0%) among students who had sexual contact with only the same sex or with both sexes, and from 28.8% to 47.3% (median: 38.3%) among students who had no sexual contact.

Drank Alcohol Before Age 13 Years

Nationwide, 17.2% of all students; 16.3% of heterosexual students; 24.5% of gay, lesbian, and bisexual students; and 22.9% of not sure students had drunk alcohol (other than a few sips) for the first time before age 13 years (Table 46). The prevalence of having drunk alcohol for the first time before age 13 years was higher among gay, lesbian, and bisexual students (24.5%) and not sure students (22.9%) than heterosexual students (16.3%). Among female students, the prevalence was higher among lesbian and bisexual students (24.5%) and not sure students (19.4%) than heterosexual students (12.9%). The prevalence also was higher among heterosexual male students (19.3%) than heterosexual female students (12.9%).

Across 25 states, the prevalence of having drunk alcohol for the first time before age 13 years ranged from 9.4% to 19.5% (median: 13.8%) among heterosexual students; from 15.2% to 35.7% (median: 23.7%) among gay, lesbian, and bisexual students; and from 13.2% to 41.0% (median: 20.8%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 13.9% to 19.4% (median: 15.6%) among heterosexual students; from 21.5% to 39.4% (median: 27.2%) among gay, lesbian, and bisexual students; and from 10.3% to 31.5% (median: 24.7%) among not sure students.

Nationwide, 20.5% of students who had sexual contact with only the opposite sex, 32.5% of students who had sexual contact with only the same sex or with both sexes, and 11.4% of students who had no sexual contact had drunk alcohol for the first time before age 13 years. The prevalence of having drunk alcohol for the first time before age 13 years was higher among students who had sexual contact with only the same sex or with both sexes (32.5%) than students who had sexual contact with only the opposite sex (20.5%) and students who had no sexual contact (11.4%) and higher among students who had sexual contact with only the opposite sex (20.5%) than students who had no sexual contact (11.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (30.6%) than those who had sexual contact with only males (15.5%) and those who had no sexual contact (10.4%) and higher among those who had sexual contact with only males (15.5%) than those who had no sexual contact (10.4%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (38.1%) than those who had sexual contact with only females (24.4%) and those who had no sexual contact (12.5%) and higher among those who had sexual contact with only females (24.4%) than those who had no sexual contact (12.5%). The prevalence also was higher among male students who had sexual contact with only females (24.4%) than female students who had sexual contact with only males (15.5%).

Across 23 states, the prevalence of having drunk alcohol for the first time before age 13 years ranged from 12.7% to 24.6% (median: 19.4%) among students who had sexual contact with only the opposite sex, from 17.3% to 41.8% (median: 33.7%) among students who had sexual contact with only the same sex or with both sexes, and from 4.9% to 13.4% (median: 8.8%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 17.2% to 25.7% (median: 20.9%) among students who had sexual contact with only the opposite sex, from 22.0% to 38.8% (median: 31.2%) among students who had sexual contact with only the same sex or with both sexes, and from 9.4% to 14.1% (median: 11.4%) among students who had no sexual contact.

Current Alcohol Use

Nationwide, 32.8% of all students; 32.1% of heterosexual students; 40.5% of gay, lesbian, and bisexual students; and 34.6% of not sure students had had at least one drink of alcohol on a least 1 day during the 30 days before the survey (i.e., current alcohol use) (Table 47). The prevalence of current alcohol use was higher among gay, lesbian, and bisexual students (40.5%) than heterosexual students (32.1%). Among female students, the prevalence was higher among lesbian and bisexual students (41.8%) than heterosexual students (32.3%).

Across 25 states, the prevalence of current alcohol use ranged from 23.1% to 34.2% (median: 28.6%) among heterosexual students; from 27.8% to 50.5% (median: 40.1%) among gay, lesbian, and bisexual students; and from 20.2% to 53.6% (median: 26.8%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 17.7% to 37.4% (median: 23.3%) among heterosexual students; from 21.1% to 51.6% (median: 37.1%) among gay, lesbian, and bisexual students; and from 13.4% to 42.2% (median: 24.3%) among not sure students.

Nationwide, the prevalence of current alcohol use was 48.2% among students who had sexual contact with only the opposite sex, 53.7% among students who had sexual contact with only the same sex or with both sexes, and 15.1% among students who had no sexual contact. The prevalence of current alcohol use was higher among students who had sexual contact with only the same sex or with both sexes (53.7%) than students who had sexual contact with only the opposite sex (48.2%) and students who had no sexual contact (15.1%) and higher among students who had sexual contact with only the opposite sex (48.2%) than students who had no sexual contact (15.1%). Among female students, the prevalence was higher among those who had sexual contact with only the opposite sex (48.6%) and those who had sexual contact with only females or with both sexes (53.6%) than those who had no sexual contact (16.9%). Among male students, the prevalence was higher among those who had sexual contact with only female students (47.9%) and those who had sexual contact with only males or with both sexes (53.9%) than those who had no sexual contact (13.3%). The prevalence also was higher among female students who had no sexual contact (16.9%) than male students who had no sexual contact (13.3%).

Across 23 states, the prevalence of current alcohol use ranged from 35.2% to 49.4% (median: 44.9%) among students who had sexual contact with only the opposite sex, from 42.1% to 65.3% (median: 53.7%) among students who had sexual contact with only the same sex or with both sexes, and from 7.6% to 16.4% (median: 11.4%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 23.0% to 52.7% (median: 36.3%) among students who had sexual contact with only the opposite sex, from 36.2% to 67.6% (median: 48.0%) among students who had sexual contact with only the same sex or with both sexes, and from 6.5% to 23.0% (median: 12.0%) among students who had no sexual contact.

Someone Gave Alcohol to Them

Among the students nationwide who currently drank alcohol, 44.1% of all those students; 45.3% of the heterosexual students; 41.4% of the gay, lesbian, and bisexual students; and 35.2% of the not sure students had usually obtained the alcohol they drank by someone giving it to them during the 30 days before the survey (Table 48). The prevalence of usually obtaining the alcohol they drank by someone giving it to them was higher among heterosexual students (45.3%) than not sure students (35.2%). Among male students, the prevalence was higher among heterosexual students (40.8%) than not sure students (24.7%). The prevalence also was higher among heterosexual female students (50.6%) than heterosexual male students (40.8%).

Across 22 states, the prevalence of usually obtaining the alcohol they drank by someone giving it to them ranged from 32.7% to 47.1% (median: 41.6%) among heterosexual students; from 27.2% to 53.7% (median: 36.5%) among gay, lesbian, and bisexual students; and from 13.6% to 51.6% (median: 30.2%) among not sure students. Across 14 large urban school districts, the prevalence ranged from 29.8% to 46.7% (median: 39.0%) among heterosexual students and from 19.4% to 48.9% (median: 36.4%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the students nationwide who currently drank alcohol, 42.5% of the students who had sexual contact with only the opposite sex, 42.8% of the students who had sexual contact with only the same sex or with both sexes, and 51.3% of the students who had no sexual contact had usually obtained the alcohol they drank by someone giving it to them. The prevalence of usually obtaining the alcohol they drank by someone giving it to them was higher among students who had no sexual contact (51.3%) than students who had sexual contact with only the opposite sex (42.5%) and students who had sexual contact with only the same sex or with both sexes (42.8%). Among female students, the prevalence was higher among those who had no sexual contact (53.3%) than those who had sexual contact with only females or with both sexes (44.7%). Among male students, the prevalence was higher among those who had no sexual contact (48.8%) than those who had sexual contact with only females (38.2%). The prevalence also was higher among female students who had sexual contact with only males (47.9%) than male students who had sexual contact with only females (38.2%).

Across 19 states, the prevalence of usually obtaining the alcohol they drank by someone giving it to them ranged from 30.1% to 44.6% (median: 38.3%) among students who had sexual contact with only the opposite sex, from 21.2% to 54.8% (median: 37.3%) among students who had sexual contact with only the same sex or with both sexes, and from 39.5% to 56.4% (median: 48.5%) among students who had no sexual contact. Across 14 large urban school districts, the prevalence ranged from 21.9% to 45.5% (median: 36.2%) among students who had sexual contact with only the opposite sex, from 23.3% to 51.7% (median: 36.2%) among students who had sexual contact with only the same sex or with both sexes, and from 27.9% to 53.9% (median: 44.8%) among students who had no sexual contact.

Consumed Five or More Drinks in a Row

Nationwide, 17.7% of all students; 17.3% of heterosexual students; 21.8% of gay, lesbian, and bisexual students; and 17.7% of not sure students had had five or more drinks of alcohol in a row (i.e., within a couple of hours) on at least 1 day during the 30 days before the survey (Table 49). The prevalence of having five or more drinks of alcohol in a row was higher among gay, lesbian, and bisexual students (21.8%) than heterosexual students (17.3%). Among female students, the prevalence was higher among lesbian and bisexual students (20.4%) than heterosexual students (16.0%). Among male students, the prevalence was higher among gay and bisexual students (26.2%) than heterosexual students (18.5%). The prevalence also was higher among heterosexual male students (18.5%) than heterosexual female students (16.0%).

Across 25 states, the prevalence of having five or more drinks of alcohol in a row ranged from 11.2% to 19.3% (median: 14.9%) among heterosexual students; from 15.4% to 28.6% (median: 21.5%) among gay, lesbian, and bisexual students; and from 10.1% to 32.5% (median: 17.1%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 6.8% to 15.2% (median: 10.6%) among heterosexual students; from 11.4% to 27.0% (median: 16.1%) among gay, lesbian, and bisexual students; and from 4.2% to 26.1% (median: 12.6%) among not sure students.

Nationwide, 27.5% of students who had sexual contact with only the opposite sex, 29.9% of students who had sexual contact with only the same or both sexes, and 6.3% of students who had no sexual contact had had five or more drinks of alcohol in a row. The prevalence of having five or more drinks of alcohol in a row was higher among students who had sexual contact with only the opposite sex (27.5%) and students who had sexual contact with only the same sex or with both sexes (29.9%) than students who had no sexual contact (6.3%). Among female students, the prevalence was higher among those who had sexual contact with only males (25.9%) and those who had sexual contact with only females or with both sexes (28.4%) than those who had no sexual contact (6.4%). Among male students, the prevalence was higher among those who had sexual contact with only females (28.8%) and those who had sexual contact with only males or with both sexes (34.7%) than those who had no sexual contact (6.2%).

Across 23 states, the prevalence of having five or more drinks of alcohol in a row ranged from 17.7% to 33.0% (median: 24.8%) among students who had sexual contact with only the opposite sex, from 20.6% to 41.1% (median: 33.3%) among students who had sexual contact with only the same sex or with both sexes, and from 2.2% to 6.7% (median: 4.5%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 10.4% to 25.5% (median: 16.9%) among students who had sexual contact with only the opposite sex, from 16.2% to 41.3% (median: 24.0%) among students who had sexual contact with only the same sex or with both sexes, and from 1.6% to 6.3% (median: 3.6%) among students who had no sexual contact.

Largest Number of Drinks in a Row Was 10 or More

Nationwide, 4.3% of all students; 4.4% of heterosexual students; 3.2% of gay, lesbian, and bisexual students; and 7.0% of not sure students reported that the largest number of drinks that they had had in a row (i.e., within a couple of hours) during the 30 days before the survey was 10 or more (Table 50). The prevalence of reporting 10 or more as the largest number of drinks in a row was higher among not sure students (7.0%) than gay, lesbian, and bisexual students (3.2%). Among male students, the prevalence was higher among not sure students (11.4%) than heterosexual students (6.1%) and gay and bisexual students (1.5%) and higher among heterosexual students (6.1%) than gay and bisexual students (1.5%). The prevalence also was higher among heterosexual male students (6.1%) than heterosexual female students (2.4%) and higher among not sure male students (11.4%) than not sure female students (3.5%).

Across 14 states, the prevalence of reporting 10 or more as the largest number of drinks in a row ranged from 2.4% to 7.1% (median: 3.4%) among heterosexual students; from 2.3% to 10.9% (median: 5.2%) among gay, lesbian, and bisexual students; and from 1.7% to 19.0% (median: 4.0%) among not sure students. Across 13 large urban school districts, the prevalence ranged from 0.7% to 3.6% (median: 1.8%) among heterosexual students; from 0.0% to 5.4% (median: 2.9%) among gay, lesbian, and bisexual students; and from 0.3% to 16.4% (median: 4.0%) among not sure students.

Nationwide, 7.4% of students who had sexual contact with only the opposite sex, 9.3% of students who had sexual contact with only the same sex or with both sexes, and 0.8% of students who had no sexual contact reported that the largest number of drinks that they had had in a row was 10 or more. The prevalence of reporting 10 or more as the largest number of drinks in a row was higher among students who had sexual contact with only the opposite sex (7.4%) and students who had sexual contact with only the same sex or with both sexes (9.3%) than students who had no sexual contact (0.8%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (8.5%) than those who had sexual contact with only males (3.9%) and those who had no sexual contact (0.5%) and higher among those who had sexual contact with only males (3.9%) than those who had no sexual contact (0.5%). Among male students, the prevalence was higher among those who had sexual contact with only females (10.1%) and those who had sexual contact with only males or with both sexes (11.7%) than those who had no sexual contact (1.1%). The prevalence also was higher among male students who had sexual contact with only females (10.1%) than female students who had sexual contact with only males (3.9%) and higher among male students who had no sexual contact (1.1%) than female students who had no sexual contact (0.5%).

Across 14 states, the prevalence of reporting 10 or more as the largest number of drinks in a row ranged from 4.0% to 12.1% (median: 6.6%) among students who had sexual contact with only the opposite sex, from 5.9% to 16.9% (median: 9.7%) among students who had sexual contact with only the same sex or with both sexes, and from 0.3% to 1.7% (median: 0.7%) among students who had no sexual contact. Across 13 large urban school districts, the prevalence ranged from 1.4% to 7.5% (median: 3.8%) among students who had sexual contact with only the opposite sex, from 0.0% to 11.8% (median: 6.1%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 1.0% (median: 0.3%) among students who had no sexual contact.

Ever Used Marijuana

Nationwide, 38.6% of all students; 37.5% of heterosexual students; 52.9% of gay, lesbian, and bisexual students; and 42.3% of not sure students had used marijuana one or more times during their life (i.e., ever used marijuana) (Table 51). The prevalence of having ever used marijuana was higher among gay, lesbian, and bisexual students (52.9%) than heterosexual students (37.5%) and not sure students (42.3%). Among female students, the prevalence was higher among lesbian and bisexual students (57.1%) than heterosexual students (34.4%) and not sure students (44.0%) and higher among not sure students (44.0%) than heterosexual students (34.4%). The prevalence also was higher among heterosexual male students (40.2%) than heterosexual female students (34.4%) and higher among lesbian and bisexual female students (57.1%) than gay and bisexual male students (41.8%).

Across 20 states, the prevalence of having ever used marijuana ranged from 30.1% to 41.5% (median: 33.1%) among heterosexual students; from 48.3% to 62.8% (median: 54.0%) among gay, lesbian, and bisexual students; and from 24.9% to 52.5% (median: 34.4%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 27.8% to 44.1% (median: 38.8%) among heterosexual students; from 45.0% to 69.7% (median: 58.1%) among gay, lesbian, and bisexual students; and from 22.1% to 48.0% (median: 39.1%) among not sure students.

Nationwide, 57.1% of students who had sexual contact with only the opposite sex, 69.4% of students who had sexual contact with only the same sex or with both sexes, and 16.3% of students who had no sexual contact had ever used marijuana. The prevalence of having ever used marijuana was higher among students who had sexual contact with only the same sex or with both sexes (69.4%) than students who had sexual contact with only the opposite sex (57.1%) and students who had no sexual contact (16.3%) and higher among students who had sexual contact with only the opposite sex (57.1%) than students who had no sexual contact (16.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (71.2%) than those who had sexual contact with only males (55.5%) and those who had no sexual contact (15.3%) and higher among those who had sexual contact with only males (55.5%) than those who had no sexual contact (15.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (58.3%) and those who had sexual contact with only males or with both sexes (63.7%) than those who had no sexual contact (17.3%).

Across 19 states, the prevalence of having ever used marijuana ranged from 48.2% to 67.5% (median: 52.3%) among students who had sexual contact with only the opposite sex, from 60.1% to 81.4% (median: 70.1%) among students who had sexual contact with only the same sex or with both sexes, and from 9.1% to 18.9% (median: 13.1%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 50.4% to 62.9% (median: 58.5%) among students who had sexual contact with only the opposite sex, from 61.5% to 74.6% (median: 68.3%) among students who had sexual contact with only the same sex or with both sexes, and from 11.5% to 25.4% (median: 18.1%) among students who had no sexual contact.

Tried Marijuana Before Age 13 Years

Nationwide, 7.5% of all students; 6.8% of heterosexual students; 13.9% of gay, lesbian, and bisexual students; and 9.9% of not sure students had tried marijuana for the first time before age 13 years (Table 52). The prevalence of having tried marijuana before aged 13 years was higher among gay, lesbian, and bisexual students (13.9%) than heterosexual students (6.8%). Among female students, the prevalence was higher among lesbian and bisexual students (13.8%) than heterosexual students (4.3%) and not sure students (6.1%). The prevalence also was higher among heterosexual male students (9.0%) than heterosexual female students (4.3%) and higher among not sure male students (14.6%) than not sure female students (6.1%).

Across 25 states, the prevalence of having tried marijuana before aged 13 years ranged from 4.3% to 14.3% (median: 6.4%) among heterosexual students; from 6.1% to 29.3% (median: 14.9%) among gay, lesbian, and bisexual students; and from 2.6% to 29.9% (median: 11.1%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 4.7% to 14.2% (median: 7.4%) among heterosexual students; from 10.7% to 23.4% (median: 16.3%) among gay, lesbian, and bisexual students; and from 4.0% to 23.2% (median: 13.2%) among not sure students.

Nationwide, 10.8% of students who had sexual contact with only the opposite sex, 18.1% of students who had sexual contact with only the same sex or with both sexes, and 2.3% of students who had no sexual contact had tried marijuana for the first time before aged 13 years. The prevalence of having tried marijuana for the first time before aged 13 years was higher among students who had sexual contact with only the same sex or with both sexes (18.1%) than students who had sexual contact with only the opposite sex (10.8%) and students who had no sexual contact (2.3%) and higher among students who had sexual contact with only the opposite sex (10.8%) than students who had no sexual contact (2.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (17.8%) than those who had sexual contact with only males (6.9%) and those who had no sexual contact (2.0%) and higher among those who had sexual contact with only males (6.9%) than those who had no sexual contact (2.0%). Among male students, the prevalence was higher among those who had sexual contact with only females (13.8%) and those who had sexual contact with only males or with both sexes (19.0%) than those who had no sexual contact (2.7%). The prevalence also was higher among male students who had sexual contact with only females (13.8%) than female students who had sexual contact with only males (6.9%).

Across 23 states, the prevalence of having tried marijuana before aged 13 years ranged from 7.3% to 23.9% (median: 10.6%) among students who had sexual contact with only the opposite sex, from 8.7% to 35.1% (median: 21.3%) among students who had sexual contact with only the same sex or with both sexes, and from 0.9% to 6.6% (median: 1.6%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 8.5% to 20.8% (median: 12.9%) among students who had sexual contact with only the opposite sex, from 11.7% to 27.2% (median: 20.5%) among students who had sexual contact with only the same sex or with both sexes, and from 1.3% to 5.6% (median: 2.1%) among students who had no sexual contact.

Current Marijuana Use

Nationwide, 21.7% of all students; 20.7% of heterosexual students; 32.0% of gay, lesbian, and bisexual students; and 26.0% of not sure students had used marijuana one or more times during the 30 days before the survey (i.e., current marijuana use) (Table 53). The prevalence of current marijuana use was higher among gay, lesbian, and bisexual students (32.0%) than heterosexual students (20.7%) and not sure students (26.0%) and higher among not sure students (26.0%) than heterosexual students (20.7%). Among female students, the prevalence was higher among lesbian and bisexual students (34.3%) than heterosexual students (17.8%) and not sure students (23.3%) and higher among not sure students (23.3%) than heterosexual students (17.8%). The prevalence also was higher among heterosexual male students (23.2%) than heterosexual female students (17.8%) and higher among lesbian and bisexual female students (34.3%) than gay and bisexual male students (25.5%).

Across 25 states, the prevalence of current marijuana use ranged from 13.9% to 24.4% (median: 17.7%) among heterosexual students; from 26.0% to 41.9% (median: 32.9%) among gay, lesbian, and bisexual students; and from 12.4% to 32.2% (median: 20.9%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 14.7% to 26.3% (median: 19.8%) among heterosexual students; from 22.1% to 43.9% (median: 35.2%) among gay, lesbian, and bisexual students; and from 9.1% to 29.1% (median: 21.3%) among not sure students.

Nationwide, the prevalence of current marijuana use was 32.7% among students who had sexual contact with only the opposite sex, 43.7% among students who had sexual contact with only the same sex or with both sexes, and 7.5% among students who had no sexual contact. The prevalence of current marijuana use was higher among students who had sexual contact with only the same sex or with both sexes (43.7%) than students who had sexual contact with only the opposite sex (32.7%) and students who had no sexual contact (7.5%) and higher among students who had sexual contact with only the opposite sex (32.7%) than students who had no sexual contact (7.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (42.9%) than those who had sexual contact with only males (29.7%) and those who had no sexual contact (7.1%) and higher among those who had sexual contact with only males (29.7%) than those who had no sexual contact (7.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (45.9%) than those who had sexual contact with only females (35.1%) and those who had no sexual contact (7.9%) and higher among those who had sexual contact with only females (35.1%) than those who had no sexual contact (7.9%). The prevalence also was higher among male students who had sexual contact with only females (35.1%) than female students who had sexual contact with only males (29.7%).

Across 23 states, the prevalence of current marijuana use ranged from 23.0% to 37.8% (median: 31.4%) among students who had sexual contact with only the opposite sex, from 35.4% to 58.0% (median: 44.6%) among students who had sexual contact with only the same sex or with both sexes, and from 3.1% to 10.6% (median: 5.5%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 26.3% to 39.8% (median: 31.4%) among students who had sexual contact with only the opposite sex, from 35.9% to 51.4% (median: 41.0%) among students who had sexual contact with only the same sex or with both sexes, and from 4.5% to 12.1% (median: 6.6%) among students who had no sexual contact.

Usually Used Marijuana by Smoking It

Among the students who currently used marijuana, 90.0% of all those students; 91.5% of the heterosexual students; 85.3% of the gay, lesbian, and bisexual students; and 87.3% of the not sure students usually used marijuana by smoking it in a joint, bong, pipe, or blunt during the 30 days before the survey (Table 54). The prevalence of usually using marijuana by smoking it was higher among heterosexual female students (93.9%) than heterosexual male students (90.2%).

Among the students who currently used marijuana, 93.0% of the students who had sexual contact with only the opposite sex, 87.9% of the students who had sexual contact with only the same sex or with both sexes, and 88.5% of the students who had no sexual contact usually used marijuana by smoking it. The prevalence of usually using marijuana by smoking it did not vary significantly by sex and sexual contact subgroup.

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of usually using marijuana by smoking it by sexual minority subgroups are not available.

Ever Used Synthetic Marijuana

Nationwide, 9.2% of all students; 8.6% of heterosexual students; 14.6% of gay, lesbian, and bisexual students; and 14.1% of not sure students had used synthetic marijuana (also called “K2,” “Spice,” “fake weed,” “King Kong,” “Yucatan Fire,” “Skunk,” or “Moon Rocks”) one or more times during their life (i.e., ever used synthetic marijuana) (Table 55). The prevalence of having ever used synthetic marijuana was higher among gay, lesbian, and bisexual students (14.6%) and not sure students (14.1%) than heterosexual students (8.6%). Among female students, the prevalence was higher among lesbian and bisexual students (14.3%) than heterosexual students (6.9%) and not sure students (9.0%). The prevalence also was higher among heterosexual male students (10.0%) than heterosexual female students (6.9%).

Across 17 states, the prevalence of having ever used synthetic marijuana ranged from 5.0% to 12.7% (median: 7.5%) among heterosexual students; from 10.8% to 27.7% (median: 20.3%) among gay, lesbian, and bisexual students; and from 5.4% to 36.1% (median: 15.0%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 3.4% to 9.6% (median: 7.5%) among heterosexual students; from 8.9% to 28.6% (median: 18.9%) among gay, lesbian, and bisexual students; and from 4.8% to 26.3% (median: 12.5%) among not sure students.

Nationwide, 14.0% of students who had sexual contact with only the opposite sex, 21.6% of students who had sexual contact with only the same sex or with both sexes, and 2.2% of students who had no sexual contact had ever used synthetic marijuana. The prevalence of having ever used synthetic marijuana was higher among students who had sexual contact with only the same sex or with both sexes (21.6%) than students who had sexual contact with only the opposite sex (14.0%) and students who had no sexual contact (2.2%) and higher among students who had sexual contact with only the opposite sex (14.0%) than students who had no sexual contact (2.2%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (21.4%) than those who had sexual contact with only males (11.7%) and those who had no sexual contact (1.9%) and higher among those who had sexual contact with only males (11.7%) than those who had no sexual contact (1.9%). Among male students, the prevalence was higher among those who had sexual contact with only females (15.9%) and those who had sexual contact with only males or with both sexes (22.1%) than those who had no sexual contact (2.4%). The prevalence also was higher among male students who had sexual contact with only females (15.9%) than female students who had sexual contact with only males (11.7%).

Across 17 states, the prevalence of having ever used synthetic marijuana ranged from 9.7% to 20.3% (median: 13.0%) among students who had sexual contact with only the opposite sex, from 15.3% to 39.0% (median: 27.6%) among students who had sexual contact with only the same sex or with both sexes, and from 0.7% to 2.7% (median: 1.6%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 5.6% to 17.5% (median: 11.5%) among students who had sexual contact with only the opposite sex, from 7.8% to 36.6% (median: 19.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.8% to 2.7% (median: 1.9%) among students who had no sexual contact.

Ever Used Hallucinogenic Drugs

Nationwide, 6.4% of all students; 5.5% of heterosexual students; 11.5% of gay, lesbian, and bisexual students; and 15.7% of not sure students had used hallucinogenic drugs (e.g., LSD, acid, PCP, angel dust, mescaline, or mushrooms) one or more times during their life (i.e., ever used hallucinogenic drugs) (Table 56). The prevalence of having ever used hallucinogenic drugs was higher among gay, lesbian, and bisexual students (11.5%) and not sure students (15.7%) than heterosexual students (5.5%). Among female students, the prevalence was higher among lesbian and bisexual students (10.7%) than heterosexual students (3.5%). Among male students, the prevalence was higher among gay and bisexual students (12.8%) and not sure students (25.2%) than heterosexual students (7.2%). The prevalence also was higher among heterosexual male students (7.2%) than heterosexual female students (3.5%) and higher among not sure male students (25.2%) than not sure female students (7.3%).

Nationwide, 9.6% of students who had sexual contact with only the opposite sex, 18.3% of students who had sexual contact with only the same sex or with both sexes, and 1.1% of students who had no sexual contact had ever used hallucinogenic drugs. The prevalence of having ever used hallucinogenic drugs was higher among students who had sexual contact with only the same sex or with both sexes (18.3%) than students who had sexual contact with only the opposite sex (9.6%) and students who had no sexual contact (1.1%) and higher among students who had sexual contact with only the opposite sex (9.6%) than students who had no sexual contact (1.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (15.5%) than those who had sexual contact with only males (5.9%) and those who had no sexual contact (1.2%) and higher among those who had sexual contact with only males (5.9%) than those who had no sexual contact (1.2%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (26.7%) than those who had sexual contact with only females (12.5%) and those who had no sexual contact (1.0%) and higher among those who had sexual contact with only females (12.5%) than those who had no sexual contact (1.0%). The prevalence also was higher among male students who had sexual contact with only females (12.5%) than female students who had sexual contact with only males (5.9%) and higher among male students who had sexual contact with only males or with both sexes (26.7%) than female students who had sexual contact with only females or with both sexes (15.5%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having ever used hallucinogenic drugs by sexual minority subgroups are not available.

Ever Used Cocaine

Nationwide, 5.2% of all students; 4.2% of heterosexual students; 10.6% of gay, lesbian, and bisexual students; and 13.7% of not sure students had used any form of cocaine (e.g., powder, crack,^†† or freebase^§§) one or more times during their life (i.e., ever used cocaine) (Table 57). The prevalence of having ever used cocaine was higher among gay, lesbian, and bisexual students (10.6%) and not sure students (13.7%) than heterosexual students (4.2%). Among female students, the prevalence was higher among lesbian and bisexual students (7.3%) and not sure students (7.0%) than heterosexual students (3.0%). Among male students, the prevalence was higher among gay and bisexual students (18.1%) and not sure students (20.5%) than heterosexual students (5.2%). The prevalence also was higher among heterosexual male students (5.2%) than heterosexual female students (3.0%), higher among gay and bisexual male students (18.1%) than lesbian and bisexual female students (7.3%), and higher among not sure male students (20.5%) than not sure female students (7.0%).

Across 24 states, the prevalence of having ever used cocaine ranged from 2.4% to 8.4% (median: 3.6%) among heterosexual students; from 3.1% to 20.3% (median: 13.3%) among gay, lesbian, and bisexual students; and from 4.9% to 22.6% (median: 13.8%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 1.7% to 7.0% (median: 4.4%) among heterosexual students; from 8.2% to 22.1% (median: 12.2%) among gay, lesbian, and bisexual students; and from 5.7% to 20.9% (median: 10.9%) among not sure students.

Nationwide, 7.2% of students who had sexual contact with only the opposite sex, 14.8% of students who had sexual contact with only the same sex or with both sexes, and 0.8% of students who had no sexual contact had ever used cocaine. The prevalence of having ever used cocaine was higher among students who had sexual contact with only the same sex or with both sexes (14.8%) than students who had sexual contact with only the opposite sex (7.2%) and students who had no sexual contact (0.8%) and higher among students who had sexual contact with only the opposite sex (7.2%) than students who had no sexual contact (0.8%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (10.3%) than those who had sexual contact with only males (5.2%) and those who had no sexual contact (0.9%) and higher among those who had sexual contact with only males (5.2%) than those who had no sexual contact (0.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (27.9%) than those who had sexual contact with only females (8.8%) and those who had no sexual contact (0.7%) and higher among those who had sexual contact with only females (8.8%) than those who had no sexual contact (0.7%). The prevalence also was higher among male students who had sexual contact with only females (8.8%) than female students who had sexual contact with only males (5.2%) and higher among male students who had sexual contact with only males or with both sexes (27.9%) than female students who had sexual contact with only females or with both sexes (10.3%).

Across 22 states, the prevalence of having ever used cocaine ranged from 3.9% to 12.5% (median: 6.2%) among students who had sexual contact with only the opposite sex, from 7.2% to 32.1% (median: 18.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.3% to 1.9% (median: 0.5%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 3.2% to 12.3% (median: 7.5%) among students who had sexual contact with only the opposite sex, from 8.9% to 27.6% (median: 16.9%) among students who had sexual contact with only the same sex or with both sexes, and from 0.3% to 1.6% (median: 0.8%) among students who had no sexual contact.

Ever Used Ecstasy

Nationwide, 5.0% of all students; 4.1% of heterosexual students; 10.1% of gay, lesbian, and bisexual students; and 13.7% of not sure students had used ecstasy (also called “MDMA”) one or more times during their life (i.e., ever used ecstasy) (Table 58). The prevalence of having ever used ecstasy was higher among gay, lesbian, and bisexual students (10.1%) and not sure students (13.7%) than heterosexual students (4.1%). Among female students, the prevalence was higher among lesbian and bisexual students (7.5%) than heterosexual students (3.1%). Among male students, the prevalence was higher among gay and bisexual students (16.3%) and not sure students (22.2%) than heterosexual students (4.9%). The prevalence also was higher among heterosexual male students (4.9%) than heterosexual female students (3.1%), higher among gay and bisexual male students (16.3%) than lesbian and bisexual female students (7.5%), and higher among not sure male students (22.2%) than not sure female students (6.1%).

Across 18 states, the prevalence of having ever used ecstasy ranged from 2.8% to 6.2% (median: 3.9%) among heterosexual students; from 6.4% to 22.8% (median: 15.2%) among gay, lesbian, and bisexual students; and from 5.2% to 28.5% (median: 13.8%) among not sure students. Across 14 large urban school districts, the prevalence ranged from 2.1% to 6.7% (median: 4.6%) among heterosexual students; from 7.6% to 21.3% (median: 12.5%) among gay, lesbian, and bisexual students; and from 5.9% to 24.1% (median: 11.6%) among not sure students.

Nationwide, 7.4% of students who had sexual contact with only the opposite sex, 15.0% of students who had sexual contact with only the same sex or with both sexes, and 0.6% of students who had no sexual contact had ever used ecstasy. The prevalence of having ever used ecstasy was higher among students who had sexual contact with only the same sex or with both sexes (15.0%) than students who had sexual contact with only the opposite sex (7.4%) and students who had no sexual contact (0.6%) and higher among students who had sexual contact with only the opposite sex (7.4%) than students who had no sexual contact (0.6%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (11.1%) than those who had sexual contact with only males (5.7%) and those who had no sexual contact (0.7%) and higher among those who had sexual contact with only males (5.7%) than those who had no sexual contact (0.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (26.8%) than those who had sexual contact with only females (8.8%) and those who had no sexual contact (0.5%) and higher among those who had sexual contact with only females (8.8%) than those who had no sexual contact (0.5%). The prevalence also was higher among male students who had sexual contact with only females (8.8%) than female students who had sexual contact with only males (5.7%) and higher among male students who had sexual contact with only males or with both sexes (26.8%) than female students who had sexual contact with only females or with both sexes (11.1%).

Across 17 states, the prevalence of having ever used ecstasy ranged from 5.8% to 11.6% (median: 7.1%) among students who had sexual contact with only the opposite sex, from 12.7% to 36.6% (median: 20.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 1.7% (median: 0.6%) among students who had no sexual contact. Across 14 large urban school districts, the prevalence ranged from 3.6% to 11.5% (median: 8.3%) among students who had sexual contact with only the opposite sex, from 8.5% to 28.4% (median: 16.9%) among students who had sexual contact with only the same sex or with both sexes, and from 0.3% to 1.5% (median: 0.8%) among students who had no sexual contact.

Ever Used Heroin

Nationwide, 2.1% of all students; 1.3% of heterosexual students; 6.0% of gay, lesbian, and bisexual students; and 9.3% of not sure students had used heroin (also called “smack,” “junk,” or “China White”) one or more times during their life (i.e., ever used heroin) (Table 59). The prevalence of having ever used heroin was higher among not sure students (9.3%) than heterosexual students (1.3%) and gay, lesbian, and bisexual students (6.0%) and higher among gay, lesbian, and bisexual students (6.0%) than heterosexual students (1.3%). Among female students, the prevalence was higher among lesbian and bisexual students (2.9%) than heterosexual students (0.8%). Among male students, the prevalence was higher among gay and bisexual students (13.7%) and not sure students (15.6%) than heterosexual students (1.7%). The prevalence also was higher among heterosexual male students (1.7%) than heterosexual female students (0.8%), higher among gay and bisexual male students (13.7%) than lesbian and bisexual female students (2.9%), and higher among not sure male students (15.6%) than not sure female students (2.9%).

Across 22 states, the prevalence of having ever used heroin ranged from 0.7% to 2.8% (median: 1.6%) among heterosexual students; from 1.1% to 18.0% (median: 9.2%) among gay, lesbian, and bisexual students; and from 2.1% to 23.6% (median: 8.6%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 1.1% to 4.0% (median: 1.9%) among heterosexual students; from 2.8% to 21.0% (median: 7.4%) among gay, lesbian, and bisexual students; and from 4.3% to 25.0% (median: 9.0%) among not sure students.

Nationwide, 2.2% of students who had sexual contact with only the opposite sex, 8.9% of students who had sexual contact with only the same sex or with both sexes, and 0.3% of students who had no sexual contact had ever used heroin. The prevalence of having ever used heroin was higher among students who had sexual contact with only the same sex or with both sexes (8.9%) than students who had sexual contact with only the opposite sex (2.2%) and students who had no sexual contact (0.3%) and higher among students who had sexual contact with only the opposite sex (2.2%) than students who had no sexual contact (0.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (4.9%) than those who had sexual contact with only males (1.2%) and those who had no sexual contact (0.4%) and higher among those who had sexual contact with only males (1.2%) than those who had no sexual contact (0.4%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.6%) than those who had sexual contact with only females (2.9%) and those who had no sexual contact (0.2%) and higher among those who had sexual contact with only females (2.9%) than those who had no sexual contact (0.2%). The prevalence also was higher among male students who had sexual contact with only females (2.9%) than female students who had sexual contact with only males (1.2%) and higher among male students who had sexual contact with only males or with both sexes (20.6%) than female students who had sexual contact with only females or with both sexes (4.9%).

Across 20 states, the prevalence of having ever used heroin ranged from 1.6% to 4.4% (median: 2.6%) among students who had sexual contact with only the opposite sex, from 3.8% to 27.7% (median: 13.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.7% (median: 0.1%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 1.2% to 5.7% (median: 3.3%) among students who had sexual contact with only the opposite sex, from 4.3% to 24.4% (median: 11.1%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.9% (median: 0.4%) among students who had no sexual contact.

Ever Used Methamphetamines

Nationwide, 3.0% of all students; 2.1% of heterosexual students; 8.2% of gay, lesbian, and bisexual students; and 10.8% of not sure students had used methamphetamines (also called “speed,” “crystal,” “crank,” or “ice”) one or more times during their life (i.e., ever used methamphetamines) (Table 60). The prevalence of having ever used methamphetamines was higher among gay, lesbian, and bisexual students (8.2%) and not sure students (10.8%) than heterosexual students (2.1%). Among female students, the prevalence was higher among lesbian and bisexual students (5.7%) and not sure students (5.0%) than heterosexual students (1.5%). Among male students, the prevalence was higher among gay and bisexual students (14.8%) and not sure students (16.5%) than heterosexual students (2.5%). The prevalence also was higher among heterosexual male students (2.5%) than heterosexual female students (1.5%) and higher among not sure male students (16.5%) than not sure female students (5.0%).

Across 19 states, the prevalence of having ever used methamphetamines ranged from 1.2% to 4.4% (median: 2.1%) among heterosexual students; from 2.9% to 14.6% (median: 10.8%) among gay, lesbian, and bisexual students; and from 3.4% to 22.7% (median: 11.8%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 1.0% to 4.6% (median: 2.6%) among heterosexual students; from 3.5% to 19.5% (median: 10.6%) among gay, lesbian, and bisexual students; and from 1.8% to 25.1% (median: 9.8%) among not sure students.

Nationwide, 3.5% of students who had sexual contact with only the opposite sex, 11.4% of students who had sexual contact with only the same sex or with both sexes, and 0.5% of students who had no sexual contact had ever used methamphetamines. The prevalence of having ever used methamphetamines was higher among students who had sexual contact with only the same sex or with both sexes (11.4%) than students who had sexual contact with only the opposite sex (3.5%) and students who had no sexual contact (0.5%) and higher among students who had sexual contact with only the opposite sex (3.5%) than students who had no sexual contact (0.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (8.5%) than those who had sexual contact with only males (2.3%) and those who had no sexual contact (0.7%) and higher among those who had sexual contact with only males (2.3%) than those who had no sexual contact (0.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.4%) than those who had sexual contact with only females (4.3%) and those who had no sexual contact (0.3%) and higher among those who had sexual contact with only females (4.3%) than those who had no sexual contact (0.3%). The prevalence also was higher among male students who had sexual contact with only females (4.3%) than female students who had sexual contact with only males (2.3%) and higher among male students who had sexual contact with only males or with both sexes (20.4%) than female students who had sexual contact with only females or with both sexes (8.5%).

Across 18 states, the prevalence of having ever used methamphetamines ranged from 2.1% to 6.4% (median: 3.4%) among students who had sexual contact with only the opposite sex, from 6.0% to 21.4% (median: 14.8%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.8% (median: 0.3%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 1.6% to 6.3% (median: 4.4%) among students who had sexual contact with only the opposite sex, from 7.2% to 24.4% (median: 13.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.9% (median: 0.5%) among students who had no sexual contact.

Ever Took Steroids Without a Doctor’s Prescription

Nationwide, 3.5% of all students; 2.6% of heterosexual students; 9.7% of gay, lesbian, and bisexual students; and 9.6% of not sure students had taken steroid pills or shots without a doctor’s prescription one or more times during their life (i.e., ever took steroids without a doctor’s prescription) (Table 61). The prevalence of having ever taken steroids without a doctor’s prescription was higher among gay, lesbian, and bisexual students (9.7%) and not sure students (9.6%) than heterosexual students (2.6%). Among female students, the prevalence was higher among lesbian and bisexual students (6.6%) than heterosexual students (2.0%). Among male students, the prevalence was higher among gay and bisexual students (16.1%) and not sure students (14.1%) than heterosexual students (3.0%). The prevalence also was higher among heterosexual male students (3.0%) than heterosexual female students (2.0%), higher among gay and bisexual male students (16.1%) than lesbian and bisexual female students (6.6%), and higher among not sure male students (14.1%) than not sure female students (4.5%).

Across 17 states, the prevalence of having ever taken steroids without a doctor’s prescription ranged from 1.1% to 4.1% (median: 2.3%) among heterosexual students; from 4.1% to 18.9% (median: 9.1%) among gay, lesbian, and bisexual students; and from 2.2% to 21.3% (median: 10.8%) among not sure students. Across 12 large urban school districts, the prevalence ranged from 1.5% to 4.2% (median: 2.3%) among heterosexual students; from 7.2% to 20.9% (median: 11.5%) among gay, lesbian, and bisexual students; and from 4.4% to 22.4% (median: 12.0%) among not sure students.

Nationwide, 4.2% of students who had sexual contact with only the opposite sex, 12.6% of students who had sexual contact with only the same sex or with both sexes, and 0.8% of students who had no sexual contact had ever taken steroid pills or shots without a doctor’s prescription. The prevalence of having ever taken steroids without a doctor’s prescription was higher among students who had sexual contact with only the same sex or with both sexes (12.6%) than students who had sexual contact with only the opposite sex (4.2%) and students who had no sexual contact (0.8%) and higher among students who had sexual contact with only the opposite sex (4.2%) than students who had no sexual contact (0.8%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (9.7%) than those who had sexual contact with only males (3.0%) and those who had no sexual contact (0.9%) and higher among those who had sexual contact with only males (3.0%) than those who had no sexual contact (0.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.8%) than those who had sexual contact with only females (5.1%) and those who had no sexual contact (0.6%) and higher among those who had sexual contact with only females (5.1%) than those who had no sexual contact (0.6%). The prevalence also was higher among male students who had sexual contact with only females (5.1%) than female students who had sexual contact with only males (3.0%) and higher among male students who had sexual contact with only males or with both sexes (20.8%) than female students who had sexual contact with only females or with both sexes (9.7%).

Across 16 states, the prevalence of having ever taken steroids without a doctor’s prescription ranged from 2.1% to 5.6% (median: 3.9%) among students who had sexual contact with only the opposite sex, from 6.4% to 20.0% (median: 14.5%) among students who had sexual contact with only the same sex or with both sexes, and from 0.1% to 1.3% (median: 0.4%) among students who had no sexual contact. Across 12 large urban school districts, the prevalence ranged from 2.9% to 6.7% (median: 3.8%) among students who had sexual contact with only the opposite sex, from 7.4% to 21.2% (median: 12.4%) among students who had sexual contact with only the same sex or with both sexes, and from 0.2% to 2.0% (median: 0.5%) among students who had no sexual contact.

Ever Took Prescription Drugs Without a Doctor’s Prescription

Nationwide, 16.8% of all students; 15.5% of heterosexual students; 27.5% of gay, lesbian, and bisexual students; and 24.3% of not sure students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life (i.e., ever took prescription drugs without a doctor’s prescription) (Table 62). The prevalence of having ever taken prescription drugs without a doctor’s prescription was higher among gay, lesbian, and bisexual students (27.5%) and not sure students (24.3%) than heterosexual students (15.5%). Among female students, the prevalence was higher among lesbian and bisexual students (26.4%) and not sure students (20.9%) than heterosexual students (13.8%). Among male students, the prevalence was higher among gay and bisexual students (29.7%) and not sure students (27.2%) than heterosexual students (17.0%). The prevalence also was higher among heterosexual male students (17.0%) than heterosexual female students (13.8%).

Across 21 states, the prevalence of having ever taken prescription drugs without a doctor’s prescription ranged from 9.2% to 17.2% (median: 12.2%) among heterosexual students; from 17.3% to 35.1% (median: 26.6%) among gay, lesbian, and bisexual students; and from 15.8% to 38.3% (median: 24.1%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 7.3% to 13.5% (median: 11.5%) among heterosexual students; from 10.9% to 30.7% (median: 23.0%) among gay, lesbian, and bisexual students; and from 10.4% to 31.2% (median: 19.4%) among not sure students.

Nationwide, 24.0% of students who had sexual contact with only the opposite sex, 35.0% of students who had sexual contact with only the same sex or with both sexes, and 7.0% of students who had no sexual contact had ever taken prescription drugs without a doctor’s prescription. The prevalence of having ever taken prescription drugs without a doctor’s prescription was higher among students who had sexual contact with only the same sex or with both sexes (35.0%) than students who had sexual contact with only the opposite sex (24.0%) and students who had no sexual contact (7.0%) and higher among students who had sexual contact with only the opposite sex (24.0%) than students who had no sexual contact (7.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (32.9%) than those who had sexual contact with only males (21.5%) and those who had no sexual contact (7.1%) and higher among those who had sexual contact with only males (21.5%) than those who had no sexual contact (7.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (41.3%) than those who had sexual contact with only females (25.8%) and those who had no sexual contact (6.8%) and higher among those who had sexual contact with only females (25.8%) than those who had no sexual contact (6.8%). The prevalence also was higher among male students who had sexual contact with only females (25.8%) than female students who had sexual contact with only males (21.5%).

Across 20 states, the prevalence of having ever taken prescription drugs without a doctor’s prescription ranged from 14.0% to 26.1% (median: 19.6%) among students who had sexual contact with only the opposite sex, from 28.5% to 47.3% (median: 37.9%) among students who had sexual contact with only the same sex or with both sexes, and from 2.6% to 6.6% (median: 4.7%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 10.2% to 24.6% (median: 18.2%) among students who had sexual contact with only the opposite sex, from 16.8% to 35.3% (median: 30.2%) among students who had sexual contact with only the same sex or with both sexes, and from 3.2% to 6.8% (median: 4.4%) among students who had no sexual contact.

Ever Used Inhalants

Nationwide, 7.0% of all students; 5.6% of heterosexual students; 17.3% of gay, lesbian, and bisexual students; and 18.1% of not sure students had sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times during their life (i.e., ever used inhalants) (Table 63). The prevalence of having ever used inhalants was higher among gay, lesbian, and bisexual students (17.3%) and not sure students (18.1%) than heterosexual students (5.6%). Among female students, the prevalence was higher among lesbian and bisexual students (15.2%) and not sure students (11.3%) than heterosexual students (5.2%). Among male students, the prevalence was higher among gay and bisexual students (21.0%) and not sure students (24.2%) than heterosexual students (6.0%). The prevalence also was higher among not sure male students (24.2%) than not sure female students (11.3%).

Across 20 states, the prevalence of having ever used inhalants ranged from 2.3% to 8.6% (median: 5.5%) among heterosexual students; from 8.6% to 28.6% (median: 19.3%) among gay, lesbian, and bisexual students; and from 7.3% to 33.1% (median: 17.4%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 4.2% to 10.1% (median: 5.8%) among heterosexual students; from 3.6% to 25.4% (median: 17.5%) among gay, lesbian, and bisexual students; and from 9.3% to 30.3% (median: 15.8%) among not sure students.

Nationwide, 8.2% of students who had sexual contact with only the opposite sex, 20.3% of students who had sexual contact with only the same sex or with both sexes, and 3.3% of students who had no sexual contact had ever used inhalants. The prevalence of having ever used inhalants was higher among students who had sexual contact with only the same sex or with both sexes (20.3%) than students who had sexual contact with only the opposite sex (8.2%) and students who had no sexual contact (3.3%) and higher among students who had sexual contact with only the opposite sex (8.2%) than students who had no sexual contact (3.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (18.0%) than those who had sexual contact with only males (7.2%) and those who had no sexual contact (3.8%) and higher among those who had sexual contact with only males (7.2%) than those who had no sexual contact (3.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (26.9%) than those who had sexual contact with only females (9.0%) and those who had no sexual contact (2.7%) and higher among those who had sexual contact with only females (9.0%) than those who had no sexual contact (2.7%).

Across 19 states, the prevalence of having ever used inhalants ranged from 3.6% to 12.2% (median: 7.7%) among students who had sexual contact with only the opposite sex, from 11.6% to 29.8% (median: 25.7%) among students who had sexual contact with only the same sex or with both sexes, and from 0.5% to 4.8% (median: 2.8%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 3.6% to 11.7% (median: 8.5%) among students who had sexual contact with only the opposite sex, from 12.8% to 27.8% (median: 19.2%) among students who had sexual contact with only the same sex or with both sexes, and from 1.9% to 6.2% (median: 3.4%) among students who had no sexual contact.

Ever Injected Any Illegal Drug

Nationwide, 1.8% of all students; 1.1% of heterosexual students; 5.4% of gay, lesbian, and bisexual students; and 7.6% of not sure students had used a needle to inject any illegal drug into their body one or more times during their life (i.e., ever injected any illegal drug) (Table 64). The prevalence of having ever injected any illegal drug was higher among gay, lesbian, and bisexual students (5.4%) and not sure students (7.6%) than heterosexual students (1.1%). Among female students, the prevalence was higher among lesbian and bisexual students (3.3%) than heterosexual students (0.5%). Among male students, the prevalence was higher among gay and bisexual students (10.1%) and not sure students (15.1%) than heterosexual students (1.5%). The prevalence also was higher among heterosexual male students (1.5%) than heterosexual female students (0.5%), higher among gay and bisexual male students (10.1%) than lesbian and bisexual female students (3.3%), and higher among not sure male students (15.1%) than not sure female students (2.0%).

Across 17 states, the prevalence of having ever injected any illegal drug ranged from 0.7% to 2.5% (median: 1.5%) among heterosexual students; from 1.1% to 15.9% (median: 10.3%) among gay, lesbian, and bisexual students; and from 2.2% to 16.7% (median: 9.8%) among not sure students. Across 13 large urban school districts, the prevalence ranged from 1.1% to 3.9% (median: 1.7%) among heterosexual students; from 3.1% to 14.3% (median: 6.6%) among gay, lesbian, and bisexual students; and from 4.1% to 18.8% (median: 10.0%) among not sure students.

Nationwide, 1.8% of students who had sexual contact with only the opposite sex, 7.3% of students who had sexual contact with only the same sex or with both sexes, and 0.3% of students who had no sexual contact had ever injected any illegal drug. The prevalence of having ever injected any illegal drug was higher among students who had sexual contact with only the same sex or with both sexes (7.3%) than students who had sexual contact with only the opposite sex (1.8%) and students who had no sexual contact (0.3%) and higher among students who had sexual contact with only the opposite sex (1.8%) than students who had no sexual contact (0.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (4.9%) than those who had sexual contact with only males (0.8%) and those who had no sexual contact (0.3%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (14.9%) than those who had sexual contact with only females (2.6%) and those who had no sexual contact (0.2%) and higher among those who had sexual contact with only females (2.6%) than those who had no sexual contact (0.2%). The prevalence also was higher among male students who had sexual contact with only females (2.6%) than female students who had sexual contact with only males (0.8%) and higher among male students who had sexual contact with only males or with both sexes (14.9%) than female students who had sexual contact with only females or with both sexes (4.9%).

Across 16 states, the prevalence of having ever injected any illegal drug ranged from 1.3% to 3.8% (median: 2.5%) among students who had sexual contact with only the opposite sex, from 3.3% to 22.5% (median: 13.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.0% to 0.7% (median: 0.4%) among students who had no sexual contact. Across 13 large urban school districts, the prevalence ranged from 1.5% to 5.5% (median: 2.7%) among students who had sexual contact with only the opposite sex, from 5.1% to 19.0% (median: 8.2%) among students who had sexual contact with only the same sex or with both sexes, and from 0.1% to 1.0% (median: 0.5%) among students who had no sexual contact.

Offered, Sold, or Given an Illegal Drug on School Property

Nationwide, 21.7% of all students; 20.8% of heterosexual students; 29.3% of gay, lesbian, and bisexual students; and 28.4% of not sure students had been offered, sold, or given an illegal drug by someone on school property during the 12 months before the survey (Table 65). The prevalence of having been offered, sold, or given an illegal drug on school property was higher among gay, lesbian, and bisexual students (29.3%) and not sure students (28.4%) than heterosexual students (20.8%). Among female students, the prevalence was higher among lesbian and bisexual students (29.8%) and not sure students (25.9%) than heterosexual students (17.1%). The prevalence also was higher among heterosexual male students (23.9%) than heterosexual female students (17.1%).

Across 23 states, the prevalence of having been offered, sold, or given an illegal drug on school property ranged from 13.7% to 28.3% (median: 23.5%) among heterosexual students; from 22.3% to 44.9% (median: 32.3%) among gay, lesbian, and bisexual students; and from 13.8% to 46.4% (median: 23.9%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 18.8% to 33.4% (median: 25.5%) among heterosexual students; from 23.7% to 44.6% (median: 34.7%) among gay, lesbian, and bisexual students; and from 16.5% to 46.1% (median: 29.7%) among not sure students.

Nationwide, 27.2% of students who had sexual contact with only the opposite sex, 38.6% of students who had sexual contact with only the same sex or with both sexes, and 13.2% of students who had no sexual contact had been offered, sold, or given an illegal drug on school property. The prevalence of having been offered, sold, or given an illegal drug on school property was higher among students who had sexual contact with only the same sex or with both sexes (38.6%) than students who had sexual contact with only the opposite sex (27.2%) and students who had no sexual contact (13.2%) and higher among students who had sexual contact with only the opposite sex (27.2%) than students who had no sexual contact (13.2%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (37.1%) than those who had sexual contact with only males (22.5%) and those who had no sexual contact (11.8%) and higher among those who had sexual contact with only males (22.5%) than those who had no sexual contact (11.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (43.4%) than those who had sexual contact with only females (30.8%) and those who had no sexual contact (14.7%) and higher among those who had sexual contact with only females (30.8%) than those who had no sexual contact (14.7%). The prevalence also was higher among male students who had sexual contact with only females (30.8%) than female students who had sexual contact with only males (22.5%).

Across 21 states, the prevalence of having been offered, sold, or given an illegal drug on school property ranged from 17.6% to 36.8% (median: 29.0%) among students who had sexual contact with only the opposite sex, from 26.3% to 46.1% (median: 37.1%) among students who had sexual contact with only the same sex or with both sexes, and from 7.7% to 20.7% (median: 14.6%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 24.6% to 40.1% (median: 33.5%) among students who had sexual contact with only the opposite sex, from 29.1% to 47.2% (median: 40.3%) among students who had sexual contact with only the same sex or with both sexes, and from 11.9% to 24.7% (median: 18.2%) among students who had no sexual contact.

Sexual Behaviors Related to Unintended Pregnancy and Sexually Transmitted Infections, Including HIV Infection

Ever Had Sexual Intercourse

Nationwide, 41.2% of all students; 40.9% of heterosexual students; 50.8% of gay, lesbian, and bisexual students; and 31.6% of not sure students had ever had sexual intercourse (Table 66). The prevalence of having ever had sexual intercourse was higher among gay, lesbian, and bisexual students (50.8%) than heterosexual students (40.9%) and not sure students (31.6%). Among female students, the prevalence was higher among lesbian and bisexual students (52.2%) than heterosexual students (38.2%) and not sure students (28.4%) and higher among heterosexual students (38.2%) than not sure students (28.4%). The prevalence also was higher among heterosexual male students (43.3%) than heterosexual female students (38.2%).

Across 23 states, the prevalence of having ever had sexual intercourse ranged from 28.9% to 46.2% (median: 38.3%) among heterosexual students; from 37.5% to 65.1% (median: 52.8%) among gay, lesbian, and bisexual students; and from 15.7% to 45.6% (median: 28.6%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 24.8% to 51.1% (median: 38.1%) among heterosexual students; from 37.6% to 61.0% (median: 51.8%) among gay, lesbian, and bisexual students; and from 14.8% to 55.3% (median: 27.2%) among not sure students.

Nationwide, 78.5% of students who had sexual contact with only the opposite sex and 72.4% of students who had sexual contact with only the same sex or with both sexes had ever had sexual intercourse (students who had no sexual contact are excluded from these analyses). The prevalence of having ever had sexual intercourse was higher among students who had sexual contact with only the opposite sex (78.5%) than students who had sexual contact with only the same sex or with both sexes (72.4%). Among female students, the prevalence was higher among those who had sexual contact with only males (78.7%) than those who had sexual contact with only females or with both sexes (68.8%). The prevalence also was higher among male students who had sexual contact with only males or with both sexes (83.5%) than female students who had sexual contact with only females or with both sexes (68.8%).

Across 21 states, the prevalence of having ever had sexual intercourse ranged from 68.2% to 99.6% (median: 77.0%) among students who had sexual contact with only the opposite sex and from 66.0% to 98.6% (median: 77.8%) among students who had sexual contact with only the same sex or with both sexes. Across 19 large urban school districts, the prevalence ranged from 66.5% to 88.5% (median: 79.5%) among students who had sexual contact with only the opposite sex and from 49.5% to 83.2% (median: 73.9%) among students who had sexual contact with only the same sex or with both sexes.

Had First Sexual Intercourse Before Age 13 Years

Nationwide, 3.9% of all students; 3.4% of heterosexual students; 7.3% of gay, lesbian, and bisexual students; and 8.8% of not sure students had had sexual intercourse for the first time before age 13 years (Table 67). The prevalence of having had sexual intercourse before age 13 years was higher among gay, lesbian, and bisexual students (7.3%) and not sure students (8.8%) than heterosexual students (3.4%). Among female students, the prevalence was higher among lesbian and bisexual students (6.4%) and not sure students (4.6%) than heterosexual students (1.6%). Among male students, the prevalence was higher among not sure students (15.2%) than heterosexual students (5.1%). The prevalence also was higher among heterosexual male students (5.1%) than heterosexual female students (1.6%) and higher among not sure male students (15.2%) than not sure female students (4.6%).

Across 25 states, the prevalence of having had sexual intercourse before age 13 years ranged from 2.1% to 6.1% (median: 2.7%) among heterosexual students; from 3.0% to 14.3% (median: 7.9%) among gay, lesbian, and bisexual students; and from 3.1% to 14.3% (median: 9.2%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 2.1% to 12.6% (median: 5.2%) among heterosexual students; from 2.6% to 14.9% (median: 8.6%) among gay, lesbian, and bisexual students; and from 0.0% to 18.7% (median: 5.8%) among not sure students.

Nationwide, 6.4% of students who had sexual contact with only the opposite sex and 14.9% of students who had sexual contact with only the same sex or with both sexes had sexual intercourse for the first time before age 13 years (students who had no sexual contact are excluded from these analyses). The prevalence of having had sexual intercourse before age 13 years was higher among students who had sexual contact with only the same sex or with both sexes (14.9%) than students who had sexual contact with only the opposite sex (6.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (11.1%) than those who had sexual contact with only males (3.0%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (26.6%) than those who had sexual contact with only females (9.1%). The prevalence also was higher among male students who had sexual contact with only females (9.1%) than female students who had sexual contact with only males (3.0%) and higher among male students who had sexual contact with only males or with both sexes (26.6%) than female students who had sexual contact with only females or with both sexes (11.1%).

Across 23 states, the prevalence of having had sexual intercourse before age 13 years ranged from 4.2% to 13.4% (median: 5.7%) among students who had sexual contact with only the opposite sex and from 5.8% to 23.0% (median: 15.7%) among students who had sexual contact with only the same sex or with both sexes. Across 19 large urban school districts, the prevalence ranged from 6.8% to 23.0% (median: 10.5%) among students who had sexual contact with only the opposite sex and from 7.2% to 23.1% (median: 13.5%) among students who had sexual contact with only the same sex or with both sexes.

Had Sexual Intercourse with Four or More Persons During Their Life

Nationwide, 11.5% of all students; 11.2% of heterosexual students; 14.7% of gay, lesbian, and bisexual students; and 12.9% of not sure students had had sexual intercourse with four or more persons during their life (Table 68). The prevalence of having had sexual intercourse with four or more persons was higher among gay, lesbian, and bisexual students (14.7%) than heterosexual students (11.2%). Among female students, the prevalence was higher among lesbian and bisexual students (15.5%) than heterosexual students (7.9%) and not sure students (7.8%). The prevalence also was higher among heterosexual male students (14.1%) than heterosexual female students (7.9%) and higher among not sure male students (20.9%) than not sure female students (7.8%).

Across 24 states, the prevalence of having had sexual intercourse with four or more persons ranged from 5.7% to 15.8% (median: 8.9%) among heterosexual students; from 9.0% to 25.3% (median: 15.9%) among gay, lesbian, and bisexual students; and from 5.4% to 25.5% (median: 11.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 5.6% to 18.8% (median: 10.8%) among heterosexual students; from 5.4% to 24.3% (median: 13.3%) among gay, lesbian, and bisexual students; and from 4.9% to 20.9% (median: 9.1%) among not sure students.

Nationwide, 20.9% of students who had sexual contact with only the opposite sex and 28.3% of students who had sexual contact with only the same sex or with both sexes had had sexual intercourse with four or more persons (students who had no sexual contact are excluded from these analyses). The prevalence of having had sexual intercourse with four or more persons was higher among students who had sexual contact with only the same sex or with both sexes (28.3%) than students who had sexual contact with only the opposite sex (20.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (26.7%) than those who had sexual contact with only males (15.3%). The prevalence also was higher among male students who had sexual contact with only females (25.4%) than female students who had sexual contact with only males (15.3%).

Across 23 states, the prevalence of having had sexual intercourse with four or more persons ranged from 11.4% to 28.6% (median: 17.5%) among students who had sexual contact with only the opposite sex and from 18.4% to 40.4% (median: 28.5%) among students who had sexual contact with only the same sex or with both sexes. Across 18 large urban school districts, the prevalence ranged from 13.5% to 32.7% (median: 21.7%) among students who had sexual contact with only the opposite sex and from 11.2% to 35.8% (median: 24.8%) among students who had sexual contact with only the same sex or with both sexes.

Currently Sexually Active

Nationwide, 30.1% of all students; 30.1% of heterosexual students; 35.1% of gay, lesbian, and bisexual students; and 22.9% of not sure students had had sexual intercourse with at least one person during the 3 months before the survey (i.e., currently sexually active) (Table 69). The prevalence of being currently sexually active was higher among gay, lesbian, and bisexual students (35.1%) than heterosexual students (30.1%) and not sure students (22.9%) and higher among heterosexual students (30.1%) than not sure students (22.9%). Among female students, the prevalence was higher among lesbian and bisexual students (36.3%) than heterosexual students (29.7%) and not sure students (18.1%) and higher among heterosexual students (29.7%) than not sure students (18.1%). The prevalence also was higher among not sure male students (30.7%) than not sure female students (18.1%).

Across 25 states, the prevalence of being currently sexually active ranged from 21.4% to 34.5% (median: 28.0%) among heterosexual students; from 27.9% to 51.0% (median: 36.5%) among gay, lesbian, and bisexual students; and from 9.7% to 28.7% (median: 21.6%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 17.8% to 36.6% (median: 26.0%) among heterosexual students; from 23.2% to 46.3% (median: 33.0%) among gay, lesbian, and bisexual students; and from 8.6% to 36.6% (median: 16.6%) among not sure students.

Nationwide, 57.6% of students who had sexual contact with only the opposite sex and 51.9% of students who had sexual contact with only the same sex or with both sexes were currently sexually active (students who had no sexual contact are excluded from these analyses). The prevalence of being currently sexually active was higher among students who had sexual contact with only the opposite sex (57.6%) than students who had sexual contact with only the same sex or with both sexes (51.9%). Among female students, the prevalence was higher among those who had sexual contact with only males (60.6%) than those who had sexual contact with only females or with both sexes (49.7%). The prevalence also was higher among female students who had sexual contact with only males (60.6%) than male students who had sexual contact with only females (55.3%).

Across 23 states, the prevalence of being currently sexually active ranged from 48.6% to 71.1% (median: 55.7%) among students who had sexual contact with only the opposite sex and from 43.4% to 73.2% (median: 55.2%) among students who had sexual contact with only the same sex or with both sexes. Across 19 large urban school districts, the prevalence ranged from 45.5% to 64.6% (median: 53.5%) among students who had sexual contact with only the opposite sex and from 32.0% to 62.7% (median: 50.6%) among students who had sexual contact with only the same sex or with both sexes.

Condom Use

Among the currently sexually active students nationwide, 56.9% of all those students; 57.8% of the heterosexual students; 47.5% of the gay, lesbian, and bisexual students; and 52.2% of the not sure students reported that either they or their partner had used a condom during last sexual intercourse (Table 70). The prevalence of having used a condom during last sexual intercourse was higher among heterosexual students (57.8%) than gay, lesbian, or bisexual students (47.5%). The prevalence also was higher among heterosexual male students (62.3%) than heterosexual female students (52.5%).

Across 25 states, the prevalence of having used a condom during last sexual intercourse ranged from 49.4% to 64.9% (median: 59.9%) among heterosexual students; from 25.7% to 72.4% (median: 39.1%) among gay, lesbian, and bisexual students; and from 32.2% to 52.6% (median: 45.0%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 55.5% to 71.5% (median: 63.3%) among heterosexual students and from 25.2% to 57.2% (median: 48.5%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 58.3% of the students who had sexual contact with only the opposite sex and 44.7% of the male students who had sexual contact with only males and the male and female students who had sexual contact with both sexes had used a condom at last sexual intercourse (male and female students who had no sexual contact and female students who had sexual contact with only females are excluded from these analyses). The prevalence of having used a condom during last sexual intercourse was higher among students who had sexual contact with only the opposite sex (58.3%) than male students who had sexual contact with only males and male and female students who had sexual contact with both sexes (44.7%). Among female students, the prevalence was higher among those who had sexual contact with only males (54.0%) than those who had sexual contact with both sexes (41.8%). The prevalence also was higher among male students who had sexual contact with only females (62.1%) than female students who had sexual contact with only males (54.0%).

Across 23 states, the prevalence of having used a condom during last sexual intercourse ranged from 50.7% to 65.4% (median: 59.2%) among students who had sexual contact with only the opposite sex and from 22.8% to 55.5% (median: 40.7%) among male students who had sexual contact with only males and male and female students who had sexual contact with both sexes. Across 19 large urban school districts, the prevalence ranged from 55.9% to 70.6% (median: 63.8%) among students who had sexual contact with only the opposite sex and from 25.8% to 57.0% (median: 46.2%) among male students who had sexual contact with only males and male and female students who had sexual contact with both sexes.

Birth Control Pill Use

Among the currently sexually active students nationwide, 18.2% of all those students; 18.7% of the heterosexual students; 14.8% of the gay, lesbian, and bisexual students; and 10.9% of the not sure students reported that either they or their partner had used birth control pills to prevent pregnancy before last sexual intercourse (Table 71). Among female students, the prevalence of having used birth control pills before last sexual intercourse was higher among heterosexual students (22.1%) than lesbian and bisexual students (16.8%). Among male students, the prevalence was higher among heterosexual students (15.8%) than gay and bisexual students (8.2%) and not sure students (4.9%). The prevalence also was higher among heterosexual female students (22.1%) than heterosexual male students (15.8%) and higher among lesbian and bisexual female students (16.8%) than gay and bisexual male students (8.2%).

Across 24 states, the prevalence of having used birth control pills before last sexual intercourse ranged from 12.9% to 36.3% (median: 21.9%) among heterosexual students; from 4.4% to 25.4% (median: 13.4%) among gay, lesbian, and bisexual students; and from 11.5% to 27.8% (median: 17.6%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 6.9% to 18.0% (median: 11.9%) among heterosexual students and from 1.2% to 27.1% (median: 9.9%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 18.6% of the students who had sexual contact with only the opposite sex and 18.6% of the students who had sexual contact with both sexes had used birth control pills before last sexual intercourse (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). Among male students, the prevalence of having used birth control pills before last sexual intercourse was higher among those who had sexual contact with only females (15.9%) than those who had sexual contact with both sexes (7.3%). The prevalence also was higher among female students who had sexual contact with only males (21.7%) than male students who had sexual contact with only females (15.9%) and higher among female students who had sexual contact with both sexes (21.4%) than male students who had sexual contact with both sexes (7.3%).

Across 23 states, the prevalence of having used birth control pills before last sexual intercourse ranged from 12.9% to 35.9% (median: 20.3%) among students who had sexual contact with only the opposite sex and from 3.2% to 32.3% (median: 17.8%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 6.4% to 17.5% (median: 11.9%) among students who had sexual contact with only the opposite sex and from 1.7% to 35.7% (median: 12.1%) among students who had sexual contact with both sexes.

IUD or Implant Use

Among the currently sexually active students nationwide, 3.3% of all those students; 3.1% of the heterosexual students; 3.7% of the gay, lesbian, and bisexual students; and 7.0% of the not sure students reported that either they or their partner had used an IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) to prevent pregnancy before last sexual intercourse (Table 72). The prevalence of having used an IUD or implant before last sexual intercourse was higher among heterosexual female students (4.2%) than heterosexual male students (2.1%).

Across 24 states, the prevalence of having used an IUD or implant before last sexual intercourse ranged from 1.0% to 6.4% (median: 3.3%) among heterosexual students; from 0.0% to 10.2% (median: 4.2%) among gay, lesbian, and bisexual students; and from 0.4% to 6.9% (median: 3.6%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 0.5% to 17.9% (median: 1.8%) among heterosexual students and from 0.0% to 15.2% (median: 3.3%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 3.0% of the students who had sexual contact with only the opposite sex and 6.5% of the students who had sexual contact with both sexes had used an IUD or implant before last sexual intercourse (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). The prevalence of having used an IUD or implant before last sexual intercourse was higher among female students who had sexual contact with only males (4.0%) than male students who had sexual contact with only females (2.2%).

Across 23 states, the prevalence of having used an IUD or implant before last sexual intercourse ranged from 1.0% to 6.3% (median: 3.2%) among students who had sexual contact with only the opposite sex and from 0.0% to 13.5% (median: 3.3%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 0.5% to 16.4% (median: 1.8%) among students who had sexual contact with only the opposite sex and from 0.0% to 27.9% (median: 3.1%) among students who had sexual contact with both sexes.

Shot, Patch, or Birth Control Ring Use

Among the currently sexually active students nationwide, 5.3% of all those students; 5.3% of the heterosexual students; 5.8% of the gay, lesbian, and bisexual students; and 6.5% of the not sure students reported that either they or their partner had used a shot (such as Depo-Provera), patch (such as OrthoEvra), or birth control ring (such as NuvaRing) to prevent pregnancy before last sexual intercourse (Table 73). Among male students, the prevalence of having used a shot, patch, or birth control ring before last sexual intercourse was higher among heterosexual students (2.9%) than gay or bisexual students (0.3%). The prevalence also was higher among heterosexual female students (8.0%) than heterosexual male students (2.9%) and higher among lesbian and bisexual female students (7.4%) than gay and bisexual male students (0.3%).

Across 24 states, the prevalence of having used a shot, patch, or birth control ring before last sexual intercourse ranged from 1.5% to 9.5% (median: 5.0%) among heterosexual students; from 1.4% to 14.6% (median: 6.3%) among gay, lesbian, and bisexual students; and from 0.0% to 9.8% (median: 3.8%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 1.0% to 11.4% (median: 4.5%) among heterosexual students and from 0.0% to 8.4% (median: 3.4%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 5.4% of the students who had sexual contact with only the opposite sex and 5.8% of the students who had sexual contact with both sexes had used a shot, patch, or birth control ring before last sexual intercourse (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). The prevalence of having used a shot, patch, or birth control ring before last sexual intercourse was higher among female students who had sexual contact with only males (8.3%) than male students who had sexual contact with only females (2.8%) and higher among female students who had sexual contact with both sexes (6.8%) than male students who had sexual contact with both sexes (1.6%).

Across 23 states, the prevalence of having used a shot, patch, or birth control ring before last sexual intercourse ranged from 1.4% to 9.1% (median: 5.5%) among students who had sexual contact with only the opposite sex and from 1.7% to 19.5% (median: 7.5%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 1.3% to 10.6% (median: 4.5%) among students who had sexual contact with only the opposite sex and from 0.0% to 14.3% (median: 4.5%) among students who had sexual contact with both sexes.

Birth Control Pill; IUD or Implant; or Shot, Patch, or Birth Control Ring Use

Among the currently sexually active students nationwide, 26.8% of all those students; 27.1% of the heterosexual students; 24.2% of the gay, lesbian, and bisexual students; and 24.4% of the not sure students reported that either they or their partner had used birth control pills; an IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon); or a shot (such as Depo-Provera), patch (such as OrthoEvra), or birth control ring (such as NuvaRing) to prevent pregnancy before last sexual intercourse (Table 74). Among male students, the prevalence of having used birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse was higher among heterosexual students (20.8%) than gay and bisexual students (9.3%). The prevalence also was higher among heterosexual female students (34.3%) than heterosexual male students (20.8%), higher among lesbian and bisexual female students (28.7%) than gay and bisexual male students (9.3%), and higher among not sure female students (35.3%) than not sure male students (14.2%).

Across 24 states, the prevalence of having used birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse ranged from 17.9% to 49.0% (median: 30.3%) among heterosexual students; from 8.3% to 37.9% (median: 26.5%) among gay, lesbian, and bisexual students; and from 16.2% to 36.8% (median: 23.3%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 10.6% to 39.3% (median: 17.0%) among heterosexual students and from 6.6% to 37.2% (median: 16.2%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 27.1% of the students who had sexual contact with only the opposite sex and 30.8% of the students who had sexual contact with both sexes had used birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). Among male students, the prevalence of having used birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse was higher among those who had sexual contact with only females (20.9%) than those who had sexual contact with both sexes (11.8%). The prevalence also was higher among female students who had sexual contact with only males (34.0%) than male students who had sexual contact with only females (20.9%) and higher among female students who had sexual contact with both sexes (35.5%) than male students who had sexual contact with both sexes (11.8%).

Across 23 states, the prevalence of having used birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse ranged from 18.2% to 48.2% (median: 30.0%) among students who had sexual contact with only the opposite sex and from 13.2% to 47.5% (median: 32.3%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 11.0% to 38.0% (median: 18.0%) among students who had sexual contact with only the opposite sex and from 7.7% to 57.3% (median: 21.5%) among students who had sexual contact with both sexes.

Condom Use and Birth Control Pill; IUD or Implant; or Shot, Patch, or Birth Control Ring Use

Among the currently sexually active students nationwide, 8.8% of all those students; 8.5% of the heterosexual students; 8.7% of the gay, lesbian, and bisexual students; and 16.1% of the not sure students reported that either they or their partner had used both a condom during last sexual intercourse and birth control pills; an IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon); or a shot (such as Depo-Provera), patch (such as OrthoEvra), or birth control ring (such as NuvaRing) to prevent pregnancy before last sexual intercourse (Table 75). The prevalence of having used both a condom during last sexual intercourse and birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse was higher among heterosexual female students (11.4%) than heterosexual male students (5.9%) and higher among lesbian and bisexual female students (10.1%) than gay and bisexual male students (3.8%).

Across 24 states, the prevalence of having used both a condom during last sexual intercourse and birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse ranged from 5.1% to 19.8% (median: 11.4%) among heterosexual students; from 0.0% to 16.5% (median: 7.1%) among gay, lesbian, and bisexual students; and from 1.7% to 21.4% (median: 10.2%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 2.7% to 10.5% (median: 6.7%) among heterosexual students and from 0.0% to 15.8% (median: 5.9%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 8.8% of the students who had sexual contact with only the opposite sex and 9.8% of the students who had sexual contact with both sexes had used both a condom during last sexual intercourse and birth control pills; an IUD or implant; or a shot, patch, or birth control ring to prevent pregnancy before last sexual intercourse (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). The prevalence of having used both a condom during last sexual intercourse and birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse was higher among female students who had sexual contact with only males (11.7%) than male students who had sexual contact with only females (6.1%) and higher among female students who had sexual contact with both sexes (11.3%) than male students who had sexual contact with both sexes (3.9%).

Across 23 states, the prevalence of having used both a condom during last sexual intercourse and birth control pills; an IUD or implant; or a shot, patch, or birth control ring before last sexual intercourse ranged from 5.2% to 19.6% (median: 11.2%) among students who had sexual contact with only the opposite sex and from 0.0% to 14.2% (median: 9.3%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 2.9% to 9.9% (median: 6.4%) among students who had sexual contact with only the opposite sex and from 0.0% to 14.8% (median: 5.4%) among students who had sexual contact with both sexes.

Did Not Use Any Method to Prevent Pregnancy

Among the currently sexually active students nationwide, 13.8% of all those students; 12.4% of the heterosexual students; 26.4% of the gay, lesbian, and bisexual students; and 19.4% of the not sure students reported that neither they nor their partner had used any method to prevent pregnancy during last sexual intercourse (Table 76). The prevalence of not having used any method to prevent pregnancy was higher among gay, lesbian, and bisexual students (26.4%) than heterosexual students (12.4%). Among female students, the prevalence was higher among lesbian and bisexual students (24.9%) than heterosexual students (13.6%). Among male students, the prevalence was higher among gay and bisexual students (32.0%) than heterosexual students (11.1%).

Across 24 states, the prevalence of not having used any method to prevent pregnancy ranged from 5.0% to 17.1% (median: 10.6%) among heterosexual students; from 18.6% to 43.9% (median: 31.0%) among gay, lesbian, and bisexual students; and from 6.4% to 40.8% (median: 18.4%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 8.0% to 20.5% (median: 14.1%) among heterosexual students and from 15.5% to 50.8% (median: 35.3%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 12.0% of the students who had sexual contact with only the opposite sex and 24.3% of the students who had sexual contact with both sexes had not used any method to prevent pregnancy (students who had no sexual contact and students who had sexual contact with only the same sex are excluded from these analyses). The prevalence of not having used any method to prevent pregnancy was higher among students who had sexual contact with both sexes (24.3%) than students who had sexual contact with only the opposite sex (12.0%). Among female students, the prevalence was higher among those who had sexual contact with both sexes (24.9%) than those who had sexual contact with only the opposite sex (12.6%).

Across 23 states, the prevalence of not having used any method to prevent pregnancy ranged from 5.1% to 16.7% (median: 10.9%) among students who had sexual contact with only the opposite sex and from 8.3% to 51.0% (median: 21.1%) among students who had sexual contact with both sexes. Across 18 large urban school districts, the prevalence ranged from 8.2% to 21.0% (median: 14.5%) among students who had sexual contact with only the opposite sex and from 15.6% to 41.5% (median: 24.2%) among students who had sexual contact with both sexes.

Drank Alcohol or Used Drugs Before Last Sexual Intercourse

Among the currently sexually active students nationwide, 20.6% of all those students; 20.0% of the heterosexual students; 22.4% of the gay, lesbian, and bisexual students; and 44.5% of the not sure students had drunk alcohol or used drugs before last sexual intercourse (Table 77). The prevalence of having drunk alcohol or used drugs before last sexual intercourse was higher among not sure students (44.5%) than heterosexual students (20.0%) and gay, lesbian, and bisexual students (22.4%). Among female students, the prevalence was higher among lesbian and bisexual students (23.5%) and not sure students (35.8%) than heterosexual students (14.9%). Among male students, the prevalence was higher among not sure students (52.5%) than heterosexual students (24.2%) and gay and bisexual students (17.4%). The prevalence also was higher among heterosexual male students (24.2%) than heterosexual female students (14.9%).

Across 24 states, the prevalence of having drunk alcohol or used drugs before last sexual intercourse ranged from 14.0% to 23.6% (median: 18.9%) among heterosexual students; from 13.5% to 35.6% (median: 23.4%) among gay, lesbian, and bisexual students; and from 21.2% to 49.6% (median: 38.5%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 12.9% to 26.4% (median: 19.1%) among heterosexual students and from 7.2% to 35.0% (median: 21.8%) among gay, lesbian, and bisexual students. The range and median are not available for not sure students because less than five large urban school districts had enough students in this subgroup for this variable to produce stable estimates.

Among the currently sexually active students nationwide, 19.5% of the students who had sexual contact with only the opposite sex and 31.0% of the students who had sexual contact with only the same sex or with both sexes had drunk alcohol or used drugs before last sexual intercourse (students who had no sexual contact are excluded from these analyses). The prevalence of having drunk alcohol or used drugs before last sexual intercourse was higher among students who had sexual contact with only the same sex or with both sexes (31.0%) than students who had sexual contact with only the opposite sex (19.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (30.5%) than those who had sexual contact with only males (14.2%). The prevalence also was higher among male students who had sexual contact with only females (24.1%) than female students who had sexual contact with only males (14.2%).

Across 22 states, the prevalence of having drunk alcohol or used drugs before last sexual intercourse ranged from 12.9% to 22.5% (median: 17.8%) among students who had sexual contact with only the opposite sex and from 18.2% to 46.9% (median: 31.8%) among students who had sexual contact with only the same sex or with both sexes. Across 19 large urban school districts, the prevalence ranged from 10.3% to 25.2% (median: 18.3%) among students who had sexual contact with only the opposite sex and from 21.2% to 42.3% (median: 26.9%) among students who had sexual contact with only the same sex or with both sexes.

Tested for HIV

Nationwide, 10.2% of all students; 9.3% of heterosexual students; 18.2% of gay, lesbian, and bisexual students; and 12.8% of not sure students had ever been tested for HIV, not including tests done when donating blood (Table 78). The prevalence of having ever been tested for HIV was higher among gay, lesbian, and bisexual students (18.2%) than heterosexual students (9.3%) and not sure students (12.8%). Among female students, the prevalence was higher among lesbian and bisexual students (19.0%) than heterosexual students (9.8%) and not sure students (12.4%). Among male students, the prevalence was higher among gay and bisexual students (16.7%) than heterosexual students (8.9%).

Across 21 states, the prevalence of having ever been tested for HIV ranged from 7.8% to 16.7% (median: 10.4%) among heterosexual students; from 12.5% to 31.0% (median: 21.1%) among gay, lesbian, and bisexual students; and from 2.5% to 23.4% (median: 12.1%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 6.1% to 36.2% (median: 18.2%) among heterosexual students; from 12.5% to 46.7% (median: 25.1%) among gay, lesbian, and bisexual students; and from 9.6% to 41.2% (median: 17.8%) among not sure students.

Nationwide, 13.7% of students who had sexual contact with only the opposite sex, 23.2% of students who had sexual contact with only the same sex or with both sexes, and 4.4% of students who had no sexual contact had ever been tested for HIV. The prevalence of having ever been tested for HIV was higher among students who had sexual contact with only the same sex or with both sexes (23.2%) than students who had sexual contact with only the opposite sex (13.7%) and students who had no sexual contact (4.4%) and higher among students who had sexual contact with only the opposite sex (13.7%) than students who had no sexual contact (4.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (24.1%) than those who had sexual contact with only males (16.4%) and those who had no sexual contact (3.8%) and higher among those who had sexual contact with only males (16.4%) than those who had no sexual contact (3.8%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (20.6%) than those who had sexual contact with only females (11.6%) and those who had no sexual contact (5.1%) and higher among those who had sexual contact with only females (11.6%) than those who had no sexual contact (5.1%). The prevalence also was higher among female students who had sexual contact with only males (16.4%) than male students who had sexual contact with only females (11.6%).

Across 21 states, the prevalence of having ever been tested for HIV ranged from 10.5% to 23.3% (median: 14.7%) among students who had sexual contact with only the opposite sex, from 13.3% to 36.8% (median: 26.2%) among students who had sexual contact with only the same sex or with both sexes, and from 2.9% to 9.2% (median: 4.6%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 10.4% to 49.0% (median: 24.8%) among students who had sexual contact with only the opposite sex, from 16.7% to 51.1% (median: 29.5%) among students who had sexual contact with only the same sex or with both sexes, and from 2.4% to 20.6% (median: 8.2%) among students who had no sexual contact.

Dietary Behaviors

Did Not Eat Fruit or Drink 100% Fruit Juices

Nationwide, 5.2% of all students; 4.6% of heterosexual students; 7.5% of gay, lesbian, and bisexual students; and 11.3% of not sure students had not eaten fruit or drunk 100% fruit juices during the 7 days before the survey (Table 79). The prevalence of not having eaten fruit or drunk 100% fruit juices was higher among gay, lesbian, and bisexual students (7.5%) and not sure students (11.3%) than heterosexual students (4.6%). Among female students, the prevalence of not having eaten fruit of drunk 100% fruit juices was higher among lesbian and bisexual students (6.8%) and not sure students (12.4%) than heterosexual students (3.6%). The prevalence also was higher among heterosexual male students (5.5%) than heterosexual female students (3.6%).

Across 25 states, the prevalence of not having eaten fruit or drunk 100% fruit juices ranged from 3.3% to 11.8% (median: 6.5%) among heterosexual students; from 2.3% to 13.7% (median: 7.8%) among gay, lesbian, and bisexual students; and from 3.0% to 19.1% (median: 11.5%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 3.8% to 12.2% (median: 7.2%) among heterosexual students; from 2.9% to 11.8% (median: 6.7%) among gay, lesbian, and bisexual students; and from 3.7% to 17.2% (median: 11.6%) among not sure students.

Nationwide, 4.6% of students who had sexual contact with only the opposite sex, 8.6% of students who had sexual contact with only the same sex or with both sexes, and 4.5% of students who had no sexual contact had not eaten fruit or drunk 100% fruit juices. The prevalence of not having eaten fruit or drunk 100% fruit juices was higher among students who had sexual contact with only the same sex or with both sexes (8.6%) than students who had sexual contact with only the opposite sex (4.6%) and students who had no sexual contact (4.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (8.7%) than those who had sexual contact with only males (3.9%) and those who had no sexual contact (3.4%). The prevalence also was higher among male students who had no sexual contact (5.7%) than female students who had no sexual contact (3.4%).

Across 23 states, the prevalence of not having eaten fruit or drunk 100% fruit juices ranged from 1.8% to 10.7% (median: 5.9%) among students who had sexual contact with only the opposite sex, from 2.3% to 15.1% (median: 7.9%) among students who had sexual contact with only the same sex or with both sexes, and from 4.5% to 10.1% (median: 6.4%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 2.9% to 10.7% (median: 6.0%) among students who had sexual contact with only the opposite sex, from 2.3% to 11.0% (median: 6.6%) among students who had sexual contact with only the same sex or with both sexes, and from 3.7% to 9.7% (median: 6.4%) among students who had no sexual contact.

Ate Fruit or Drank 100% Fruit Juices One or More Times per Day

Nationwide, 63.3% of all students; 64.3% of heterosexual students; 58.6% of gay, lesbian, and bisexual students; and 52.3% of not sure students had eaten fruit or drunk 100% fruit juices one or more times per day during the 7 days before the survey (Table 80). The prevalence of having eaten fruit or drunk 100% fruit juices one or more times per day was higher among heterosexual students (64.3%) than gay, lesbian, and bisexual students (58.6%) and not sure students (52.3%). Among female students, the prevalence was higher among heterosexual students (62.8%) than not sure students (52.6%). Among male students, the prevalence was higher among heterosexual students (65.6%) than gay and bisexual students (58.2%) and not sure students (53.5%).

Across 25 states, the prevalence of having eaten fruit or drunk 100% fruit juices one or more times per day ranged from 49.1% to 68.2% (median: 60.4%) among heterosexual students; from 40.2% to 67.5% (median: 55.3%) among gay, lesbian, and bisexual students; and from 44.9% to 66.5% (median: 53.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 52.3% to 67.5% (median: 58.2%) among heterosexual students; from 46.1% to 68.9% (median: 56.3%) among gay, lesbian, and bisexual students; and from 49.5% to 70.7% (median: 57.6%) among not sure students.

Nationwide, 64.3% of students who had sexual contact with only the opposite sex, 57.9% of students who had sexual contact with only the same sex or with both sexes, and 63.7% of students who had no sexual contact had eaten fruit or drunk 100% fruit juices one or more times per day. The prevalence of having eaten fruit or drunk 100% fruit juices one or more times per day was higher among students who had sexual contact with only the opposite sex (64.3%) and students who had no sexual contact (63.7%) than students who had sexual contact with only the same sex or with both sexes (57.9%). Among female students, the prevalence was higher among those who had no sexual contact (64.5%) than those who had sexual contact with only males (60.5%) and those who had sexual contact with only females or with both sexes (56.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (67.2%) than those who had no sexual contact (62.8%). The prevalence also was higher among male students who had sexual contact with only females (67.2%) than female students who had sexual contact with only males (60.5%).

Across 23 states, the prevalence of having eaten fruit or drunk 100% fruit juices one or more times per day ranged from 51.3% to 68.5% (median: 60.8%) among students who had sexual contact with only the opposite sex, from 45.4% to 71.6% (median: 58.7%) among students who had sexual contact with only the same sex or with both sexes, and from 48.3% to 67.8% (median: 58.8%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 55.7% to 68.1% (median: 60.8%) among students who had sexual contact with only the opposite sex, from 49.9% to 67.3% (median: 57.5%) among students who had sexual contact with only the same sex or with both sexes, and from 50.3% to 68.6% (median: 56.7%) among students who had no sexual contact.

Ate Fruit or Drank 100% Fruit Juices Two or More Times per Day

Nationwide, 31.5% of all students; 31.9% of heterosexual students; 28.3% of gay, lesbian, and bisexual students; and 27.3% of not sure students had eaten fruit or drunk 100% fruit juices two or more times per day during the 7 days before the survey (Table 81). Among male students, the prevalence of having eaten fruit or drunk 100% fruit juices two or more times per day was higher among heterosexual students (33.7%) than gay and bisexual students (22.7%). The prevalence also was higher among heterosexual male students (33.7%) than heterosexual female students (29.8%).

Across 25 states, the prevalence of having eaten fruit or drunk 100% fruit juices two or more times per day ranged from 20.0% to 34.5% (median: 29.0%) among heterosexual students; from 15.7% to 34.6% (median: 28.2%) among gay, lesbian, and bisexual students; and from 19.3% to 35.7% (median: 29.1%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 24.2% to 38.0% (median: 31.9%) among heterosexual students; from 18.8% to 38.8% (median: 31.1%) among gay, lesbian, and bisexual students; and from 20.4% to 39.0% (median: 32.1%) among not sure students.

Nationwide, 32.7% of students who had sexual contact with only the opposite sex, 31.1% of students who had sexual contact with only the same sex or with both sexes, and 30.6% of students who had no sexual contact had eaten fruit or drunk 100% fruit juices two or more times per day. Among male students, the prevalence of having eaten fruit or drunk 100% fruit juices two or more times per day was higher among those who had sexual contact with only females (35.8%) than those who had no sexual contact (30.6%). The prevalence also was higher among male students who had sexual contact with only females (35.8%) than female students who had sexual contact with only males (28.6%).

Across 23 states, the prevalence of having eaten fruit or drunk 100% fruit juices two or more times per day ranged from 21.5% to 36.0% (median: 29.8%) among students who had sexual contact with only the opposite sex, from 16.5% to 45.8% (median: 29.3%) among students who had sexual contact with only the same sex or with both sexes, and from 17.8% to 32.6% (median: 28.7%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 28.5% to 39.0% (median: 34.8%) among students who had sexual contact with only the opposite sex, from 23.9% to 41.8% (median: 31.7%) among students who had sexual contact with only the same sex or with both sexes, and from 24.4% to 39.3% (median: 29.1%) among students who had no sexual contact.

Ate Fruit or Drank 100% Fruit Juices Three or More Times per Day

Nationwide, 20.0% of all students; 20.0% of heterosexual students; 19.2% of gay, lesbian, and bisexual students; and 18.6% of not sure students had eaten fruit or drunk 100% fruit juices three or more times per day during the 7 days before the survey (Table 82). Among female students, the prevalence of having eaten fruit or drunk 100% fruit juices three or more times per day was higher among lesbian and bisexual students (20.6%) than not sure students (12.8%). The prevalence also was higher among heterosexual male students (22.2%) than heterosexual female students (17.6%) and higher among not sure male students (27.1%) than not sure female students (12.8%).

Across 25 states, the prevalence of having eaten fruit or drunk 100% fruit juices three or more times per day ranged from 13.3% to 22.2% (median: 17.9%) among heterosexual students; from 10.1% to 24.7% (median: 16.7%) among gay, lesbian, and bisexual students; and from 7.1% to 26.1% (median: 16.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 17.0% to 24.9% (median: 21.2%) among heterosexual students; from 14.8% to 25.9% (median: 19.8%) among gay, lesbian, and bisexual students; and from 9.8% to 30.3% (median: 23.7%) among not sure students.

Nationwide, 21.8% of students who had sexual contact with only the opposite sex, 24.3% of students who had sexual contact with only the same sex or with both sexes, and 17.7% of students who had no sexual contact had eaten fruit or drunk 100% fruit juices three or more times per day. The prevalence of having eaten fruit or drunk 100% fruit juices three or more times per day was higher among students who had sexual contact with only the opposite sex (21.8%) and students who had sexual contact with only the same sex or with both sexes (24.3%) than students who had no sexual contact (17.7%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (22.2%) than those who had no sexual contact (16.7%). Among male students, the prevalence was higher among those who had sexual contact with only females (25.0%) and those who had sexual contact with only males or with both sexes (30.5%) than those who had no sexual contact (18.7%). The prevalence also was higher among male students who had sexual contact with only females (25.0%) than female students who had sexual contact with only males (17.7%) and higher among male students who had sexual contact with only males or with both sexes (30.5%) than female students who had sexual contact with only females or with both sexes (22.2%).

Across 23 states, the prevalence of having eaten fruit or drunk 100% fruit juices three or more times per day ranged from 13.5% to 25.4% (median: 18.8%) among students who had sexual contact with only the opposite sex, from 8.7% to 39.5% (median: 20.4%) among students who had sexual contact with only the same sex or with both sexes, and from 9.9% to 20.0% (median: 16.3%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 19.7% to 28.5% (median: 23.8%) among students who had sexual contact with only the opposite sex, from 15.9% to 31.0% (median: 21.7%) among students who had sexual contact with only the same sex or with both sexes, and from 15.3% to 21.7% (median: 19.2%) among students who had no sexual contact.

Did Not Eat Vegetables

Nationwide, 6.7% of all students; 6.3% of heterosexual students; 9.7% of gay, lesbian, and bisexual students; and 12.5% of not sure students had not eaten vegetables^¶¶ during the 7 days before the survey (Table 83). The prevalence of not having eaten vegetables was higher among gay, lesbian, and bisexual students (9.7%) and not sure students (12.5%) than heterosexual students (6.3%). Among female students, the prevalence was higher among lesbian and bisexual students (8.2%) and not sure students (10.3%) than heterosexual students (5.2%). Among male students, the prevalence was higher among gay and bisexual students (12.4%) and not sure students (13.9%) than heterosexual students (7.2%). The prevalence also was higher among heterosexual male students (7.2%) than heterosexual female students (5.2%).

Across 21 states, the prevalence of not having eaten vegetables ranged from 4.0% to 11.4% (median: 6.9%) among heterosexual students; from 4.3% to 12.9% (median: 8.0%) among gay, lesbian, and bisexual students; and from 4.0% to 20.4% (median: 10.6%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 5.8% to 12.4% (median: 10.7%) among heterosexual students; from 3.5% to 11.3% (median: 9.0%) among gay, lesbian, and bisexual students; and from 5.0% to 22.5% (median: 11.1%) among not sure students.

Nationwide, 5.9% of students who had sexual contact with only the opposite sex, 10.4% of students who had sexual contact with only the same sex or with both sexes, and 6.4% of students who had no sexual contact had not eaten vegetables. The prevalence of not having eaten vegetables was higher among students who had sexual contact with only the same sex or with both sexes (10.4%) than students who had sexual contact with only the opposite sex (5.9%) and students who had no sexual contact (6.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (9.9%) than those who had sexual contact with only the opposite sex (4.7%) and those who had no sexual contact (5.5%). The prevalence also was higher among male students who had sexual contact with only females (6.9%) than female students who had sexual contact with only males (4.7%).

Across 19 states, the prevalence of not having eaten vegetables ranged from 3.5% to 10.3% (median: 6.5%) among students who had sexual contact with only the opposite sex, from 5.3% to 11.8% (median: 7.6%) among students who had sexual contact with only the same sex or with both sexes, and from 4.7% to 10.4% (median: 6.9%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 4.2% to 12.1% (median: 9.4%) among students who had sexual contact with only the opposite sex, from 4.6% to 14.9% (median: 9.8%) among students who had sexual contact with only the same sex or with both sexes, and from 6.4% to 13.1% (median: 9.8%) among students who had no sexual contact.

Ate Vegetables One or More Times per Day

Nationwide, 61.0% of all students; 61.1% of heterosexual students; 56.4% of gay, lesbian, and bisexual students; and 57.9% of not sure students had eaten vegetables one or more times per day during the 7 days before the survey (Table 84). The prevalence of having eaten vegetables one or more times per day did not vary significantly by sexual identity subgroup.

Across 21 states, the prevalence of having eaten vegetables one or more times per day ranged from 53.4% to 72.6% (median: 58.4%) among heterosexual students; from 50.0% to 70.4% (median: 58.6%) among gay, lesbian, and bisexual students; and from 49.8% to 73.5% (median: 59.3%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 46.1% to 61.1% (median: 53.5%) among heterosexual students; from 49.0% to 63.3% (median: 54.5%) among gay, lesbian, and bisexual students; and from 43.4% to 69.2% (median: 60.3%) among not sure students.

Nationwide, 61.1% of students who had sexual contact with only the opposite sex, 58.0% of students who had sexual contact with only the same sex or with both sexes, and 61.1% of students who had no sexual contact had eaten vegetables one or more times per day. The prevalence of having eaten vegetables one or more times per day was higher among male students who had sexual contact with only females (62.8%) than female students who had sexual contact with only males (59.0%) and higher among male students who had sexual contact with only males or with both sexes (67.2%) than female students who had sexual contact with only females or with both sexes (54.9%).

Across 19 states, the prevalence of having eaten vegetables one or more times per day ranged from 55.1% to 72.8% (median: 59.3%) among students who had sexual contact with only the opposite sex, from 49.7% to 71.8% (median: 62.4%) among students who had sexual contact with only the same sex or with both sexes, and from 51.5% to 72.3% (median: 58.3%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 46.3% to 64.0% (median: 54.8%) among students who had sexual contact with only the opposite sex, from 45.7% to 67.4% (median: 54.3%) among students who had sexual contact with only the same sex or with both sexes, and from 46.9% to 57.6% (median: 52.9%) among students who had no sexual contact.

Ate Vegetables Two or More Times per Day

Nationwide, 28.0% of all students; 27.8% of heterosexual students; 29.0% of gay, lesbian, and bisexual students; and 26.2% of not sure students had eaten vegetables two or more times per day during the 7 days before the survey (Table 85). Among female students, the prevalence of having eaten vegetables two or more times per day was higher among heterosexual students (26.3%) and lesbian and bisexual students (26.6%) than not sure students (20.0%). The prevalence also was higher among heterosexual male students (29.1%) than heterosexual female students (26.3%), higher among gay and bisexual male students (36.0%) than lesbian and bisexual female students (26.6%), and higher among not sure male students (34.3%) than not sure female students (20.0%).

Across 21 states, the prevalence of having eaten vegetables two or more times per day ranged from 22.1% to 35.9% (median: 25.2%) among heterosexual students; from 20.4% to 35.8% (median: 25.9%) among gay, lesbian, and bisexual students; and from 14.6% to 43.4% (median: 29.3%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 17.3% to 26.6% (median: 22.4%) among heterosexual students; from 19.5% to 32.0% (median: 24.7%) among gay, lesbian, and bisexual students; and from 20.7% to 45.3% (median: 30.1%) among not sure students.

Nationwide, 27.8% of students who had sexual contact with only the opposite sex, 27.6% of students who had sexual contact with only the same sex or with both sexes, and 28.1% of students who had no sexual contact had eaten vegetables two or more times per day. Among male students, the prevalence of having eaten vegetables two or more times per day was higher among those who had sexual contact with only males and with both sexes (39.0%) than those who had sexual contact with only females (29.4%). The prevalence also was higher among male students who had sexual contact with only males or with both sexes (39.0%) than female students who had sexual contact with only females or with both sexes (23.7%).

Across 19 states, the prevalence of having eaten vegetables two or more times per day ranged from 20.6% to 36.0% (median: 25.9%) among students who had sexual contact with only the opposite sex, from 19.3% to 39.0% (median: 28.3%) among students who had sexual contact with only the same sex or with both sexes, and from 19.6% to 35.8% (median: 24.0%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 16.7% to 29.0% (median: 23.1%) among students who had sexual contact with only the opposite sex, from 17.8% to 40.2% (median: 27.7%) among students who had sexual contact with only the same sex or with both sexes, and from 18.9% to 26.8% (median: 21.8%) among students who had no sexual contact.

Ate Vegetables Three or More Times per Day

Nationwide, 14.8% of all students; 14.4% of heterosexual students; 15.5% of gay, lesbian, and bisexual students; and 18.3% of not sure students had eaten vegetables three or more times per day during the 7 days before the survey (Table 86). Among male students, the prevalence of having eaten vegetables three or more times per day was higher among not sure students (25.8%) than heterosexual students (16.0%). The prevalence also was higher among heterosexual male students (16.0%) than heterosexual female students (12.4%), higher among gay or bisexual male students (20.8%) than lesbian or bisexual female students (13.5%), and higher among not sure male students (25.8%) than not sure female students (12.9%).

Across 21 states, the prevalence of having eaten vegetables three or more times per day ranged from 9.0% to 17.5% (median: 12.4%) among heterosexual students; from 11.1% to 20.0% (median: 14.4%) among gay, lesbian, and bisexual students; and from 6.5% to 30.6% (median: 19.7%) among not sure students. Across 16 large urban school districts, the prevalence ranged from 8.2% to 15.6% (median: 11.7%) among heterosexual students; from 10.3% to 26.4% (median: 14.1%) among gay, lesbian, and bisexual students; and from 12.6% to 34.2% (median: 18.5%) among not sure students.

Nationwide, 15.1% of students who had sexual contact with only the opposite sex, 18.0% of students who had sexual contact with only the same sex or with both sexes, and 13.7% of students who had no sexual contact had eaten vegetables three or more times per day. The prevalence of having eaten vegetables three or more times per day was higher among students who had sexual contact with only the same sex or with both sexes (18.0%) than students who had no sexual contact (13.7%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (28.0%) than those who had sexual contact with only females (17.0%) and those who had no sexual contact (15.3%). The prevalence also was higher among male students who had sexual contact with only females (17.0%) than female students who had sexual contact with only males (12.7%) and higher among male students who had sexual contact with only males or with both sexes (28.0%) than female students who had sexual contact with only females or with both sexes (14.6%).

Across 19 states, the prevalence of having eaten vegetables three or more times per day ranged from 8.2% to 18.1% (median: 13.4%) among students who had sexual contact with only the opposite sex, from 10.3% to 23.6% (median: 17.8%) among students who had sexual contact with only the same sex or with both sexes, and from 7.1% to 17.0% (median: 11.2%) among students who had no sexual contact. Across 16 large urban school districts, the prevalence ranged from 7.3% to 18.7% (median: 12.4%) among students who had sexual contact with only the opposite sex, from 10.4% to 29.6% (median: 15.5%) among students who had sexual contact with only the same sex or with both sexes, and from 9.1% to 14.1% (median: 11.1%) among students who had no sexual contact.

Did Not Drink Milk

Nationwide, 21.5% of all students; 20.4% of heterosexual students; 29.2% of gay, lesbian, and bisexual students; and 30.1% of not sure students had not drunk milk during the 7 days before the survey (Table 87). The prevalence of not having drunk milk was higher among gay, lesbian, and bisexual students (29.2%) and not sure students (30.1%) than heterosexual students (20.4%). Among female students, the prevalence was higher among not sure students (35.8%) than heterosexual students (28.1%). Among male students, the prevalence was higher among gay and bisexual students (29.6%) and not sure students (23.4%) than heterosexual students (13.9%). The prevalence also was higher among heterosexual female students (28.1%) than heterosexual male students (13.9%) and higher among not sure female students (35.8%) than not sure male students (23.4%).

Across 18 states, the prevalence of not having drunk milk ranged from 13.6% to 30.1% (median: 22.3%) among heterosexual students; from 19.6% to 36.1% (median: 27.0%) among gay, lesbian, and bisexual students; and from 11.0% to 40.0% (median: 26.1%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 19.5% to 38.0% (median: 25.8%) among heterosexual students; from 20.0% to 44.2% (median: 33.7%) among gay, lesbian, and bisexual students; and from 24.1% to 41.0% (median: 30.5%) among not sure students.

Nationwide, 21.2% of students who had sexual contact with only the opposite sex, 28.8% of students who had sexual contact with only the same sex or with both sexes, and 20.0% of students who had no sexual contact had not drunk milk during the 7 days before the survey. The prevalence was higher among students who had sexual contact with only the same sex or with both sexes (28.8%) than students who had sexual contact with only the opposite sex (21.2%) and students who had no sexual contact (20.0%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both males and females (24.2%) than those who had sexual contact with only females (14.5%) and those who had no sexual contact (13.1%). The prevalence also was higher among female students who had sexual contact with only males (29.9%) than male students who had sexual contact with only females (14.5%) and higher among female students who had no sexual contact (26.5%) than male students who had no sexual contact (13.1%).

Across 17 states, the prevalence of not having drunk milk ranged from 17.8% to 30.3% (median: 22.4%) among students who had sexual contact with only the opposite sex, from 17.9% to 42.1% (median: 25.5%) among students who had sexual contact with only the same sex or with both sexes, and from 15.9% to 29.5% (median: 21.4%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 19.8% to 36.3% (median: 27.0%) among students who had sexual contact with only the opposite sex, from 25.1% to 44.6% (median: 32.2%) among students who had sexual contact with only the same sex or with both sexes, and from 20.1% to 36.3% (median: 24.9%) among students who had no sexual contact.

Drank One or More Glasses of Milk per Day

Nationwide, 37.5% of all students; 38.5% of heterosexual students; 29.5% of gay, lesbian, and bisexual students; and 31.9% of not sure students had drunk one or more glasses of milk per day during the 7 days before the survey (Table 88). The prevalence of having drunk one or more glasses of milk per day was higher among heterosexual students (38.5%) than gay, lesbian, and bisexual students (29.5%) and not sure students (31.9%). Among male students, the prevalence was higher among heterosexual students (47.3%) than gay or bisexual students (37.3%) and not sure students (36.7%). The prevalence also was higher among heterosexual male students (47.3%) than heterosexual female students (28.3%) and higher among gay or bisexual male students (37.3%) than lesbian or bisexual female students (27.0%).

Across 18 states, the prevalence of having drunk one or more glasses of milk per day ranged from 22.4% to 52.6% (median: 34.6%) among heterosexual students; from 20.8% to 37.9% (median: 28.6%) among gay, lesbian, and bisexual students; and from 18.4% to 53.3% (median: 33.0%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 15.5% to 34.4% (median: 26.4%) among heterosexual students; from 15.1% to 35.1% (median: 23.1%) among gay, lesbian, and bisexual students; and from 16.5% to 36.2% (median: 27.1%) among not sure students.

Nationwide, 36.3% of students who had sexual contact with only the opposite sex, 29.2% of students who had sexual contact with only the same sex or with both sexes, and 40.5% of students who had no sexual contact had drunk one or more glasses of milk per day. The prevalence of having drunk one or more glasses of milk per day was higher among students who had no sexual contact (40.5%) than students who had sexual contact with only the opposite sex (36.3%) and students who had sexual contact with only the same sex or with both sexes (29.2%) and higher among students who had sexual contact with only the opposite sex (36.3%) than students who had sexual contact with only the same sex or with both sexes (29.2%). Among female students, the prevalence was higher among those who had no sexual contact (31.4%) than those who had sexual contact with only males (25.4%). Among male students, the prevalence was higher among those who had no sexual contact (50.2%) than those who had sexual contact with only females (44.8%) and those who had sexual contact with only males or with both sexes (40.4%). The prevalence also was higher among male students who had sexual contact with only females (44.8%) than female students who had sexual contact with only males (25.4%), higher among male students who had sexual contact with only males or with both sexes (40.4%) than female students who had sexual contact with only females or with both sexes (25.5%), and higher among male students who had no sexual contact (50.2%) than female students who had no sexual contact (31.4%).

Across 17 states, the prevalence of having drunk one or more glasses of milk per day ranged from 20.8% to 42.7% (median: 34.2%) among students who had sexual contact with only the opposite sex, from 24.2% to 37.1% (median: 30.8%) among students who had sexual contact with only the same sex or with both sexes, and from 23.8% to 44.4% (median: 34.1%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 17.0% to 36.1% (median: 25.8%) among students who had sexual contact with only the opposite sex, from 17.3% to 38.1% (median: 23.2%) among students who had sexual contact with only the same sex or with both sexes, and from 15.4% to 33.7% (median: 28.6%) among students who had no sexual contact.

Drank Two or More Glasses of Milk per Day

Nationwide, 22.4% of all students; 23.3% of heterosexual students; 15.7% of gay, lesbian, and bisexual students; and 17.3% of not sure students had drunk two or more glasses of milk per day during the 7 days before the survey (Table 89). The prevalence of having drunk two or more glasses of milk per day was higher among heterosexual students (23.3%) than gay, lesbian, or bisexual students (15.7%) and not sure students (17.3%). Among male students, the prevalence was higher among heterosexual students (30.5%) than gay or bisexual students (21.8%). The prevalence also was higher among heterosexual male students (30.5%) than heterosexual female students (14.9%) and higher among gay or bisexual male students (21.8%) than lesbian or bisexual female students (13.7%).

Across 18 states, the prevalence of having drunk two or more glasses of milk per day ranged from 11.8% to 36.6% (median: 20.7%) among heterosexual students; from 11.8% to 24.4% (median: 16.5%) among gay, lesbian, and bisexual students; and from 9.3% to 35.1% (median: 21.1%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 7.6% to 19.9% (median: 15.2%) among heterosexual students; from 7.3% to 23.0% (median: 10.8%) among gay, lesbian, and bisexual students; and from 5.4% to 27.1% (median: 13.7%) among not sure students.

Nationwide, 22.0% of students who had sexual contact with only the opposite sex, 16.5% of students who had sexual contact with only the same sex or with both sexes, and 24.0% of students who had no sexual contact had drunk two or more glasses of milk per day. The prevalence of having drunk two or more glasses of milk per day was higher among students who had sexual contact with only the opposite sex (22.0%) and students who had no sexual contact (24.0%) than students who had sexual contact with only the same sex or with both sexes (16.5%). The prevalence also was higher among male students who had sexual contact with only females (28.4%) than female students who had sexual contact with only males (13.9%), higher among male students who had sexual contact with only males or with both sexes (27.0%) than female students who had sexual contact with only females or with both sexes (13.0%), and higher among male students who had no sexual contact (32.6%) than female students who had no sexual contact (16.0%).

Across 17 states, the prevalence of having drunk two or more glasses of milk per day ranged from 11.7% to 27.2% (median: 21.0%) among students who had sexual contact with only the opposite sex, from 10.5% to 29.7% (median: 18.1%) among students who had sexual contact with only the same sex or with both sexes, and from 12.4% to 28.5% (median: 19.3%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 8.6% to 22.2% (median: 14.3%) among students who had sexual contact with only the opposite sex, from 7.6% to 25.8% (median: 11.8%) among students who had sexual contact with only the same sex or with both sexes, and from 7.5% to 19.4% (median: 15.3%) among students who had no sexual contact.

Drank Three or More Glasses of Milk per Day

Nationwide, 10.2% of all students; 10.5% of heterosexual students; 7.4% of gay, lesbian, and bisexual students; and 9.5% of not sure students had drunk three or more glasses of milk per day during the 7 days before the survey (Table 90). The prevalence of having drunk three or more glasses of milk per day was higher among heterosexual students (10.5%) than gay, lesbian, or bisexual students (7.4%). The prevalence also was higher among heterosexual male students (15.1%) than heterosexual female students (5.2%) and higher among gay or bisexual male students (12.1%) than lesbian or bisexual female students (5.8%).

Across 18 states, the prevalence of having drunk three or more glasses of milk per day ranged from 5.4% to 17.4% (median: 9.4%) among heterosexual students; from 2.3% to 11.4% (median: 8.0%) among gay, lesbian, and bisexual students; and from 2.5% to 19.0% (median: 10.3%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 3.9% to 9.2% (median: 7.4%) among heterosexual students; from 3.3% to 12.9% (median: 5.5%) among gay, lesbian, and bisexual students; and from 2.8% to 17.3% (median: 8.4%) among not sure students.

Nationwide, 10.2% of students who had sexual contact with only the opposite sex, 8.1% of students who had sexual contact with only the same sex or with both sexes, and 10.5% of students who had no sexual contact had drunk three or more glasses of milk per day. The prevalence of having drunk three or more glasses of milk per day was higher among male students who had sexual contact with only females (14.5%) than female students who had sexual contact with only males (4.7%), higher among male students who had sexual contact with only males or with both sexes (14.4%) than female students who had sexual contact with only females or with both sexes (6.0%), and higher among male students who had no sexual contact (15.7%) than female students who had no sexual contact (5.7%).

Across 17 states, the prevalence of having drunk three or more glasses of milk per day ranged from 5.6% to 13.3% (median: 9.8%) among students who had sexual contact with only the opposite sex, from 1.9% to 16.8% (median: 9.7%) among students who had sexual contact with only the same sex or with both sexes, and from 5.1% to 14.1% (median: 8.8%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 5.2% to 11.5% (median: 7.2%) among students who had sexual contact with only the opposite sex, from 3.3% to 17.2% (median: 6.4%) among students who had sexual contact with only the same sex or with both sexes, and from 3.4% to 8.7% (median: 6.6%) among students who had no sexual contact.

Did Not Drink Soda or Pop

Nationwide, 26.2% of all students; 26.1% of heterosexual students; 22.2% of gay, lesbian, and bisexual students; and 28.5% of not sure students had not drunk soda or pop (not including diet soda or diet pop) during the 7 days before the survey (Table 91). The prevalence of not having drunk soda or pop was higher among not sure students (28.5%) than gay, lesbian, or bisexual students (22.2%). Among female students, the prevalence was higher among heterosexual students (32.0%) than lesbian or bisexual students (22.2%). The prevalence also was higher among heterosexual female students (32.0%) than heterosexual male students (21.0%).

Across 24 states, the prevalence of not having drunk soda or pop ranged from 21.3% to 35.0% (median: 28.4%) among heterosexual students; from 12.8% to 32.2% (median: 25.2%) among gay, lesbian, and bisexual students; and from 16.6% to 40.6% (median: 31.3%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 18.4% to 39.2% (median: 27.5%) among heterosexual students; from 15.4% to 33.2% (median: 25.9%) among gay, lesbian, and bisexual students; and from 18.2% to 48.9% (median: 31.0%) among not sure students.

Nationwide, 23.1% of students who had sexual contact with only the opposite sex, 22.5% of students who had sexual contact with only the same sex or with both sexes, and 28.8% of students who had no sexual contact had not drunk soda or pop. The prevalence of not having drunk soda or pop was higher among students who had no sexual contact (28.8%) than students who had sexual contact with only the opposite sex (23.1%) and students who had sexual contact with only the same sex or with both sexes (22.5%). Among female students, the prevalence was higher among those who had no sexual contact (33.3%) than those who had sexual contact with only males (28.9%) and those who had sexual contact with only females or with both sexes (23.2%). Among male students, the prevalence was higher among those who had no sexual contact (24.0%) than those who had sexual contact with only females (18.5%). The prevalence also was higher among female students who had sexual contact with only males (28.9%) than male students who had sexual contact with only females (18.5%) and higher among female students who had no sexual contact (33.3%) than male students who had no sexual contact (24.0%).

Across 22 states, the prevalence of not having drunk soda or pop ranged from 17.7% to 31.8% (median: 24.3%) among students who had sexual contact with only the opposite sex, from 13.8% to 38.5% (median: 24.6%) among students who had sexual contact with only the same sex or with both sexes, and from 22.0% to 39.0% (median: 31.5%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 14.8% to 34.1% (median: 24.4%) among students who had sexual contact with only the opposite sex, from 12.2% to 35.1% (median: 25.1%) among students who had sexual contact with only the same sex or with both sexes, and from 21.1% to 44.0% (median: 29.4%) among students who had no sexual contact.

Drank Soda or Pop One or More Times per Day

Nationwide, 20.4% of all students; 20.2% of heterosexual students; 23.2% of gay, lesbian, and bisexual students; and 22.6% of not sure students had drunk a can, bottle, or glass of soda or pop (not counting diet soda or diet pop) one or more times per day during the 7 days before the survey (Table 92). Among female students, the prevalence of having drunk soda or pop one or more times per day was higher among lesbian and bisexual students (24.2%) than heterosexual students (15.5%). The prevalence also was higher among heterosexual male students (24.3%) than heterosexual female students (15.5%) and higher among not sure male students (28.9%) than not sure female students (18.2%).

Across 24 states, the prevalence of having drunk soda or pop one or more times per day ranged from 11.5% to 31.6% (median: 18.6%) among heterosexual students; from 13.6% to 42.5% (median: 21.2%) among gay, lesbian, and bisexual students; and from 9.5% to 43.5% (median: 21.0%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 9.4% to 27.5% (median: 18.2%) among heterosexual students; from 8.8% to 35.2% (median: 19.5%) among gay, lesbian, and bisexual students; and from 5.6% to 30.5% (median: 17.5%) among not sure students.

Nationwide, 23.5% of students who had sexual contact with only the opposite sex, 27.6% of students who had sexual contact with only the same sex or with both sexes, and 16.5% of students who had no sexual contact had drunk soda or pop one or more times per day. The prevalence of having drunk soda or pop one or more times per day was higher among students who had sexual contact with only the opposite sex (23.5%) and students who had sexual contact with only the same sex or with both sexes (27.6%) than students who had no sexual contact (16.5%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (26.5%) than those who had sexual contact with only males (18.2%) and those who had no sexual contact (13.3%) and higher among those who had sexual contact with only males (18.2%) than those who had no sexual contact (13.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (27.7%) and those who had sexual contact with only males or with both sexes (31.1%) than those who had no sexual contact (19.9%). The prevalence also was higher among male students who had sexual contact with only females (27.7%) than female students who had sexual contact with only males (18.2%) and higher among male students who had no sexual contact (19.9%) than female students who had no sexual contact (13.3%).

Across 22 states, the prevalence of having drunk soda or pop one or more times per day ranged from 13.7% to 37.1% (median: 21.8%) among students who had sexual contact with only the opposite sex, from 11.5% to 39.9% (median: 24.8%) among students who had sexual contact with only the same sex or with both sexes, and from 9.1% to 26.9% (median: 13.6%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 11.1% to 31.9% (median: 21.0%) among students who had sexual contact with only the opposite sex, from 11.0% to 37.4% (median: 22.0%) among students who had sexual contact with only the same sex or with both sexes, and from 6.5% to 25.3% (median: 15.4%) among students who had no sexual contact.

Drank Soda or Pop Two or More Times per Day

Nationwide, 13.0% of all students; 12.8% of heterosexual students; 15.9% of gay, lesbian, and bisexual students; and 15.0% of not sure students had drunk a can, bottle, or glass of soda or pop (not counting diet soda or diet pop) two or more times per day during the 7 days before the survey (Table 93). Among female students, the prevalence of having drunk soda or pop two or more times per day was higher among lesbian and bisexual students (18.1%) than heterosexual students (9.6%) and not sure students (11.5%). Among male students, the prevalence was higher among heterosexual male students (15.6%) than gay and bisexual students (10.9%). The prevalence also was higher among heterosexual male students (15.6%) than heterosexual female students (9.6%) and higher among lesbian or bisexual female students (18.1%) than gay or bisexual male students (10.9%).

Across 24 states, the prevalence of having drunk soda or pop two or more times per day ranged from 7.1% to 22.6% (median: 11.3%) among heterosexual students; from 8.1% to 32.5% (median: 15.1%) among gay, lesbian, and bisexual students; and from 5.2% to 36.3% (median: 13.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 5.6% to 18.8% (median: 11.6%) among heterosexual students; from 7.0% to 27.6% (median: 14.4%) among gay, lesbian, and bisexual students; and from 3.2% to 24.8% (median: 11.2%) among not sure students.

Nationwide, 15.9% of students who had sexual contact with only the opposite sex, 20.3% of students who had sexual contact with only the same sex or with both sexes, and 9.3% of students who had no sexual contact had drunk soda or pop three or more times per day. The prevalence of having drunk soda or pop three or more times per day was higher among students who had sexual contact with only the opposite sex (15.9%) and students who had sexual contact with only the same sex or with both sexes (20.3%) than students who had no sexual contact (9.3%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (19.4%) than those who had sexual contact with only males (12.2%) and those who had no sexual contact (7.4%) and higher among those who had sexual contact with only males (12.2%) than those who had no sexual contact (7.4%). Among male students, the prevalence was higher among those who had sexual contact with only females (18.8%) and those who had sexual contact with only males or with both sexes (22.9%) than those who had no sexual contact (11.2%). The prevalence also was higher among male students who had sexual contact with only females (18.8%) than female students who had sexual contact with only males (12.2%) and higher among male students who had no sexual contact (11.2%) than female students who had no sexual contact (7.4%).

Across 22 states, the prevalence of having drunk soda or pop two or more times per day ranged from 8.8% to 27.1% (median: 14.0%) among students who had sexual contact with only the opposite sex, from 6.7% to 33.7% (median: 17.8%) among students who had sexual contact with only the same sex or with both sexes, and from 5.8% to 18.6% (median: 8.0%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 7.0% to 21.9% (median: 14.6%) among students who had sexual contact with only the opposite sex, from 8.9% to 28.7% (median: 15.8%) among students who had sexual contact with only the same sex or with both sexes, and from 3.9% to 19.2% (median: 9.3%) among students who had no sexual contact.

Drank Soda or Pop Three or More Times per Day

Nationwide, 7.1% of all students; 6.7% of heterosexual students; 11.1% of gay, lesbian, and bisexual students; and 8.8% of not sure students had drunk a can, bottle, or glass of soda or pop (not counting diet soda or diet pop) three or more times per day during the 7 days before the survey (Table 94). The prevalence of having drunk soda or pop three or more times per day was higher among gay, lesbian, and bisexual students (11.1%) than heterosexual students (6.7%). Among female students, the prevalence was higher among lesbian and bisexual students (12.8%) than heterosexual students (5.2%) and not sure students (5.0%). The prevalence also was higher among heterosexual male students (8.0%) than heterosexual female students (5.2%), higher among lesbian or bisexual female students (12.8%) than gay or bisexual male students (7.5%), and higher among not sure male students (13.8%) than not sure female students (5.0%).

Across 24 states, the prevalence of having drunk soda or pop three or more times per day ranged from 4.1% to 13.6% (median: 6.0%) among heterosexual students; from 3.5% to 17.4% (median: 9.2%) among gay, lesbian, and bisexual students; and from 1.7% to 14.4% (median: 9.3%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 2.3% to 13.6% (median: 7.0%) among heterosexual students; from 3.6% to 19.7% (median: 8.7%) among gay, lesbian, and bisexual students; and from 0.8% to 21.3% (median: 6.7%) among not sure students.

Nationwide, 8.8% of students who had sexual contact with only the opposite sex, 14.4% of students who had sexual contact with only the same sex or with both sexes, and 4.4% of students who had no sexual contact had drunk soda or pop three or more times per day. The prevalence of having drunk soda or pop three or more times per day was higher among students who had sexual contact with only the same sex or with both sexes (14.4%) than students who had sexual contact with only the opposite sex (8.8%) and students who had no sexual contact (4.4%) and higher among students who had sexual contact with only the opposite sex (8.8%) than students who had no sexual contact (4.4%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (13.3%) than those who had sexual contact with only males (6.9%) and those who had no sexual contact (3.7%) and higher among those who had sexual contact with only males (6.9%) than those who had no sexual contact (3.7%). Among male students, the prevalence was higher among those who had sexual contact with only females (10.3%) and those who had sexual contact with only males or with both sexes (17.5%) than those who had no sexual contact (5.2%). The prevalence also was higher among male students who had sexual contact with only females (10.3%) than female students who had sexual contact with only males (6.9%) and higher among male students who had no sexual contact (5.2%) than female students who had no sexual contact (3.7%).

Across 22 states, the prevalence of having drunk soda or pop three or more times per day ranged from 4.4% to 16.7% (median: 8.2%) among students who had sexual contact with only the opposite sex, from 4.9% to 19.1% (median: 11.4%) among students who had sexual contact with only the same sex or with both sexes, and from 2.8% to 10.0% (median: 4.2%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 3.8% to 16.2% (median: 8.6%) among students who had sexual contact with only the opposite sex, from 5.2% to 19.6% (median: 10.4%) among students who had sexual contact with only the same sex or with both sexes, and from 1.6% to 12.9% (median: 5.1%) among students who had no sexual contact.

Did Not Drink Sports Drinks

Nationwide, 42.4% of all students; 41.2% of heterosexual students; 52.3% of gay, lesbian, and bisexual students; and 53.3% of not sure students had not drunk a can, bottle, or glass of sports drink (not counting low-calorie sports drinks) during the 7 days before the survey (Table 95). The prevalence of not having drunk a sports drink was higher among gay, lesbian, and bisexual students (52.3%) and not sure students (53.3%) than heterosexual students (41.2%). Among male students, the prevalence was higher among gay and bisexual students (51.9%) and not sure students (45.5%) than heterosexual students (31.0%). The prevalence also was higher among heterosexual female students (52.9%) than heterosexual male students (31.0%).

Nationwide, 34.6% of students who had sexual contact with only the opposite sex, 45.2% of students who had sexual contact with only the same sex or with both sexes, and 49.9% of students who had no sexual contact had not drunk a sports drink. The prevalence of not having drunk a sports drink was higher among students who had sexual contact with only the same sex or with both sexes (45.2%) and students who had no sexual contact (49.9%) than students who had sexual contact with only the opposite sex (34.6%). Among female students, the prevalence was higher among those who had no sexual contact (59.2%) than those who had sexual contact with only males (47.1%) and those who had sexual contact with only females or with both sexes (45.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (42.8%) and those who had no sexual contact (40.3%) than those who had sexual contact with only females (24.6%). The prevalence also was higher among female students who had sexual contact with only males (47.1%) than male students who had sexual contact with only females (24.6%) and higher among female students who had no sexual contact (59.2%) than male students who had no sexual contact (40.3%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of not having drunk a sports drink by sexual minority subgroups are not available.

Drank Sports Drinks One or More Times per Day

Nationwide, 13.8% of all students; 14.1% of heterosexual students; 10.0% of gay, lesbian, and bisexual students; and 13.6% of not sure students had drunk a can, bottle, or glass of a sports drink (not counting low-calorie sports drinks) one or more times per day during the 7 days before the survey (Table 96). The prevalence of having drunk a sports drink one or more times per day was higher among heterosexual students (14.1%) than gay, lesbian, and bisexual students (10.0%). Among male students, the prevalence was higher among heterosexual students (19.1%) and not sure students (22.9%) than gay and bisexual students (7.2%). The prevalence also was higher among heterosexual male students (19.1%) than heterosexual female students (8.3%) and higher among not sure male students (22.9%) than not sure female students (6.8%).

Nationwide, 17.2% of students who had sexual contact with only the opposite sex, 14.7% of students who had sexual contact with only the same sex or with both sexes, and 9.8% of students who had no sexual contact had drunk a sports drink one or more times per day. The prevalence of having drunk a sports drink one or more times per day was higher among students who had sexual contact with only the opposite sex (17.2%) and students who had sexual contact with only the same sex or with both sexes (14.7%) than students who had no sexual contact (9.8%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (14.6%) than those who had no sexual contact (7.2%). Among male students, the prevalence was higher among those who had sexual contact with only females (23.7%) than those who had sexual contact with only males or with both sexes (15.3%) and those who had no sexual contact (12.5%). The prevalence also was higher among male students who had sexual contact with only females (23.7%) than female students who had sexual contact with only males (9.1%) and higher among male students who had no sexual contact (12.5%) than female students who had no sexual contact (7.2%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk a sports drink one or more times per day by sexual minority subgroups are not available.

Drank Sports Drinks Two or More Times per Day

Nationwide, 8.3% of all students; 8.3% of heterosexual students; 7.2% of gay, lesbian, and bisexual students; and 10.0% of not sure students had drunk a can, bottle, or glass of a sports drink (not counting low-calorie sports drinks) two or more times per day during the 7 days before the survey (Table 97). Among male students, the prevalence of having drunk a sports drink two or more times per day was higher among heterosexual students (11.3%) and not sure students (17.0%) than gay and bisexual students (4.5%). The prevalence also was higher among heterosexual male students (11.3%) than heterosexual female students (4.9%) and higher among not sure male students (17.0%) than not sure female students (4.7%).

Nationwide, 10.9% of students who had sexual contact with only the opposite sex, 10.3% of students who had sexual contact with only the same sex or with both sexes, and 5.0% of students who had no sexual contact had drunk a sports drink two or more times per day. The prevalence of having drunk a sports drink two or more times per day was higher among students who had sexual contact with only the opposite sex (10.9%) and students who had sexual contact with only the same sex or with both sexes (10.3%) than students who had no sexual contact (5.0%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (10.2%) than those who had sexual contact with only males (5.6%) and those who had no sexual contact (4.1%) and higher among those who had sexual contact with only males (5.6%) than those who had no sexual contact (4.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (15.2%) than those who had no sexual contact (5.8%). The prevalence also was higher among male students who had sexual contact with only females (15.2%) than female students who had sexual contact with only males (5.6%) and higher among male students who had no sexual contact (5.8%) than female students who had no sexual contact (4.1%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk a sports drink two or more times per day by sexual minority subgroups are not available.

Drank Sports Drinks Three or More Times per Day

Nationwide, 4.8% of all students; 4.7% of heterosexual students; 4.1% of gay, lesbian, and bisexual students; and 6.1% of not sure students had drunk a can, bottle, or glass of a sports drink (not counting low-calorie sports drinks) three or more times per day during the 7 days before the survey (Table 98). Among male students, the prevalence of having drunk a sports drink three or more times per day was higher among heterosexual students (6.6%) and not sure students (9.9%) than gay and bisexual students (1.8%). The prevalence also was higher among heterosexual male students (6.4%) than heterosexual female students (2.8%) and higher among lesbian or bisexual female students (5.0%) than gay or bisexual male students (1.8%).

Nationwide, 6.5% of students who had sexual contact with only the opposite sex, 7.0% of students who had sexual contact with only the same sex or with both sexes, and 2.7% of students who had no sexual contact had drunk a sports drink three or more times per day. The prevalence of having drunk a sports drink three or more times per day was higher among students who had sexual contact with only the opposite sex (6.5%) and students who had sexual contact with only the same sex or with both sexes (7.0%) than students who had no sexual contact (2.7%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (7.0%) than those who had sexual contact with only males (3.2%) and those who had no sexual contact (2.3%) and higher among those who had sexual contact with only males (3.2%) than those who had no sexual contact (2.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (9.1%) than those who had no sexual contact (3.1%). The prevalence also was higher among male students who had sexual contact with only females (9.1%) than female students who had sexual contact with only males (3.2%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk a sports drink three or more times per day by sexual minority subgroups are not available.

Did Not Drink Water

Nationwide, 3.5% of all students; 3.1% of heterosexual students; 6.2% of gay, lesbian, and bisexual students; and 6.2% of not sure students had not drunk water during the 7 days before the survey (Table 99). The prevalence of not having drunk water during the 7 days before the survey was higher among gay, lesbian, and bisexual students (6.2%) than heterosexual students (3.1%). Among female students, the prevalence was higher among lesbian and bisexual students (5.9%) than heterosexual students (2.8%).

Nationwide, 3.3% of students who had sexual contact with only the opposite sex, 4.3% of students who had sexual contact with only the same sex or with both sexes, and 3.0% of students who had no sexual contact had not drunk water during the 7 days before the survey. The prevalence of not having drunk water did not vary significantly by sex of sexual contact subgroup.

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of not having drunk water during the 7 days before the survey by sexual minority subgroups are not available.

Drank One or More Glasses of Water per Day

Nationwide, 73.6% of all students; 74.3% of heterosexual students; 63.8% of gay, lesbian, and bisexual students; and 67.2% of not sure students had drunk one or more glasses of water per day during the 7 days before the survey (Table 100). The prevalence of having drunk one or more glasses of water per day was higher among heterosexual students (74.3%) than gay, lesbian, and bisexual students (63.8%) and not sure students (67.2%). Among female students, the prevalence was higher among heterosexual students (74.2%) and not sure students (69.8%) than gay, lesbian, and bisexual students (62.6%). Among male students, the prevalence was higher among heterosexual students (74.6%) than not sure students (63.7%).

Nationwide, 72.4% of students who had sexual contact with only the opposite sex, 69.4% of students who had sexual contact with only the same sex or with both sexes, and 75.3% of students who had no sexual contact had drunk one or more glasses of water per day. The prevalence of having drunk one or more glasses of water per day was higher among students who had no sexual contact (75.3%) than students who had sexual contact with only the opposite sex (72.4%). Among female students, the prevalence of having drunk one or more glasses of water per day was higher among those who had no sexual contact (75.2%) than those who had sexual contact with only males (71.7%) and those who had sexual contact with only females or with both sexes (67.1%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk one or more glasses of water per day by sexual minority subgroups are not available.

Drank Two or More Glasses of Water per Day

Nationwide, 64.3% of all students; 65.0% of heterosexual students; 55.0% of gay, lesbian, and bisexual students; and 57.9% of not sure students had drunk two or more glasses of water per day during the 7 days before the survey (Table 101). The prevalence of having drunk two or more glasses of water per day was higher among heterosexual students (65.0%) than gay, lesbian, and bisexual students (55.0%) and not sure students (57.9%). Among female students, the prevalence of having drunk two or more glasses of water per day was higher among heterosexual students (63.8%) than lesbian and bisexual students (53.5%).

Nationwide, 63.2% of students who had sexual contact with only the opposite sex, 59.3% of students who had sexual contact with only the same sex or with both sexes, and 66.1% of students who had no sexual contact had drunk two or more glasses of water per day. The prevalence of having drunk two or more glasses of water per day was higher among students who had no sexual contact (66.1%) than students who had sexual contact with only the opposite sex (63.2%). Among female students, the prevalence was higher among those who had no sexual contact (65.3%) than those who had sexual contact with only males (61.1%) and those who had sexual contact with only females or with both sexes (56.6%). The prevalence also was higher among male students who had sexual contact with only females (64.9%) than female students who had sexual contact with only males (61.1%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk two or more glasses of water per day by sexual minority subgroups are not available.

Drank Three or More Glasses of Water per Day

Nationwide, 49.5% of all students; 50.1% of heterosexual students; 42.0% of gay, lesbian, and bisexual students; and 42.5% of not sure students had drunk three or more glasses of water per day during the 7 days before the survey (Table 102). The prevalence of having drunk three or more glasses of water per day was higher among heterosexual students (50.1%) than gay, lesbian, and bisexual students (42.0%) and not sure students (42.5%). Among female students, the prevalence of having drunk three or more glasses of water per day was higher among heterosexual students (48.6%) than lesbian and bisexual students (41.1%). Among male students, the prevalence was higher among heterosexual students (51.5%) than not sure students (39.6%). The prevalence also was higher among heterosexual male students (51.5%) than heterosexual female students (48.6%).

Nationwide, 48.8% of students who had sexual contact with only the opposite sex, 46.6% of students who had sexual contact with only the same sex or with both sexes, and 50.5% of students who had no sexual contact had drunk three or more glasses of water per day. The prevalence of having drunk three or more glasses of water per day was higher among male students who had no sexual contact (52.4%) than female students who had no sexual contact (48.7%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having drunk three or more glasses of water per day by sexual minority subgroups are not available.

Did Not Eat Breakfast

Nationwide, 13.8% of all students; 13.3% of heterosexual students; 18.1% of gay, lesbian, and bisexual students; and 17.9% of not sure students had not eaten breakfast during the 7 days before the survey (Table 103). The prevalence of not having eaten breakfast was higher among gay, lesbian, and bisexual students (18.1%) and not sure students (17.9%) than heterosexual students (13.3%). Among female students, the prevalence was higher among lesbian and bisexual students (17.9%) than heterosexual students (13.5%).

Across 23 states, the prevalence of not having eaten breakfast ranged from 9.9% to 16.9% (median: 13.4%) among heterosexual students; from 15.4% to 28.7% (median: 21.1%) among gay, lesbian, and bisexual students; and from 10.4% to 29.7% (median: 19.5%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 10.8% to 22.2% (median: 15.3%) among heterosexual students; from 13.5% to 27.6% (median: 19.9%) among gay, lesbian, and bisexual students; and from 11.6% to 30.5% (median: 20.1%) among not sure students.

Nationwide, 14.5% of students who had sexual contact with only the opposite sex, 20.1% of students who had sexual contact with only the same sex or with both sexes, and 11.6% of students who had no sexual contact had not eaten breakfast during the 7 days before the survey. The prevalence of not having eaten breakfast was higher among students who had sexual contact with only the same sex or with both sexes (20.1%) than students who had sexual contact with only the opposite sex (14.5%) and students who had no sexual contact (11.6%) and higher among students who had sexual contact with only the opposite sex (14.5%) than students who had no sexual contact (11.6%). Among female students, the prevalence was higher among those who had sexual contact with only males (15.6%) and those who had sexual contact with only females or with both sexes (19.1%) than those who had no sexual contact (11.9%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (23.1%) than those who had sexual contact with only females (13.6%) and those who had no sexual contact (11.3%).

Across 21 states, the prevalence of not having eaten breakfast ranged from 11.2% to 19.4% (median: 14.1%) among students who had sexual contact with only the opposite sex, from 12.8% to 31.4% (median: 19.4%) among students who had sexual contact with only the same sex or with both sexes, and from 7.9% to 14.3% (median: 12.1%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 11.2% to 22.5% (median: 15.2%) among students who had sexual contact with only the opposite sex, from 9.7% to 29.7% (median: 19.5%) among students who had sexual contact with only the same sex or with both sexes, and from 9.5% to 22.5% (median: 13.3%) among students who had no sexual contact.

Ate Breakfast on All 7 Days

Nationwide, 36.3% of all students; 37.6% of heterosexual students; 24.8% of gay, lesbian, and bisexual students; and 27.3% of not sure students had eaten breakfast on all 7 days before the survey (Table 104). The prevalence of having eaten breakfast on all 7 days was higher among heterosexual students (37.6%) than gay, lesbian, and bisexual students (24.8%) and not sure students (27.3%). Among female students, the prevalence was higher among heterosexual students (33.5%) than lesbian and bisexual students (23.2%) and not sure students (22.5%). Among male students, the prevalence was higher among heterosexual students (41.1%) than gay and bisexual students (30.5%). The prevalence also was higher among male students who had sexual contact with only females (41.1%) than female students who had sexual contact with only males (33.5%).

Across 23 states, the prevalence of having eaten breakfast on all 7 days ranged from 31.2% to 43.4% (median: 36.0%) among heterosexual students; from 15.4% to 29.5% (median: 23.8%) among gay, lesbian, and bisexual students; and from 17.6% to 43.1% (median: 28.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 17.9% to 45.2% (median: 31.7%) among heterosexual students; from 3.6% to 38.3% (median: 19.5%) among gay, lesbian, and bisexual students; and from 15.2% to 40.1% (median: 30.4%) among not sure students.

Nationwide, 32.4% of students who had sexual contact with only the opposite sex, 21.9% of students who had sexual contact with only the same sex or with both sexes, and 42.5% of students who had no sexual contact had eaten breakfast on all 7 days. The prevalence of having eaten breakfast on all 7 days was higher among students who had no sexual contact (42.5%) than students who had sexual contact with only the opposite sex (32.4%) and students who had sexual contact with only the same sex or with both sexes (21.9%) and higher among students who had sexual contact with only the opposite sex (32.4%) than students who had sexual contact with only the same sex or with both sexes (21.9%). Among female students, the prevalence was higher among those who had no sexual contact (21.2%) than those who had sexual contact with only males (26.8%) and those who had sexual contact with only females or with both sexes (38.6%). Among male students, the prevalence was higher among those who had no sexual contact (46.7%) than those who had sexual contact with only females (36.7%) and those who had sexual contact with only males or with both sexes (23.8%). The prevalence also was higher among male students who had sexual contact with only females (36.7%) than female students who had sexual contact with only males (26.8%) and higher among male students who had no sexual contact (23.8%) than female students who had no sexual contact (38.6%).

Across 21 states, the prevalence of having eaten breakfast on all 7 days ranged from 25.7% to 36.7% (median: 31.6%) among students who had sexual contact with only the opposite sex, from 15.8% to 31.4% (median: 21.2%) among students who had sexual contact with only the same sex or with both sexes, and from 36.0% to 49.7% (median: 41.4%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 17.4% to 40.9% (median: 27.6%) among students who had sexual contact with only the opposite sex, from 4.4% to 34.0% (median: 18.9%) among students who had sexual contact with only the same sex or with both sexes, and from 20.0% to 50.0% (median: 37.3%) among students who had no sexual contact.

Physical Activity

Did Not Participate in at Least 60 Minutes of Physical Activity on at Least 1 Day

Nationwide, 14.3% of all students; 12.6% of heterosexual students; 25.7% of gay, lesbian, and bisexual students; and 27.0% of not sure students had not participated in at least 60 minutes of any kind of physical activity that increased their heart rate and made them breathe hard some of the time on at least 1 day during the 7 days before the survey (i.e., did not participate in at least 60 minutes of physical activity on at least 1 day) (Table 105). The prevalence of not having participated in at least 60 minutes of physical activity on at least 1 day was higher among gay, lesbian, and bisexual students (25.7%) and not sure students (27.0%) than heterosexual students (12.6%). Among female students, the prevalence was higher among lesbian and bisexual students (25.5%) and not sure students (25.1%) than heterosexual students (16.0%). Among male students, the prevalence was higher among gay and bisexual students (24.7%) and not sure students (28.2%) than heterosexual students (9.7%). The prevalence also was higher among heterosexual female students (16.0%) than heterosexual male students (9.7%).

Across 25 states, the prevalence of not having participated in at least 60 minutes of physical activity on at least 1 day ranged from 10.7% to 19.2% (median: 14.3%) among heterosexual students; from 15.4% to 30.9% (median: 24.7%) among gay, lesbian, and bisexual students; and from 11.3% to 41.7% (median: 25.2%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 12.9% to 29.7% (median: 20.6%) among heterosexual students; from 14.8% to 32.1% (median: 24.8%) among gay, lesbian, and bisexual students; and from 14.0% to 43.1% (median: 31.7%) among not sure students.

Nationwide, 12.3% of students who had sexual contact with only the opposite sex, 24.0% of students who had sexual contact with only the same sex or with both sexes, and 13.9% of students who had no sexual contact had not participated in at least 60 minutes of physical activity on at least 1 day. The prevalence of not having participated in at least 60 minutes of physical activity on at least 1 day was higher among students who had sexual contact with only the same sex or with both sexes (24.0%) than students who had sexual contact with only the opposite sex (12.3%) and students who had no sexual contact (13.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (22.4%) than those who had sexual contact with only males (17.3%) and those who had no sexual contact (16.4%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (28.6%) than those who had sexual contact with only females (8.4%) and those who had no sexual contact (11.2%) and higher among those who had no sexual contact (11.2%) than those who had sexual contact with only females (8.4%). The prevalence also was higher among female students who had sexual contact with only males (17.3%) than male students who had sexual contact with only females (8.4%) and higher among female students who had no sexual contact (16.4%) than male students who had no sexual contact (11.2%).

Across 23 states, the prevalence of not having participated in at least 60 minutes of physical activity on at least 1 day ranged from 9.8% to 19.3% (median: 13.0%) among students who had sexual contact with only the opposite sex, from 16.2% to 31.0% (median: 22.7%) among students who had sexual contact with only the same sex or with both sexes, and from 11.2% to 22.4% (median: 15.3%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 11.0% to 26.1% (median: 18.8%) among students who had sexual contact with only the opposite sex, from 14.4% to 32.5% (median: 23.7%) among students who had sexual contact with only the same sex or with both sexes, and from 13.7% to 32.1% (median: 21.2%) among students who had no sexual contact.

Physically Active at Least 60 Minutes per Day on 5 or More Days

Nationwide, 48.6% of all students; 51.6% of heterosexual students; 29.5% of gay, lesbian, and bisexual students; and 28.9% of not sure students had been physically active doing any kind of physical activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more days during the 7 days before the survey (i.e., physically active at least 60 minutes per day on 5 or more days) (Table 106). The prevalence of having been physically active at least 60 minutes per day on 5 or more days was higher among heterosexual students (51.6%) than gay, lesbian, or bisexual students (29.5%) and not sure students (28.9%). Among female students, the prevalence was higher among heterosexual students (41.4%) than lesbian or bisexual students (30.5%) and not sure students (27.5%). Among male students, the prevalence was higher among heterosexual students (60.4%) than gay or bisexual students (26.8%) and not sure students (32.0%). The prevalence also was higher among heterosexual male students (60.4%) than heterosexual female students (41.4%).

Across 25 states, the prevalence of having been physically active at least 60 minutes per day on 5 or more days ranged from 39.1% to 56.7% (median: 47.6%) among heterosexual students; from 23.1% to 43.1% (median: 29.4%) among gay, lesbian, and bisexual students; and from 20.8% to 40.2% (median: 29.9%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 28.9% to 52.5% (median: 38.1%) among heterosexual students; from 18.4% to 39.2% (median: 26.3%) among gay, lesbian, and bisexual students; and from 13.4% to 41.7% (median: 22.8%) among not sure students.

Nationwide, 52.5% of students who had sexual contact with only the opposite sex, 33.7% of students who had sexual contact with only the same sex or with both sexes, and 47.8% of students who had no sexual contact had been physically active at least 60 minutes per day on 5 or more days. The prevalence of having been physically active at least 60 minutes per day on 5 or more days was higher among students who had sexual contact with only the opposite sex (52.5%) than students who had sexual contact with only the same sex or with both sexes (33.7%) and students who had no sexual contact (47.8%). Among female students, the prevalence was higher among those who had no sexual contact (41.3%) than those who had sexual contact with only females or with both sexes (34.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (63.3%) than those who had sexual contact with only males or with both sexes (32.1%) and those who had no sexual contact (54.6%) and higher among those who had no sexual contact (54.6%) than those who had sexual contact with only males or with both sexes (32.1%). The prevalence also was higher among male students who had sexual contact with only females (63.3%) than female students who had sexual contact with only males (38.6%) and higher among male students who had no sexual contact (54.6%) than female students who had no sexual contact (41.3%)

Across 23 states, the prevalence of having been physically active at least 60 minutes per day on 5 or more days ranged from 38.8% to 58.5% (median: 48.3%) among students who had sexual contact with only the opposite sex, from 22.0% to 47.6% (median: 32.1%) among students who had sexual contact with only the same sex or with both sexes, and from 36.3% to 53.3% (median: 44.9%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 32.6% to 54.4% (median: 42.0%) among students who had sexual contact with only the opposite sex, from 22.1% to 42.1% (median: 27.5%) among students who had sexual contact with only the same sex or with both sexes, and from 25.5% to 50.1% (median: 35.9%) among students who had no sexual contact.

Physically Active at Least 60 Minutes per Day on All 7 Days

Nationwide, 27.1% of all students; 28.8% of heterosexual students; 15.3% of gay, lesbian, and bisexual students; and 14.1% of not sure students had been physically active doing any kind of physical activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes per day on each of the 7 days before the survey (i.e., physically active at least 60 minutes per day on all 7 days) (Table 107). The prevalence of having been physically active at least 60 minutes per day on all 7 days was higher among heterosexual students (28.8%) than gay, lesbian, or bisexual students (15.3%) and not sure students (14.1%). Among female students, the prevalence was higher among heterosexual students (18.6%) than not sure students (10.6%). Among male students, the prevalence was higher among heterosexual students (37.6%) than gay or bisexual students (16.6%) and not sure students (19.2%). The prevalence also was higher among heterosexual male students (37.6%) than heterosexual female students (18.6%).

Across 25 states, the prevalence of having been physically active at least 60 minutes per day on all 7 days ranged from 21.1% to 34.7% (median: 26.2%) among heterosexual students; from 8.0% to 26.8% (median: 15.4%) among gay, lesbian, and bisexual students; and from 7.1% to 23.6% (median: 14.7%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 15.8% to 27.8% (median: 21.6%) among heterosexual students; from 9.3% to 22.6% (median: 12.3%) among gay, lesbian, and bisexual students; and from 8.6% to 20.0% (median: 13.2%) among not sure students.

Nationwide, 31.2% of students who had sexual contact with only the opposite sex, 19.5% of students who had sexual contact with only the same sex or with both sexes, and 23.9% of students who had no sexual contact had been physically active at least 60 minutes per day on all 7 days. The prevalence of having been physically active at least 60 minutes per day on all 7 days was higher among students who had sexual contact with only the opposite sex (31.2%) than students who had sexual contact with only the same sex or with both sexes (19.5%) and students who had no sexual contact (23.9%). Among male students, the prevalence was higher among those who had sexual contact with only females (41.5%) than those who had sexual contact with only males or with both sexes (20.2%) and those who had no sexual contact (30.7%) and higher among those who had no sexual contact (30.7%) than those who had sexual contact with only males or with both sexes (20.2%). The prevalence also was higher among male students who had sexual contact with only females (41.5%) than female students who had sexual contact with only males (17.9%) and higher among male students who had no sexual contact (30.7%) than female students who had no sexual contact (17.5%).

Across 23 states, the prevalence of having been physically active at least 60 minutes per day on all 7 days ranged from 22.5% to 37.4% (median: 29.3%) among students who had sexual contact with only the opposite sex, from 10.7% to 31.4% (median: 17.8%) among students who had sexual contact with only the same sex or with both sexes, and from 17.9% to 30.0% (median: 23.1%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 18.5% to 30.0% (median: 23.8%) among students who had sexual contact with only the opposite sex, from 11.6% to 27.1% (median: 15.0%) among students who had sexual contact with only the same sex or with both sexes, and from 12.9% to 25.6% (median: 18.0%) among students who had no sexual contact.

Participated in Muscle Strengthening Activities

Nationwide, 53.4% of all students; 56.2% of heterosexual students; 33.9% of gay, lesbian, and bisexual students; and 35.8% of not sure students had participated in muscle strengthening exercises (e.g., push-ups, sit-ups, or weight lifting) on 3 or more days during the 7 days before the survey (Table 108). The prevalence of having participated in muscle strengthening exercises on 3 or more days was higher among heterosexual students (56.2%) than gay, lesbian, and bisexual students (33.9%) and not sure students (35.8%). Among female students, the prevalence was higher among heterosexual students (45.0%) than lesbian and bisexual students (32.7%) and not sure students (30.4%). Among male students, the prevalence was higher among heterosexual students (65.8%) than gay and bisexual students (38.6%) and not sure students (42.7%). The prevalence also was higher among male students who had sexual contact with only females (65.8%) than female students who had sexual contact with only males (45.0%).

Nationwide, 58.8% of students who had sexual contact with only the opposite sex, 39.0% of students who had sexual contact with only the same sex or with both sexes, and 51.1% of students who had no sexual contact had participated in muscle strengthening exercises on 3 or more days. The prevalence of having participated in muscle strengthening exercises on 3 or more days was higher among students who had sexual contact with only the opposite sex (58.8%) than students who had sexual contact with only the same sex or with both sexes (39.0%) and students who had no sexual contact (51.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (70.4%) than those who had sexual contact with only males or with both sexes (40.9%) and those who had no sexual contact (59.5%) and higher among those who had no sexual contact (59.5%) than those who had sexual contact with only males or with both sexes (40.9%). The prevalence also was higher among male students who had sexual contact with only females (70.4%) than female students who had sexual contact with only males (44.0%) and higher among male students who had no sexual contact (59.5%) than female students who had no sexual contact (42.9%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having participated in muscle strengthening exercises on 3 or more days by sexual minority subgroups are not available.

Used Computers 3 or More Hours per Day

Nationwide, 41.7% of all students; 40.2% of heterosexual students; 52.2% of gay, lesbian, and bisexual students; and 53.3% of not sure students played video or computer games or used a computer for something that was not school work for 3 or more hours per day on an average school day (i.e., used computers 3 or more hours per day) (Table 109). The prevalence of having used computers 3 or more hours per day was higher among gay, lesbian, and bisexual students (52.2%) and not sure students (53.3%) than heterosexual students (40.2%). Among female students the prevalence was higher among lesbian and bisexual students (53.5%) than heterosexual students (40.9%). Among male students, the prevalence was higher among gay and bisexual students (48.8%) and not sure students (59.1%) than heterosexual students (39.6%).

Across 24 states, the prevalence of having used computers 3 or more hours per day ranged from 28.7% to 44.7% (median: 38.3%) among heterosexual students; from 38.6% to 62.7% (median: 50.5%) among gay, lesbian, and bisexual students; and from 34.4% to 58.3% (median: 47.3%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 34.1% to 47.6% (median: 41.1%) among heterosexual students; from 29.2% to 57.4% (median: 45.6%) among gay, lesbian, and bisexual students; and from 28.3% to 59.2% (median: 39.8%) among not sure students.

Nationwide, 40.1% of students who had sexual contact with only the opposite sex, 52.0% of students who had sexual contact with only the same sex or with both sexes, and 42.7% of students who had no sexual contact had used computers 3 or more hours per day. The prevalence of having used computers 3 or more hours per day was higher among students who had sexual contact with only the same sex or with both sexes (52.0%) than students who had sexual contact with only the opposite sex (40.1%) and students who had no sexual contact (42.7%) and higher among students who had no sexual contact (42.7%) than students who had sexual contact with only the opposite sex (40.1%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (51.2%) than those who had sexual contact with only males (42.4%) and those who had no sexual contact (42.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (54.3%) than those who had sexual contact with only females (38.4%) and those who had no sexual contact (43.4%) and higher among those who had no sexual contact (43.4%) than those who had sexual contact with only females (38.4%).

Across 22 states, the prevalence of having used computers 3 or more hours per day ranged from 27.7% to 43.6% (median: 37.9%) among students who had sexual contact with only the opposite sex, from 36.7% to 65.9% (median: 45.2%) among students who had sexual contact with only the same sex or with both sexes, and from 31.4% to 45.6% (median: 42.3%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 34.9% to 47.3% (median: 41.6%) among students who had sexual contact with only the opposite sex, from 29.1% to 56.9% (median: 42.6%) among students who had sexual contact with only the same sex or with both sexes, and from 36.3% to 52.4% (median: 42.6%) among students who had no sexual contact.

Watched Television 3 or More Hours per Day

Nationwide, 24.7% of all students; 24.4% of heterosexual students; 24.6% of gay, lesbian, and bisexual students; and 30.7% of not sure students watched television 3 or more hours per day on an average school day (Table 110). The prevalence of having watched television 3 or more hours per day was higher among not sure students (30.7%) than heterosexual students (24.4%).

Across 23 states, the prevalence of having watched television 3 or more hours per day ranged from 18.1% to 31.3% (median: 23.7%) among heterosexual students; from 19.6% to 39.5% (median: 25.5%) among gay, lesbian, and bisexual students; and from 17.7% to 41.9% (median: 27.9%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 20.2% to 37.6% (median: 29.9%) among heterosexual students; from 15.3% to 36.1% (median: 29.4%) among gay, lesbian, and bisexual students; and from 13.4% to 41.5% (median: 24.3%) among not sure students.

Nationwide, 24.7% of students who had sexual contact with only the opposite sex, 29.8% of students who had sexual contact with only the same sex or with both sexes, and 24.2% of students who had no sexual contact watched television 3 or more hours per day. The prevalence of having watched television 3 or more hours per day was higher among students who had sexual contact with only the same sex or with both sexes (29.8%) than students who had sexual contact with only the opposite sex (24.7%) and students who had no sexual contact (24.2%).

Across 21 states, the prevalence of having watched television 3 or more hours per day ranged from 20.6% to 31.1% (median: 23.9%) among students who had sexual contact with only the opposite sex, from 18.4% to 36.4% (median: 26.1%) among students who had sexual contact with only the same sex or with both sexes, and from 18.4% to 36.4% (median: 26.1%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 19.4% to 38.6% (median: 31.0%) among students who had sexual contact with only the opposite sex, from 20.4% to 40.9% (median: 31.3%) among students who had sexual contact with only the same sex or with both sexes, and from 20.3% to 41.4% (median: 28.1%) among students who had no sexual contact.

Attended Physical Education Classes

Nationwide, 51.6% of all students; 52.2% of heterosexual students; 50.2% of gay, lesbian, and bisexual students; and 50.7% of not sure students went to physical education (PE) classes on 1 or more days in an average week when they were in school (i.e., attended PE classes) (Table 111). Among male students, the prevalence of having attended PE classes was higher among heterosexual students (56.2%) than gay or bisexual students (44.7%). The prevalence also was higher among heterosexual male students (56.2%) than heterosexual female students (47.6%).

Across 24 states, the prevalence of having attended PE classes ranged from 31.1% to 88.6% (median: 42.4%) among heterosexual students; from 33.6% to 84.2% (median: 39.0%) among gay, lesbian, and bisexual students; and from 27.8% to 83.6% (median: 41.9%) among not sure students. Across 14 large urban school districts, the prevalence ranged from 31.3% to 84.3% (median: 44.4%) among heterosexual students; from 33.5% to 83.2% (median: 43.0%) among gay, lesbian, and bisexual students; and from 29.3% to 84.2% (median: 45.8%) among not sure students.

Nationwide, 50.0% of students who had sexual contact with only the opposite sex, 47.7% of students who had sexual contact with only the same sex or with both sexes, and 54.9% of students who had no sexual contact had attended PE classes. The prevalence of having attended PE classes was higher among students who had no sexual contact (54.9%) than students who had sexual contact with only the opposite sex (50.0%) and students who had sexual contact with only the same sex or with both sexes (47.7%). Among female students, the prevalence was higher among those who had no sexual contact (53.5%) than those who had sexual contact with only males (42.1%). The prevalence also was higher among heterosexual male students (56.0%) than heterosexual female students (42.1%).

Across 22 states, the prevalence of having attended PE classes ranged from 31.4% to 90.1% (median: 42.3%) among students who had sexual contact with only the opposite sex, from 28.3% to 81.1% (median: 39.5%) among students who had sexual contact with only the same sex or with both sexes, and from 27.8% to 92.9% (median: 43.6%) among students who had no sexual contact. Across 14 large urban school districts, the prevalence ranged from 32.8% to 83.5% (median: 44.4%) among students who had sexual contact with only the opposite sex, from 29.5% to 82.3% (median: 43.6%) among students who had sexual contact with only the same sex or with both sexes, and from 29.8% to 87.0% (median: 43.2%) among students who had no sexual contact.

Attended Physical Education Classes Daily

Nationwide, 29.8% of all students; 30.6% of heterosexual students; 27.4% of gay, lesbian, and bisexual students; and 29.1% of not sure students went to physical education (PE) classes on all 5 days in an average week when they were in school (i.e., attended PE classes daily) (Table 112). Among male students, the prevalence of having attended PE classes daily was higher among heterosexual students (35.1%) than gay or bisexual students (22.1%). The prevalence also was higher among heterosexual male students (35.1%) than heterosexual female students (25.3%).

Across 24 states, the prevalence of having attended PE classes daily ranged from 5.8% to 63.1% (median: 22.9%) among heterosexual students; from 4.5% to 42.8% (median: 18.8%) among gay, lesbian, and bisexual students; and from 6.8% to 56.8% (median: 16.6%) among not sure students. Across 14 large urban school districts, the prevalence ranged from 8.7% to 43.0% (median: 24.2%) among heterosexual students; from 9.7% to 39.2% (median: 17.9%) among gay, lesbian, and bisexual students; and from 2.6% to 40.3% (median: 16.5%) among not sure students.

Nationwide, 31.0% of students who had sexual contact with only the opposite sex, 26.1% of students who had sexual contact with only the same sex or with both sexes, and 30.2% of students who had no sexual contact had attended PE classes daily. The prevalence of having attended PE classes daily was higher among students who had sexual contact with only the opposite sex (31.0%) than students who sexual contact with only the same sex or with both sexes (26.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (36.2%) than those who had sexual contact with only the same sex or with both sexes (24.7%). The prevalence also was higher among heterosexual male students (36.2%) than heterosexual female students (24.1%).

Across 22 states, the prevalence of having attended PE classes daily ranged from 5.3% to 61.0% (median: 21.6%) among students who had sexual contact with only the opposite sex, from 4.0% to 53.7% (median: 17.6%) among students who had sexual contact with only the same sex or with both sexes, and from 6.2% to 66.1% (median: 22.3%) among students who had no sexual contact. Across 14 large urban school districts, the prevalence ranged from 9.5% to 38.8% (median: 25.4%) among students who had sexual contact with only the opposite sex, from 9.2% to 36.4% (median: 18.3%) among students who had sexual contact with only the same sex or with both sexes, and from 6.4% to 50.8% (median: 23.1%) among students who had no sexual contact.

Played on at Least One Sports Team

Nationwide, 57.6% of all students; 60.7% of heterosexual students; 36.9% of gay, lesbian, and bisexual students; and 37.4% of not sure students had played on at least one sports team (run by their school or community groups) during the 12 months before the survey (Table 113). The prevalence of having played on at least one sports team was higher among heterosexual students (60.7%) than gay, lesbian, and bisexual students (36.9%) and not sure students (37.4%). Among female students, the prevalence was higher among heterosexual students (56.4%) than lesbian or bisexual students (35.5%) and not sure students (38.0%). Among male students, the prevalence was higher among heterosexual students (64.3%) than gay or bisexual students (40.5%) and not sure students (37.5%). The prevalence also was higher among heterosexual male students (64.3%) than heterosexual female students (56.4%).

Across 15 states, the prevalence of having played on at least one sports team ranged from 49.9% to 64.7% (median: 57.7%) among heterosexual students; from 27.2% to 51.0% (median: 39.4%) among gay, lesbian, and bisexual students; and from 28.5% to 57.4% (median: 39.2%) among not sure students. Across 15 large urban school districts, the prevalence ranged from 45.6% to 57.7% (median: 49.1%) among heterosexual students; from 30.8% to 52.5% (median: 45.5%) among gay, lesbian, and bisexual students; and from 26.8% to 54.4% (median: 40.7%) among not sure students.

Nationwide, 62.1% of students who had sexual contact with only the opposite sex, 43.2% of students who had sexual contact with only the same sex or with both sexes, and 55.9% of students who had no sexual contact had played on at least one sports team. The prevalence of having played on at least one sports team was higher among students who had sexual contact with only the opposite sex (62.1%) than students who had sexual contact with only the same sex or with both sexes (43.2%) than students who had no sexual contact (55.9%). Among female students, the prevalence was higher among those who had sexual contact with only males (53.9%) and those who had no sexual contact (54.6%) than those who had sexual contact with only females or with both sexes (44.1%). Among male students, the prevalence was higher among those who had sexual contact with only females (68.5%) than those who had sexual contact with only males or with both sexes (40.3%) and those who had no sexual contact (57.4%). The prevalence also was higher among male students who had sexual contact with only females (68.5%) than female students who had sexual contact with only males (53.9%).

Across 14 states, the prevalence of having played on at least one sports team ranged from 53.0% to 64.8% (median: 58.5%) among students who had sexual contact with only the opposite sex, from 29.8% to 58.1% (median: 47.1%) among students who had sexual contact with only the same sex or with both sexes, and from 43.0% to 65.5% (median: 52.6%) among students who had no sexual contact. Across 15 large urban school districts, the prevalence ranged from 48.8% to 62.1% (median: 56.6%) among students who had sexual contact with only the opposite sex, from 39.5% to 56.9% (median: 47.6%) among students who had sexual contact with only the same sex or with both sexes, and from 38.8% to 50.7% (median: 44.3%) among students who had no sexual contact.

Obesity, Overweight, and Weight Control

Obesity

Nationwide, 13.9% of all students; 13.4% of heterosexual students; 18.1% of gay, lesbian, and bisexual students; and16.3% of not sure students had obesity (Table 114). The prevalence of obesity was higher among gay, lesbian and bisexual students (18.1%) than heterosexual students (13.4%). Among female students, the prevalence was higher among lesbian and bisexual students (17.2%) than heterosexual students (9.8%). The prevalence also was higher among heterosexual male students (16.5%) than heterosexual female students (9.8%).

Across 25 states, the prevalence of obesity ranged from 9.9% to 17.8% (median: 12.7%) among heterosexual students; from 11.4% to 28.1% (median: 20.1) among gay, lesbian, and bisexual students; and from 6.1% to 37.3% (median: 16.9%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 9.6% to 22.3% (median: 12.4%) among heterosexual students; from 10.0% to 28.4% (median: 16.4%) among gay, lesbian, and bisexual students; and from 6.9% to 30.0% (median: 14.3%) among not sure students.

Nationwide, 12.7% of students who had sexual contact with only the opposite sex, 16.1% of students who had sexual contact with only the same sex or with both sexes, and 14.9% of students who had no sexual contact had obesity. The prevalence of obesity was higher among students who had no sexual contact (14.9%) than students who had sexual contact with only the opposite sex (12.7%). Among female students, the prevalence was higher among those who had no sexual contact (11.5%) than those who had sexual contact with only males (9.3%). Among male students, the prevalence was higher among those who had no sexual contact (18.4%) than those who had sexual contact with only females (15.3%). The prevalence also was higher among male students who had sexual contact with only females (15.3%) than female students who had sexual contact with only males (9.3%) and higher among male students who had no sexual contact (18.4%) than female students who had no sexual contact (11.5%).

Across 23 states, the prevalence of obesity ranged from 8.2% to 15.8% (median: 11.0%) among students who had sexual contact with only the opposite sex, from 8.4% to 34.7% (median: 18.4%) among students who had sexual contact with only the same sex or with both sexes, and from 10.6% to 20.5% (median: 14.5%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 9.9% to 21.4% (median: 12.7%) among students who had sexual contact with only the opposite sex, from 7.9% to 22.0% (median: 15.8%) among students who had sexual contact with only the same sex or with both sexes, and from 8.9% to 20.5% (median: 13.4%) among students who had no sexual contact.

Overweight

Nationwide, 16.0% of all students; 16.1% of heterosexual students; 17.4% of gay, lesbian, and bisexual students; and 15.2% of not sure students were overweight (Table 115). The prevalence of overweight was higher among lesbian and bisexual female students (19.5%) than gay and bisexual male students (11.8%).

Across 25 states, the prevalence of overweight ranged from 13.6% to 17.5% (median: 15.1%) among heterosexual students; from 12.1% to 27.0% (median: 17.8%) among gay, lesbian, and bisexual students; and from 13.4% to 25.8% (median: 17.4%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 12.8% to 21.4% (median: 16.7%) among heterosexual students; from 12.1% to 26.8% (median: 18.7%) among gay, lesbian, and bisexual students; and from 4.8% to 25.4% (median: 18.4%) among not sure students.

Nationwide, 16.1% of students who had sexual contact with only the opposite sex, 20.3% of students who had sexual contact with only the same sex or with both sexes, and 15.7% of students who had no sexual contact were overweight. The prevalence of overweight was higher among students who had sexual contact with only the same sex or with both sexes (20.3%) than students who had sexual contact with only the opposite sex (16.1%) and students who had no sexual contact (15.7%). Among female students, the prevalence of overweight was higher among those who had sexual contact with only females or with both sexes (21.5%) than those who had sexual contact with only males (15.6%).

Across 23 states, the prevalence of overweight ranged from 13.5% to 18.5% (median: 15.0%) among students who had sexual contact with only the opposite sex, from 11.9% to 27.5% (median: 17.9%) among students who had sexual contact with only the same sex or with both sexes, and from 12.6% to 17.1% (median: 14.9%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 12.0% to 21.0% (median: 16.4%) among students who had sexual contact with only the opposite sex, from 12.3% to 28.4% (median: 20.7%) among students who had sexual contact with only the same sex or with both sexes, and from 9.6% to 19.6% (median: 16.9%) among students who had no sexual contact.

Described Themselves as Overweight

Nationwide, 31.5% of all students; 30.1% of heterosexual students; 41.1% of gay, lesbian, and bisexual students; and 38.1% of not sure students described themselves as slightly or very overweight (Table 116). The prevalence of students describing themselves as overweight was higher among gay, lesbian, and bisexual students (41.1%) and not sure students (38.1%) than heterosexual students (30.1%). Among female students, the prevalence was higher among lesbian and bisexual students (44.7%) and not sure students (47.2%) than heterosexual students (36.8%). The prevalence also was higher among heterosexual female students (36.8%) than heterosexual male students (24.4%), higher among lesbian and bisexual female students (44.7%) than gay and bisexual male students (31.7%), and higher among not sure female students (47.2%) than not sure male students (27.1%).

Across 22 states, the prevalence of students describing themselves as overweight ranged from 25.1% to 32.6% (median: 29.7%) among heterosexual students; from 31.7% to 49.4% (median: 41.9%) among gay, lesbian, and bisexual students; and from 23.7% to 62.0% (median: 41.1%) among not sure students. Across 18 large urban school districts, the prevalence ranged from 23.4% to 34.1% (median: 28.4%) among heterosexual students; from 24.1% to 55.2% (median: 33.8%) among gay, lesbian, and bisexual students; and from 27.0% to 48.8% (median: 35.5%) among not sure students.

Nationwide, 28.7% of students who had sexual contact with only the opposite sex, 44.9% of students who had sexual contact with only the same sex or with both sexes, and 32.6% of students who had no sexual contact described themselves as slightly or very overweight. The prevalence of students describing themselves as overweight was higher among students who had sexual contact with only the same sex or with both sexes (44.9%) than students who had sexual contact with only the opposite sex (28.7%) and students who had no sexual contact (32.6%) and higher among students who had no sexual contact (32.6%) than students who had sexual contact with only the opposite sex (28.7%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (48.5%) than those who had sexual contact with only males (37.0%) and those who had no sexual contact (37.6%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (34.3%) and those who had no sexual contact (27.4%) than those who had sexual contact with only females (22.2%). The prevalence also was higher among female students who had sexual contact with only males (37.0%) than male students who had sexual contact with only females (22.2%), higher among female students who had sexual contact with only females or with both sexes (48.5%) than male students who had sexual contact with only males or with both sexes (34.3%), and higher among female students who had no sexual contact (37.6%) than male students who had no sexual contact (27.4%).

Across 20 states, the prevalence of students describing themselves as overweight ranged from 23.8% to 33.2% (median: 28.2%) among students who had sexual contact with only the opposite sex, from 32.3% to 49.9% (median: 41.4%) among students who had sexual contact with only the same sex or with both sexes, and from 27.3% to 35.7% (median: 32.4%) among students who had no sexual contact. Across 18 large urban school districts, the prevalence ranged from 20.0% to 31.4% (median: 26.5%) among students who had sexual contact with only the opposite sex, from 21.9% to 49.8% (median: 34.5%) among students who had sexual contact with only the same sex or with both sexes, and from 27.6% to 37.9% (median: 32.3%) among students who had no sexual contact.

Were Trying to Lose Weight

Nationwide, 45.6% of all students; 44.5% of heterosexual students; 56.3% of gay, lesbian, and bisexual students; and 46.2% of not sure students were trying to lose weight (Table 117). The prevalence of trying to lose weight was higher among gay, lesbian, and bisexual students (56.3%) than heterosexual students (44.5%) and not sure students (46.2%). The prevalence also was higher among heterosexual female students (60.6%) than heterosexual male students (30.8%), higher among lesbian and bisexual female students (62.8%) than gay and bisexual male students (39.1%), and higher among not sure female students (57.3%) than not sure male students (32.1%).

Across 20 states, the prevalence of trying to lose weight ranged from 40.5% to 48.5% (median: 45.5%) among heterosexual students; from 48.6% to 68.2% (median: 55.3%) among gay, lesbian, and bisexual students; and from 31.0% to 70.7% (median: 46.0%) among not sure students. Across 7 large urban school districts, the prevalence ranged from 38.8% to 54.3% (median: 45.3%) among heterosexual students; from 42.3% to 68.7% (median: 51.3%) among gay, lesbian, and bisexual students; and from 39.0% to 57.7% (median: 49.6%) among not sure students.

Nationwide, 43.4% of students who had sexual contact with only the opposite sex, 58.1% of students who had sexual contact with only the same sex or with both sexes, and 46.1% of students who had no sexual contact were trying to lose weight. The prevalence of trying to lose weight was higher among students who had sexual contact with only the same sex or with both sexes (58.1%) than students who had sexual contact with only the opposite sex (43.4%) and students who had no sexual contact (46.1%) and higher among students who had no sexual contact (46.1%) than students who had sexual contact with only the opposite sex (43.4%). Among female students, the prevalence was higher among those who had sexual contact with only males (63.0%) and those who had sexual contact with only females or with both sexes (65.2%) than those who had no sexual contact (58.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (37.0%) and those who had no sexual contact (33.4%) than those who had sexual contact with only females (28.4%). The prevalence also was higher among female students who had sexual contact with only males (63.0%) than male students who had sexual contact with only females (28.4%), higher among female students who had sexual contact with only females or with both sexes (65.2%) than male students who had sexual contact with only males or with both sexes (37.0%), and higher among female students who had no sexual contact (58.1%) than male students who had no sexual contact (33.4%).

Across 18 states, the prevalence of trying to lose weight ranged from 40.0% to 48.7% (median: 44.1%) among students who had sexual contact with only the opposite sex, from 45.8% to 63.7% (median: 56.6%) among students who had sexual contact with only the same sex or with both sexes, and from 40.9% to 50.1% (median: 46.3%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 30.2% to 51.2% (median: 41.9%) among students who had sexual contact with only the opposite sex, from 41.8% to 66.2% (median: 52.9%) among students who had sexual contact with only the same sex or with both sexes, and from 43.5% to 56.2% (median: 48.7%) among students who had no sexual contact.

Other Health-Related Topics

Ever Had Asthma

Nationwide, 22.8% of all students; 22.5% of heterosexual students; 28.9% of gay, lesbian, and bisexual students; and 24.3% of not sure students had ever been told by a doctor or nurse that they had asthma (i.e., ever had asthma) (Table 118). The prevalence of having ever had asthma was higher among gay, lesbian, and bisexual students (28.9%) than heterosexual students (22.5%). Among female students, the prevalence was higher among lesbian and bisexual students (28.3%) than heterosexual students (23.0%). Among male students, the prevalence was higher among gay and bisexual students (30.8%) than heterosexual students (21.9%).

Across 18 states, the prevalence of having ever had asthma ranged from 20.1% to 31.1% (median: 24.6%) among heterosexual students; from 20.2% to 36.4% (median: 30.6%) among gay, lesbian, and bisexual students; and from 15.0% to 36.7% (median: 23.7%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 18.1% to 33.7% (median: 23.1%) among heterosexual students; from 20.3% to 39.1% (median: 29.6%) among gay, lesbian, and bisexual students; and from 13.0% to 48.4% (median: 23.4%) among not sure students.

Nationwide, 24.7% of students who had sexual contact with only the opposite sex, 29.5% of students who had sexual contact with only the same sex or with both sexes, and 19.9% of students who had no sexual contact had ever had asthma. The prevalence of having ever had asthma was higher among students who had sexual contact with only the same sex or with both sexes (29.5%) than students who had sexual contact with only the opposite sex (24.7%) and students who had no sexual contact (19.9%) and higher among students who had sexual contact with only the opposite sex (24.7%) than students who had no sexual contact (19.9%). Among female students, the prevalence was higher among those who had sexual contact with only females or with both sexes (31.4%) than those who had sexual contact with only males (25.8%) and those who had no sexual contact (19.9%) and higher among those who had sexual contact with only males (25.8%) than those who had no sexual contact (19.9%). Among male students, the prevalence was higher among those who had sexual contact with only females (23.9%) than those who had no sexual contact (19.8%). The prevalence also was higher among female students who had sexual contact with only females or with both sexes (31.4%) than male students who had sexual contact with only males or with both sexes (23.3%).

Across 18 states, the prevalence of having ever had asthma ranged from 20.1% to 33.4% (median: 24.9%) among students who had sexual contact with only the opposite sex, from 18.1% to 39.9% (median: 30.4%) among students who had sexual contact with only the same sex or with both sexes, and from 18.6% to 29.5% (median: 22.4%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 20.4% to 35.3% (median: 24.4%) among students who had sexual contact with only the opposite sex, from 19.9% to 36.9% (median: 28.5%) among students who had sexual contact with only the same sex or with both sexes, and from 16.1% to 29.4% (median: 19.7%) among students who had no sexual contact.

Saw a Dentist

Nationwide, 74.4% of all students; 75.6% of heterosexual students; 66.0% of gay, lesbian, and bisexual students; and 60.4% of not sure students saw a dentist for a check-up, exam, teeth cleaning, or other dental work during the 12 months before the survey (Table 119). The prevalence of having seen a dentist was higher among heterosexual students (75.6%) than gay, lesbian, and bisexual students (66.0%) and not sure students (60.4%). Among female students, the prevalence was higher among heterosexual students (76.9%) than lesbian and bisexual students (67.2%) and not sure students (63.3%). Among male students, the prevalence was higher among heterosexual students (74.6%) than not sure students (58.7%).

Across 20 states, the prevalence of having seen a dentist ranged from 67.2% to 83.2% (median: 75.4%) among heterosexual students; from 54.9% to 74.7% (median: 65.3%) among gay, lesbian, and bisexual students; and from 42.1% to 76.2% (median: 61.0%) among not sure students. Across 17 large urban school districts, the prevalence ranged from 56.3% to 73.4% (median: 67.3%) among heterosexual students; from 49.3% to 69.2% (median: 58.0%) among gay, lesbian, and bisexual students; and from 40.6% to 69.0% (median: 56.4%) among not sure students.

Nationwide, 72.7% of students who had sexual contact with only the opposite sex, 63.0% of students who had sexual contact with only the same sex or with both sexes, and 78.7% of students who had no sexual contact had seen a dentist. The prevalence of having seen a dentist was higher among students who had no sexual contact (78.7%) than students who had sexual contact with only the opposite sex (72.7%) and students who had sexual contact with only the same sex or with both sexes (63.0%) and higher among students who had sexual contact with only the opposite sex (72.7%) than students who had sexual contact with only the same sex or with both sexes (63.0%). Among female students, the prevalence was higher among those who had no sexual contact (79.5%) than those who had sexual contact with only males (73.6%) and those who had sexual contact with only females or with both sexes (65.0%). Among male students, the prevalence was higher among those who had no sexual contact (77.8%) than those who had sexual contact with only females (72.1%) and those who had sexual contact with only males or with both sexes (57.0%).

Across 19 states, the prevalence of having seen a dentist ranged from 65.3% to 81.3% (median: 72.8%) among students who had sexual contact with only the opposite sex, from 53.4% to 76.4% (median: 65.0%) among students who had sexual contact with only the same sex or with both sexes, and from 68.7% to 85.0% (median: 76.9%) among students who had no sexual contact. Across 17 large urban school districts, the prevalence ranged from 56.4% to 73.6% (median: 66.0%) among students who had sexual contact with only the opposite sex, from 46.8% to 67.1% (median: 56.8%) among students who had sexual contact with only the same sex or with both sexes, and from 60.1% to 74.8% (median: 69.5%) among students who had no sexual contact.

Eight or More Hours of Sleep

Nationwide, 27.3% of all students; 28.3% of heterosexual students; 23.4% of gay, lesbian, and bisexual students; and 21.5% of not sure students got 8 or more hours of sleep on an average school night (Table 120). The prevalence of getting 8 or more hours of sleep was higher among heterosexual students (28.3%) than gay, lesbian, and bisexual students (23.4%) and not sure students (21.5%). The prevalence also was higher among heterosexual male students (30.8%) than heterosexual female students (25.3%).

Across 21 states, the prevalence of getting 8 or more hours of sleep ranged from 19.0% to 33.1% (median: 24.8%) among heterosexual students; from 8.5% to 25.9% (median: 17.4%) among gay, lesbian, and bisexual students; and from 5.2% to 28.3% (median: 21.6%) among not sure students. Across 19 large urban school districts, the prevalence ranged from 14.6% to 31.2% (median: 21.4%) among heterosexual students; from 9.4% to 26.6% (median: 16.8%) among gay, lesbian, and bisexual students; and from 12.8% to 38.8% (median: 20.9%) among not sure students.

Nationwide, 24.8% of students who had sexual contact with only the opposite sex, 20.5% of students who had sexual contact with only the same sex or with both sexes, and 31.2% of students who had no sexual contact got 8 or more hours of sleep. The prevalence of getting 8 or more hours of sleep was higher among students who had no sexual contact (31.2%) than students who had sexual contact with only the opposite sex (24.8%) and students who had sexual contact with only the same sex or with both sexes (20.5%). Among female students, the prevalence was higher among those who had no sexual contact (27.4%) than those who had sexual contact with only males (22.8%) and those who had sexual contact with only females or with both sexes (18.1%). Among male students, the prevalence was higher among those who had no sexual contact (35.3%) than those who had sexual contact with only females (26.3%). The prevalence also was higher among male students who had sexual contact with only females (26.3%) than female students who had sexual contact with only males (22.8%), higher among male students who had sexual contact with only males or with both sexes (27.4%) than female students who had sexual contact with only females or with both sexes (18.1%), and higher among male students who had no sexual contact (35.3%) than female students who had no sexual contact (27.4%).

Across 20 states, the prevalence of getting 8 or more hours of sleep ranged from 13.9% to 27.7% (median: 21.2%) among students who had sexual contact with only the opposite sex, from 8.3% to 26.6% (median: 17.6%) among students who had sexual contact with only the same sex or with both sexes, and from 23.4% to 37.1% (median: 27.4%) among students who had no sexual contact. Across 19 large urban school districts, the prevalence ranged from 12.7% to 28.9% (median: 19.2%) among students who had sexual contact with only the opposite sex, from 8.0% to 22.6% (median: 17.0%) among students who had sexual contact with only the same sex or with both sexes, and from 17.9% to 37.6% (median: 24.2%) among students who had no sexual contact.

Indoor Tanning Device Use

Nationwide, 7.3% of all students; 7.2% of heterosexual students; 6.2% of gay, lesbian, and bisexual students; and 13.1% of not sure students had used an indoor tanning device, such as a sunlamp, sunbed, or tanning booth (not including getting a spray-on tan), one or more times during the 12 months before the survey (i.e., indoor tanning device use) (Table 121). The prevalence of indoor tanning device use was higher among not sure students (13.1%) than heterosexual students (7.2%) and gay, lesbian, and bisexual students (6.2%). Among female students, the prevalence was higher among heterosexual females (11.7%) than lesbian and bisexual students (5.8%). Among male students, the prevalence was higher among not sure students (18.1%) than heterosexual students (3.4%). The prevalence also was higher among heterosexual female students (11.7%) than heterosexual male students (3.4%).

Nationwide, 10.7% of students who had sexual contact with only the opposite sex, 13.0% of students who had sexual contact with only the same sex or with both sexes, and 2.8% of students who had no sexual contact had used an indoor tanning device. The prevalence of indoor tanning device use was higher among students who had sexual contact with only the opposite sex (10.7%) and students who had sexual contact with only the same sex or with both sexes (13.0%) than students who had no sexual contact (2.8%). Among female students, the prevalence was higher among those who had sexual contact with only males (18.2%) than those who had sexual contact with only females or with both sexes (11.9%) and those who had no sexual contact (4.1%) and higher among those who had sexual contact with only females or with both sexes (11.9%) than those who had no sexual contact (4.1%). Among male students, the prevalence was higher among those who had sexual contact with only males or with both sexes (16.5%) than those who had sexual contact with only females (4.7%) and those who had no sexual contact (1.4%) and higher among those who had sexual contact with only females (4.7%) than those who had no sexual contact (1.4%). The prevalence also was higher among female students who had sexual contact with only males (18.2%) than male students who had sexual contact with only females (4.7%) and higher among female students who had no sexual contact (4.1%) than male students who had no sexual contact (1.4%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of indoor tanning device use by sexual minority subgroups are not available.

Had a Sunburn

Nationwide, 55.8% of all students; 56.3% of heterosexual students; 52.3% of gay, lesbian, and bisexual students; and 50.6% of not sure students had a sunburn (including even a small part of their skin turning red or hurting for 12 hours or more after being outside in the sun or after using a sunlamp or other indoor tanning device) one or more times during the 12 months before the survey (i.e., had a sunburn) (Table 122). Among female students, the prevalence of having had a sunburn was higher among heterosexual students (61.0%) than lesbian or bisexual students (52.7%) and not sure students (48.9%). The prevalence also was higher among heterosexual female students (61.0%) than heterosexual male students (52.2%).

Nationwide, 58.3% of students who had sexual contact with only the opposite sex, 58.1% of students who had sexual contact with only the same sex or with both sexes, and 52.9% of students who had no sexual contact had had a sunburn. The prevalence of having had a sunburn was higher among students who had sexual contact with only the opposite sex (58.3%) than students who had no sexual contact (52.9%). Among female students, the prevalence was higher among those who had sexual contact with only males (64.1%) than those who had no sexual contact (55.9%). The prevalence also was higher among female students who had sexual contact with only males (64.1%) than male students who had sexual contact with only females (53.6%) and higher among female students who had no sexual contact (55.9%) than male students who had no sexual contact (49.8%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of having had a sunburn by sexual minority subgroups are not available.

Avoided Foods Because of Allergic Reaction Risk

Nationwide, 16.0% of all students; 15.1% of heterosexual students; 23.3% of gay, lesbian, and bisexual students; and 17.4% of not sure students avoided foods because eating the food could cause an allergic reaction (such as skin rashes, swelling, itching, vomiting, coughing, or trouble breathing) (Table 123). The prevalence of avoiding foods because eating the food could cause an allergic reaction was higher among gay, lesbian, and bisexual students (23.3%) than heterosexual students (15.1%) and not sure students (17.4%). Among female students, the prevalence was higher among lesbian and bisexual students (25.2%) than heterosexual students (19.1%). The prevalence also was higher among heterosexual female students (19.1%) than heterosexual male students (11.6%) and higher among lesbian and bisexual female students (25.2%) than gay and bisexual male students (15.0%).

Nationwide, 16.5% of students who had sexual contact with only the opposite sex, 22.5% of students who had sexual contact with only the same sex or with both sexes, and 13.8% of students who had no sexual contact had avoided foods because eating the food could cause an allergic reaction. The prevalence of avoiding foods because eating the food could cause an allergic reaction was higher among students who had sexual contact with only the same sex or with both sexes (22.5%) than students who had sexual contact with only the opposite sex (16.5%) and students who had no sexual contact (13.8%) and higher among students who had sexual contact with only the opposite sex (16.5%) than students who had no sexual contact (13.8%). Among female students, the prevalence was higher among those who had sexual contact with only males (20.9%) and those who had sexual contact with only females or with both sexes (24.8%) than those who had no sexual contact (17.3%). Among male students, the prevalence was higher among those who had sexual contact with only females (13.0%) than those who had no sexual contact (10.1%). The prevalence also was higher among female students who had sexual contact with only males (20.9%) than male students who had sexual contact with only females (13.0%), higher among female students who had sexual contact with only females or with both sexes (24.8%) than male students who had sexual contact with only males or with both sexes (15.3%), and higher among female students who had no sexual contact (17.3%) than male students who had no sexual contact (10.1%).

The question this variable is based on was not included in the standard questionnaire used in the state and large urban school district surveys in 2015. Consequently, the range and median prevalence estimates across states and large urban school districts for the prevalence of avoiding foods because eating the food could cause an allergic reaction by sexual minority subgroups are not available.

Discussion

YRBSS has been measuring sexual identity and sex of sexual contacts at the state and local levels longer than any other public health surveillance system in the United States and has now generated the first national estimates of the size of sexual minority subgroups (as defined by sexual identity and sex of sexual contacts) among students in grades 9–12. Other large, national public health surveys (National Survey of Family Growth, National Health Interview Survey, National Health and Nutrition Examination Survey, and the National Survey on Drug Use and Health) have published estimates of sexual identity subgroups and/or sex of sexual contact subgroups mostly for adults aged ≥18 years.

Although the majority of the 16,067,000 students estimated to be attending public and private schools in grades 9–12 nationwide in 2015 (18) are heterosexual, this report indicates that approximately 321,000 are gay or lesbian, 964,000 are bisexual, and 514,000 are not sure of their sexual identity. In addition, approximately 273,000 of all students in grades 9–12 have had sexual contact with only the same sex and 739,000 have had sexual contact with both sexes. Sexual minority students are part of every community and are as racially, ethnically, socially, economically, and geographically diverse as their nonsexual minority peers.

Regardless of whether sexual identity or sex of sexual contacts is used to describe sexual minority students, this report documents that sexual minority students have a higher prevalence of many health-risk behaviors compared with nonsexual minority students. For example, across the 18 violence-related risk behaviors nationwide, the prevalence of 16 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 15 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. For nine of these behaviors (did not go to school because of safety concerns; having ever been forced to have sexual intercourse; physical dating violence; sexual dating violence; having felt sad or hopeless; seriously considered attempting suicide; made a suicide plan; attempted suicide; and made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse), gay, lesbian, or bisexual students had a twofold or greater prevalence estimate than heterosexual students and for nine of these behaviors (injured in a physical fight; did not go to school because of safety concerns; having ever been forced to have sexual intercourse; physical dating violence; sexual dating violence; seriously considered attempting suicide; make a suicide plan; attempted suicide; and made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse) students who had sexual contact with only the same sex or with both sexes had a twofold or greater prevalence estimate than students who had sexual contact with only the opposite sex.

Across the 13 tobacco use-related risk behaviors, the prevalence of 11 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 10 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. For three of these behaviors (having smoked a whole cigarette before age 13 years, current frequent cigarette use, and current daily cigarette use) gay, lesbian, or bisexual students had a twofold or greater prevalence estimate than heterosexual students and for three of these behaviors (current frequent cigarette use, smoking more than 10 cigarettes per day, and current daily cigarette use) students who had sexual contact with only the same sex or with both sexes had a twofold or greater prevalence estimate than students who had sexual contact with only the opposite sex.

Similarly, across the 19 alcohol or other drug use-related risk behaviors, the prevalence of 18 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 17 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. For nine of these behaviors (tried marijuana before age 13 years, ever used hallucinogenic drugs, ever used cocaine, ever used ecstasy, ever used heroin, ever used methamphetamines, ever took steroids without a doctor’s prescription, ever used inhalants, and ever injected any illegal drug) gay, lesbian, or bisexual students had a twofold or greater prevalence estimate than heterosexual students and for seven of these behaviors (ever used cocaine, ever used ecstasy, ever used heroin, ever used methamphetamines, ever took steroids without a doctor’s prescription, ever used inhalants, and ever injected any illegal drug) students who had sexual contact with only the same sex or with both sexes had a twofold or greater prevalence estimate than students who had sexual contact with only the opposite sex.

The same pattern also was evident across the six sexual risk behaviors. The prevalence of five of these risk behaviors was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of four was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. For two of these risk behaviors (had sexual intercourse before aged 13 years and not using any method to prevent pregnancy) gay, lesbian, or bisexual students and students who had sexual contact with only the same sex or with both sexes had a twofold or greater prevalence estimate than heterosexual students and students who had sexual contact with only the opposite sex, respectively.

When the results were examined for male and female students separately, the same general patterns emerged for violence-related risk behaviors, tobacco use-related risk behaviors, alcohol or other drug use-related risk behaviors, and sexual risk behaviors. In contrast, no clear pattern of differences by sexual identity or sex of sexual contact subgroups overall or for male and female students separately emerged for birth control use, dietary behaviors, and physical activity. However, the prevalence of not drinking water and not participating in at least 60 minutes of physical activity on at least 1 day during the 7 days before the survey was twofold or greater among gay, lesbian, and bisexual students than heterosexual students.

This report also demonstrates that some students are not yet sure of their sexual identity. Not sure students and gay, lesbian, and bisexual students often have a similar prevalence of many health-risk behaviors and not sure students often have a higher prevalence of many health-risk behaviors than heterosexual students. For example, across the 18 violence-related risk behaviors nationwide, the prevalence of 15 was higher among not sure students than heterosexual students and across the 19 alcohol or other drug use-related risk behaviors, the prevalence of 13 was higher among not sure students than heterosexual students.

Further, this report demonstrates that students who had no sexual contact have a much lower prevalence of most health-risk behaviors compared with students who had sexual contact with only the opposite sex and students who had sexual contact with only the same sex or with both sexes. For example, across the 18 violence-related risk behaviors nationwide, the prevalence of all 18 was higher among students who had sexual contact with only the opposite sex and students who had sexual contact with only the same sex or with both sexes than students who had no sexual contact. Across the 13 tobacco use-related risk behaviors, the prevalence of all 13 was higher among students who had sexual contact with only the opposite sex and students who had sexual contact with only the same sex or with both sexes than students who had no sexual contact. Similarly, across the 19 alcohol or other drug use-related risk behaviors, the prevalence of all 19 was higher among students who had sexual contact with only the opposite sex and students who had sexual contact with only the same sex or with both sexes than students who had no sexual contact.

Comparison of Data Across Sites

Because all the state and large urban school district surveys share similar sampling designs, questionnaires, data collection strategies, and data processing procedures, YRBS data can be compared across the states and large urban school districts. Across states, a substantial difference (i.e., a range of 25 or more percentage points or a fivefold variation or greater) was identified for 17 behaviors among heterosexual students; 38 behaviors among gay, lesbian, and bisexual students; 69 behaviors among not sure students; 19 behaviors among students who had sexual contact with only the opposite sex; 41 behaviors for students who had sexual contact with only the same sex or with both sexes; and 27 behaviors for students who had no sexual contact. Across the large urban school districts, a substantial difference was identified for 18 behaviors among heterosexual students; 38 behaviors among gay, lesbian, and bisexual students; 58 behaviors among not sure students; 15 behaviors among students who had sexual contact with only the opposite sex; 33 behaviors for students who had sexual contact with only the same sex or with both sexes; and 25 behaviors for students who had no sexual contact. Only eight behaviors (having been electronically bullied, seriously considered attempting suicide, current marijuana use, ever took prescription drugs without a doctor’s prescription, having sexual intercourse with four or more persons during their life, eating vegetables three or more times per day, not eating breakfast, and being physically active for at least 60 minutes per day on all 7 days) did not have a substantial difference across any of the sexual identity or sex of sexual contact subgroups among states or large urban school districts. The substantial differences across states and large urban school districts may reflect differences in state and local laws and policies, enforcement practices, access to drugs, availability of effective school and community interventions, prevailing behavioral and social norms (including attitudes toward sexual minorities), the amount of stigma and discrimination, demographic characteristics of the population, and adult practices and health-related behaviors. The differences also highlight how changes in one or more of these factors might contribute to reductions in health-risk behaviors within and across states and large urban school districts among students in grades 9–12.

Public Health Action

Most sexual minority students cope with the transition from childhood through adolescence to adulthood successfully and become healthy and productive adults. However, some sexual minority students struggle because of the disparities in health-related behaviors documented in this report, particularly violence-related behaviors and alcohol and other drug use, that can be compounded by stigma, discrimination, and homophobia. Because many health-related behaviors initiated during adolescence often extend into adulthood, they can potentially have a life-long negative effect on health outcomes, educational attainment, employment, housing, and overall quality of life.

Schools have a unique and important role to play in addressing the health-related behaviors of sexual minority students. In particular, schools can help reduce stigma and discrimination by creating and sustaining positive school environments which are associated with less suicide ideation and fewer suicide attempts, lower prevalence of substance use, and fewer school absences among sexual minority students (19–22). This might be accomplished through the following policies and practices:

• Encourage respect for all students and do not allow bullying, harassment, or violence against any student.

• Identify “safe spaces” (e.g., counselors’ offices, designated classrooms, or student organizations) where sexual minority students can get support from administrators, teachers, or other school staff.

• Encourage student-led and student-organized school clubs (e.g., gay/straight alliances) that promote school connectedness and a safe, welcoming, and accepting school environment for all students.

• Ensure that health classes and educational materials include information that is relevant to sexual minority students and use inclusive words or terms.

• Implement professional development opportunities and encourage all school staff to attend on how to create safe and supportive school environments for all students, regardless of sexual minority status.

• Make it easier for students to have access to community-based health care providers who have experience providing health services, including HIV/STD testing and counseling and social and psychological services, to sexual minority youth.

• Promote parent engagement through outreach efforts and educational programs that provide parents with the information and skills they need to help support sexual minority youth.

The 2014 School Health Policies and Practices Study (SHPPS) (23) indicates that nationwide during 2014, 21.5% of middle schools and 51.5% of high schools taught about sexual identity and sexual orientation as part of required instruction. In addition, 20.2% of middle schools and 34.6% of high schools provided health services specifically for gay, lesbian, and bisexual students and 17.7% of middle schools and 13.9% of high schools provided services specifically for gay, lesbian, and bisexual students through providers not on school property. Nationwide, 12.0% of school health services coordinators in elementary schools, 10.1% in middle schools, and 16.6% in high schools and 22.4% of school mental health and social services coordinators in elementary schools, 21.2% in middle schools, and 29.7% in high schools had received professional development on services specifically for gay, lesbian, and bisexual students during the 2 years before the study.

Schools address bullying through both policies and practices. According to SHPPS, nationwide in 2014, 98.5% of elementary, middle, and high schools had adopted a policy prohibiting bullying on school property; 90.7% had adopted a policy prohibiting bullying at off-campus, school-sponsored events; 91.2% had adopted a policy prohibiting electronic aggression or cyber-bullying on school property; and 84.8% had adopted a policy prohibiting electronic aggression or cyber-bullying at off-campus, school-sponsored events. In addition, 81.5% of elementary schools, 86.5% of middle schools, and 66.2% of high schools had or participated in a program to prevent bullying.

School Health Profiles (Profiles) (24) provides additional information about how schools nationwide are addressing the health-related behaviors of sexual minority youth. Specifically in 2014, a median of 26.7% of middle and high schools across 47 states had a gay/straight alliance or similar club and a median of 61.4% of middle and high schools identified safe spaces where sexual minority students can receive support from administrators, teachers, or other school staff. During 2008–2014, in 15 of 37 states, significant increases were observed in the percentage of secondary schools having a gay/straight alliance or similar club, and in 26 of 36 states significant increases were observed in the percentage of secondary schools identifying safe spaces for sexual minority students. Nonetheless, these SHPPS and Profiles data demonstrate how much more schools could be doing to address the needs of sexual minority students and the health-risk behaviors they practice.

CDC provides funding and technical assistance to education agencies in 18 states and the District of Columbia and to 17 large urban school districts to help schools implement effective policies and practices to reduce sexual risk behaviors among youth. These programs are focusing increasingly on sexual minority youth as part of their HIV, STD, and pregnancy prevention activities. Examples of program activities include: providing training for district and school staff to ensure that health curricula are inclusive of and relevant to sexual minority students, supporting schools in establishing gay/straight alliances and safe and supportive environments for sexual minority students, linking schools to community organizations that provide sexual health services for sexual minority youth, and developing resources to help school staff understand the special concerns and needs of sexual minority students. In addition, CDC provides funding and technical assistance to 47 states and 21 large urban school districts to conduct YRBS.

State and local education and health agencies are using their YRBS data on sexual identity and sex of sexual contacts to inform a variety of policies and programs designed to help reduce health-risk behaviors among sexual minority students. For example, the Connecticut State Department of Education used their YRBS data to identify the needs of populations that are disproportionally affected by HIV, other sexually transmitted infections, and teen pregnancy and help develop Guidelines for the Sexual Health Education Component of Comprehensive Health Education for local school districts on best practice policies, programs, and instruction in sexual health education. The Massachusetts Department of Elementary and Secondary Education used their YRBS data to describe the health-related needs of sexual minority youth and to support schools in modifying their sexual health curricula and lessons to make them more inclusive of all youth. The state reported that, as a result, differences between the percent of sexual minority youth and all other students who ever learned about HIV in school were reduced. In addition, YRBS data were used in a 2-day training of school counselors, social workers, and nurses to help them understand the risks faced by sexual minority youth in Massachusetts and how their support can help reduce those risks. The Vermont Department of Education used their YRBS data on sexual behaviors and sexual minority students in a series of data briefs to help inform educators and the community about the health-related needs of youth throughout the state. In the District of Columbia, the DC Concerned Providers Coalition used the District of Columbia YRBS data on sexual behaviors and sexual minority students to initiate development of a youth mentoring program for sexual minority youth and the District of Columbia Child and Family Services Agency used their YRBS data on sexual behaviors and sexual minority youth to support the development and implementation of a training program for working effectively with sexual minority youth involved in the foster care system. The District reported that the training program helped reduce complaints from sexual minority youth about unfair or insensitive care while in a placement. The School District of Philadelphia used their YRBS data on sexual minority youth to implement changes in professional development programs for teachers and other school staff to increase sensitivity and understanding of the issues facing sexual minority youth and to provide programming directly for students and parents. The San Diego Unified School District distributed their YRBS data on sexual minority students to superintendents, the Board of Directors, principals, and other key stakeholders to support sexuality education, sexual health services, and a revision to their sexual health education curriculum to include age-appropriate information and build support for gender minority students district-wide. San Francisco Unified School District used their YRBS data on sexual minority youth to support the creation of gay/straight alliances, encourage schools to implement activities during the school district’s LGBTQ Pride Month, assist in implementation of curricula inclusive of all students, create school-specific safer school strategies, and increase referrals to and collaboration with community-based organizations that serve sexual minority youth.

Limitations

The findings in this report are subject to at least eight limitations. First, these data apply only to youth who attend school and, therefore, are not representative of all persons in this age group. Nationwide, in 2012, of persons aged 16–17 years, approximately 3% were not enrolled in a high school program and had not completed high school (25). Sexual minority youth might represent a disproportionate percentage of high school dropouts and other youths who are absent from or do not attend school (26). Second, the extent of underreporting or overreporting of health-related behaviors cannot be determined, although the survey questions demonstrate good test-retest reliability (10,13). Third, some students might not have known their sexual identity; might have been unwilling to disclose it on the YRBS questionnaire; might have been unwilling to label themselves as heterosexual, gay, lesbian, or bisexual; or might not have understood the sexual identity question. Although the “not sure” response option for the sexual identity question is a credible choice for youth who might truly be unsure of their sexual identity at this point in their lives, it is also possible that this response option was selected by students who did not know what the question or the other response options meant. Nonetheless, evidence that the words used to describe various types of sexual identity are unclear to youth is not available. Fourth, because no definition was provided for sexual contact, it is likely that students considered a range of sexual activities when responding to this question, possibly including involuntary activities. Fifth, the questions used to ascertain sexual minority status focused only on sexual identity and sex of sexual contacts. Questions focused on sexual attraction might have identified a different subgroup of sexual minority students and different estimates of health-related behaviors. Sixth, BMI is calculated on the basis of self-reported height and weight, and, therefore, tends to underestimate the prevalence of obesity and overweight (27). Seventh, not all states and large urban school districts included all of the standard questions on their YRBS questionnaire; therefore, data for certain variables are not available for some sites. Finally, these analyses are based on cross-sectional surveys and can only provide an indication of association, not causality.

Conclusions

To reduce the disparities in health-related behaviors experienced by sexual minority students, it is important to use this and other reports based on scientifically sound data to raise awareness about the prevalence of priority health-related behaviors among sexual minority students in grades 9–12 among policy makers, the public, and a wide variety of agencies and organizations that work with youth. These agencies and organizations, including schools and youth-friendly health care providers, can help facilitate access to education, health care, and evidence-based interventions designed to address priority health-related behaviors among sexual minority youth. It is also important to continue to implement YRBSS at the national, state, and large urban school district levels to document and monitor the effect of broad policy and programmatic interventions on the health-related behaviors of sexual minority youth. In particular, more states could include questions on sexual identity and sex of sexual contacts on their YRBS questionnaire. Because sexual minority students represent a relatively small proportion of all students, use of large, population-based samples of students is key to obtaining the most generalizable and highest quality data on which to base policy and programmatic decisions that can help eliminate the health-related behavior disparities and improve health status, educational outcomes, and overall quality of life for sexual minority and all youth.