Original article
Teen Pregnancy Among Sexual Minority Women: Results From the National Longitudinal Study of Adolescent to Adult Health

https://doi.org/10.1016/j.jadohealth.2016.05.009Get rights and content

Abstract

Purpose

The purpose of this study was to explore the association between sexual orientation and teen pregnancy (before age 20 years) in a U.S. nationally representative cohort of young adult females aged 24–32 years.

Methods

A total of 5,972 participants in Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health were included. Self-reported sexual orientation identity was categorized as heterosexual, and three sexual minority (SM) groups: mostly heterosexual, bisexual, and lesbian (combining “mostly homosexual” and “100% homosexual”). Stepwise multivariate regression models were fit to compare odds of teen pregnancy and relative risk ratios of timing of teen pregnancy, between heterosexual and SM groups, adjusting for sociodemographic characteristics, sexual victimization history, and sexual risk behaviors.

Results

After adjusting for sociodemographics and sexual victimization, bisexual women had significantly higher odds than heterosexual peers of teen pregnancy (odds ratio [OR] = 1.70; 95% confidence interval [CI] = 1.05–2.75); this association was marginally significant after adjusting for sexual risk behaviors. Bisexuals were also more likely to have an early (before age 18 years) teen pregnancy (OR = 2.04; 95% CI = 1.17–3.56). In contrast, lesbian women were significantly less likely to have a teen pregnancy than heterosexual (OR = .47; 95% CI = .23–.97), mostly heterosexual (OR = .46; 95% CI = .21–.99), and bisexual (OR = .29; 95% CI = .12–.71) women in final models.

Conclusions

Expanding on extant literature, we found opposing risk patterns for teen pregnancy between bisexual and lesbian women, likely due to distinct patterns of sexual risk taking. Findings suggest that SM-inclusive teen pregnancy prevention efforts tailored to meet the unique needs of SM young women, particularly bisexuals, are needed.

Section snippets

Sample

We use data from Add Health, an ongoing prospective study of a nationally representative probability sample of adolescents in Grades 7–12 during the 1994–1995 school year (see Harris [18] for study design details). To date, one in-school and four in-home interviews have been completed; data for present analyses came from the Wave IV in-home interview (2008; respondents aged 24–32 years) and Wave I/baseline. Add Health procedures were approved by the University of North Carolina, Chapel Hill,

Results

Table 2 depicts the distributions of demographic and behavioral characteristics by sexual orientation. Most respondents (79%; n = 4,739) identified as heterosexual, followed by mostly heterosexual (17.6%; n = 1,013), bisexual (2.5%; n = 145), and lesbian (1.2%; n = 75). Almost 30% of the sample (n = 1,766) reported a teen pregnancy; bisexuals reported the highest proportion of pregnancies (46.7%, n = 58), and lesbians reported the lowest (17.8%, n = 17). Among those who had a teen pregnancy, a

Discussion

Previous studies have found mixed associations between sexual orientation and teen pregnancy. In our nationally representative sample, we found the highest prevalence of teen pregnancy among bisexuals and the lowest among lesbians, with heterosexual (28.4%) and mostly heterosexual (31.4%) females falling in-between. Bisexuals and lesbians were also more likely to have multiple teen pregnancies, though associations were nonsignificant. After adjusting for covariates and sexual victimization,

Acknowledgments

Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design of Add Health. Everyone who contributed significantly to this work has been acknowledged. Preliminary findings were presented as an oral presentation at the Adolescent Pregnancy Prevention Campaign of North Carolina (APPCNC; now known as SHIFT NC) Annual meeting in June 2014, and as a poster presentation at the Population Association of America 2015 Annual Meeting in May 2015.

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    Conflicts of Interest: The authors report no conflicts of interests.

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