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” Testing and diagnosis were considered as separate outcomes based on the low correlation among these experiences ( = 0.20) and 23% of those diagnosed with an STD reporting not being tested.

Single items were also used to assess sexual risk behaviors (use of a condom at last sex, multiple sex partners [≥2 in the past 3 months]).

” Responses included: “No”; “Yes, I have been tested for HIV”; “Yes, I have been tested for other STDs”; and “Yes, I have been tested for both HIV and for other STDs.” Diagnosis of STD/HIV was assessed by a single yes/no item that asked: “Have you ever been told by a doctor or other health care professional that you had HIV infection or any other sexually transmitted disease (STD)?

The Youth Risk Behavior Survey (YRBS) is conducted in a majority of states every 2 years to track the incidence and prevalence of leading causes of morbidity and mortality among high school students.

The YRBS is a self-report, written instrument; in Massachusetts, a Spanish translation of the survey is available.

The Massachusetts YRBS was administered in 19 to 9th- through 12th-grade students in randomly selected classrooms within selected public high schools throughout the state.

The probability of an individual school being selected was proportional to its enrollment.

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