O4361: Reported Sun Tanning Device Use Among Adolescent Males: Exploring the Role of Sexual Orientation - An Analysis of The Youth Risk Behavior Surveillance System (2015-2019)

Background: The use of tanning devices before adulthood can increase the risk of developing melanoma by 47%. Sexual minority adult men report greater tanning device behaviors and lifetime prevalence of skin cancers when compared to their heterosexual peers. Past inquiries into self-reported adolescent tanning device use by sexual orientation have offered valuable insights, yet this topic has not been comprehensively explored since 2015 despite newer data. This study’s multi-cycle analysis of nationally representative samples enhances our understanding of the sun tanning device behaviors of male high school students in the USA.

Methods: This study analyzes the 2015, 2017, and 2019 cycles of the national Youth Risk Behavior Surveillance System (YRBSS), a biennial self-administered survey by the CDC assessing health-risk behaviors among U.S. high school students (grades 9-12) in public and private schools.

Participants self-reported UV-based tanning device use in the past 12 months, categorized as any use vs. none. Sexual orientation options included heterosexual, gay/lesbian, bisexual, or unsure. For analysis, we grouped gay/lesbian and bisexual respondents into a Sexual Minority (SM) category to enhance statistical power. Only male respondents with complete data on race, ethnicity, age, sexual orientation, and tanning use were included.

Multivariable logistic regression, adjusted for age, race, and ethnicity, estimated adjusted odds ratios. All analyses used R Studio and the Survey package to account for YRBSS’ complex design.

Results: Across all respondents (N=14,900) the prevalence of self-reported tanning device usage within the previous 12 months was 3.5% (95% CI:3.0 - 4.0%). However, this prevalence differed significantly among different groups. Among SM respondents, the prevalence was 9.1% (95% CI: 6.4 - 13.0%), while 13.7% (95% CI: 9.9 - 18.8%) of questioning respondents reported tanning device usage. In contrast, the prevalence reported by straight respondents was 2.9% (95% CI: 2.5 - 3.4%).

Further, when adjusting for the influence of race and ethnicity, SM respondents displayed an adjusted odds ratio (aOR) of 3.4 (95%CI: 2.3 - 5.1, P < 0.001) when compared to straight respondents. Similarly, questioning respondents exhibited an aOR of 5.4 (95% CI: 3.6 - 8.0, P < 0.001). These findings underscore the heightened inclination for tanning device utilization on sexual minorities and questioning adolescent US males.

Conclusion: Our study highlights disparities in indoor tanning behavior among U.S. high school-aged males based on sexual orientation. Strengths include a comprehensive multi-cycle analysis of nationally representative data, though reliance on self-reported data may introduce bias. While combining SM respondents improved statistical power, it may mask subgroup differences.

In conclusion, our findings emphasize the complex link between sexual orientation and tanning device use, underscoring the need for further research to clarify underlying factors and inform targeted interventions to mitigate health risks.