COVID-19 policies such as physical distancing and school closures have been essential in mitigating the spread of the virus, but there is increasing concern among public health experts on whether and how the pandemic is impacting the health of adolescents.

Kimberly Nelson, assistant professor of community health sciences, has received a grant from the Eunice Kennedy Shriver National Institute of Child Health & Human Development to examine the short and long-term impacts of the pandemic on the sexual health behaviors of youth in the United States.

The five-year grant, totaling $3,209,224, will fund research aiming to better understand the challenges adolescents may be experiencing in accessing contraception, as well as HIV and sexually transmitted infection (STI) testing and treatment. The study will also examine how the pandemic may be exacerbating sexual health disparities among sexual and gender minority and racial and ethnic minority youth, and how the increased mental health toll and substance use during COVID-19 could be affecting adolescents’ sexual health decision-making.

“Adolescence is a critical stage of development, and particularly sexual development,” says Nelson, co-principal investigator of the study, along with Michele Ybarra, president and research director of the Center for Innovative Public Health Research. “Mental health concerns and substance use—both associated with risky sexual behavior—either commence or peak during adolescence, and health behavior patterns developed during adolescence predict later health behaviors, including sexual behaviors and medical care-seeking. Understanding whether, and if so, how, the pandemic is affecting these sexual health behaviors, including at sex initiation, is an important inquiry that this grant will help to address.”

For the study, Nelson, Ybarra, and Shira Dunsiger, associate professor of behavioral and social sciences at Brown University, will survey 2,000 youth ages 13-17 on their experiences with physical distancing, school closures, and vaccination, and their sexual health behaviors. The participants will share details on how they feel the pandemic has impacted their sexual health and their overall well-being.

The team will examine trends in adolescent sexual health behavior over time, as the pandemic and related public health policies continue to evolve. Using the COVID-19 US State Policy Database, led by Julia Raifman, associate professor of health law, policy & management, and other publicly available information the researches will monitor potential changes to school closures and protocols, mask mandates, new surges in COVID-19 cases, testing and vaccine access, and vaccine uptake.

To better understand how the pandemic and related policies are differentially impacting marginalized youth and their sexual health behaviors, the researchers will analyze outcomes by sex assigned at birth, gender identity, sexual identity, and racial/ethnic identity.

“Prior to COVID-19, sexually and gender minority and racial/ethnic minority youth faced substantial health inequities, including increased HIV/STI and unintended pregnancy rates,” Nelson says. “Given that COVID-19 continues to disproportionately impact marginalized communities, it is critical to understand how the pandemic is contributing to these ongoing sexual health disparities.”

“Ultimately, the hope is that findings from this study will provide a comprehensive view directly from adolescents about how the COVID-19 pandemic is impacting them and inform where and how health supports and sexual health interventions aimed at alleviating the impacts of COVID-19 can be targeted, particularly those that address adolescent sexual health disparities.”