Mental Health and Sexual Dating Violence Victimization Among U.S. High-School Students During the COVID-19 Pandemic: Results From 2021 National Survey

<h2>Abstract</h2><h3>Objective</h3> Sexual dating violence victimization (SDV) is a significant public health issue among high school students, impacting short-term (physical injuries) and long-term (substance abuse). Mental health issues during the pandemic may have increased adolescents' vulnerability to experiencing SDV by impairing coping mechanisms, reducing decision-making capacity, and limiting access to protective social support. Few studies have investigated demographic disparities in SDV and how the pandemic impacted SDV among high school students. Our aim was to examine the demographic and racialized disparities in SDV and assess the association between mental health during the pandemic and SDV among high school students. <h3>Methods</h3> We conducted a cross-sectional study using 2021 national pooled Youth Risk Behavior Surveillance surveys of 234,572 US high school students. We used complex survey-weighted multivariable logistic regression models to assess the association between mental health during the pandemic and SDV in US high school students overall and subgroups. <h3>Results</h3> We identified demographic and racialized disparities in SDV, including differences in age, sex, and race. Females were more likely to experience SDV when compared to males (AOR=3.50, p<0.001). Worse mental health during the pandemic was independently associated with SDV in high school students overall and subgroups. Compared to high school students with "never not good" mental health, those with "always not good" mental health were more likely to experience SDV (AOR=5.15, p<0.001). The association was stronger in younger students (14 years old or younger), females, 9th graders, and those of minority races compared to the overall high school student population. For example, females with "always not good" mental health were more likely to experience SDV (AOR=7.67, p<0.001) than those with "never not good" mental health. <h3>Conclusion</h3> It is imperative to implement prevention strategies to reduce SDV among high school students. Strategies should prioritize mental health support, especially for those demographic and racialized at-risk groups.