An Index of Partner-Level Risk Factors for Non-Condom Use and STI Acquisition among Sexually Active African-American Females

Introduction: Although, correct and consistent condom use decreases STI risk, rates of condom use among adolescents are not optimal. Investigations of condom use practices within high-risk subgroups have focused mainly on individual-level factors such as condom attitudes and skills. This research examines partner-specific aspects of young women's sexual relationships related to STI risk. Methods: Data, including sociodemographics, self-reported sexual behaviors, partner characteristics, condom use behavior, and STD history were collected via ACASI from 715 African-American adolescent females, 15-21 years, seeking services at reproductive health clinics in the south. Data were obtained at baseline, prior to randomization in an HIV prevention intervention. Using a five-factor risk categorization, statistical analyses explored the influence of male sexual partners on STI risk and condoms at last sex. Results: Adolescents with male sexual partners classified as having one or more levels of risk reported more sex while high or drunk (p<.001), fewer instances of condom use (p=.018), a history of STD infection (p=.003), and depression (p=.023). Multiple logistic regression analysis, with age as a covariate, revealed that adolescents with higher risk male sexual partners relative to those with low risk sexual partners were less likely to report using a condom at last sex (AOR=1.5, p=.024). Conclusion: Compared to adolescents in a sexual relationship with a partner with zero risks, females with a partner exhibiting multiple risk factors have an increased risk for STI acquisition. Continued research efforts are needed that investigate the strength of partner-level variables on sexual risk and promote dialogue regarding partner selection.