Risky Partners, Sexual Behavior and HIV/STD Risk Among African-American Adolescent Females

Context: Individual behavior, partners and relationship factors influence STD risk.

Objective: To explore whether having a risky male sex partner (one just released from jail, prison or detention) is associated with increased sexual risk among African-American adolescent females.

Methods: Sociodemographic, psychosocial and sexual behavior data were collected at baseline, 6- and 12-months from African-American females, 15-21 years, participating in an HIV prevention trial. Generalized estimating equations tested the effect of having a risky partner in the 6 months prior to the two follow-up visits on HIV/STD-associated behaviors, adjusting for age, treatment assignment and the corresponding baseline measure.

Results: Six hundred fifty-three (91%) participants had follow-up data; 83 (14%) reported a risky partner at 6-months and 56 (9%) at 12-months. In the 60 days preceding follow-up visits, those with a risky partner were more likely to: be infected with Chlamydia (AOR: 1.8, p=.012); use condoms inconsistently (AOR: .56, p=.017); have sex while high/ drunk (AOR: 1.6, p=.042) or with a high/ drunk partner (AOR: 2.3, p<.001); be physically (AOR: 3.0, p<.001), emotionally (AOR: 2.7, p=.001) or sexually abused (AOR: 2.9, p=.047) by a boyfriend and emotionally abused by a casual partner (AOR: 3.1, p=.046). Those with a risky partner had a higher mean number of vaginal (p<.001) and oral (p=.002) sex partners in the past 60 days and lower refusal self-efficacy scores (p=.014).

Conclusions: Risky partners are associated with increased sexual risk among African-American adolescent females. HIV/STD prevention programs should attempt to decrease affiliations with social networks which support sexual risk-taking.