Conceptualization of sexual behavior within sexual partner relationships for modification of evidence-based sexual risk reduction/health promotion interventions

Background: Understanding of the context of anal sex behavior among Black and Hispanic adolescent women with a history of sexually transmitted infection (STI/HIV) has public health implications for health promotion and risk reduction behavioral interventions. Methods: African-American (n=94, 16.8%) and Mexican-American (n=465, 83.2%) women (14-18 years) with histories of sexual risk behavior, STI or abuse, recruited from metropolitan sexual health clinics for participation in a clinical trial for behavioral interventions, completed semi-structured interviews to assess psychosocial and situational factors associated with high sexual risk behavior, substance use, STI/HIV acquisition, and abuse occurrence at study entry. Results: Anal sex varied by ethnicity (24.1% Mexican-American, 10.6% African-American, P=.004). Anal sex was associated with more (P <.05) run-away, school dropout, sexual partners, bisexuality, sex for favors, money or friends with benefits, group sex, substance and alcohol use, sex when high, history of STI, withdrawal for birth control and psychological distress. More abuse (94.3% vs. 85.1%) and higher levels of abuse (8.37 vs. 6.38) overall, and by comparisons of sexual, physical and emotional abuse was identified. Age at first anal sex (15.85 years) with partner age (18.43 years), ever condom use for anal sex (38%), anal sex past year (79.5%), past 6 months (61.2%), past 3 months (36.7%) with limited condom use (40.8%) was self-reported. Conclusions: Conceptualization of anal sexual behavior within sexual partner relationships is important for modification of evidence-based sexual risk reduction/health promotion interventions to enhance efficacy for prevention of abuse, substance use, unintended pregnancy and STI/HIV among ethnic minority adolescent women.