Partner-level STI risk factors and perceptions of partner risk among adolescents

Background: Adolescents have the highest rates of sexually transmitted infections (STIs). Although STI risk operates among couples, most prevention and research efforts fail to account for relationship and partner-level determinants of risk. The objectives were to: 1) assess associations between sex with a male partner recently released from incarceration and STI acquisition, sexual risk behavior, psychosocial constructs related to sexual risk behavior and intimate partner violence (IPV) among African-American adolescent females; and 2) explore the accuracy of perceptions about partner's sexual concurrency during the relationship among young expecting parents and investigate factors related to inaccurate perceptions.;Methods: African-American adolescent females enrolled in an HIV/STI prevention trial provided data at baseline, 6- and 12-months. Among 653 participants with ≥1 follow-up assessments, generalized estimating equations tested the associations between having a recently released partner and STI acquisition and risk factors, adjusting for age, treatment assignment and corresponding baseline measure. Using baseline data from a study of 296 couples comprised of adolescent mothers and the biologic father of her child, kappa statistics assessed the accuracy of perceptions about partner's sexual concurrency. Logistic regression models using generalized estimating equations assessed associations between respondents' self-reported concurrency, relationship factors and inaccurate perceptions.;Results: Participants with a recently released partner were twice as likely to acquire Chlamydia, had greater sexual risk behaviors, were 3-4 times more likely to experience IPV and had lower partner sexual communication- and refusal-self-efficacy. Among pregnant adolescents and their partners, inaccurate perceptions about sexual concurrency were common. Among participants whose partner was concurrent, 60% were inaccurate; greater relationship satisfaction increased the likelihood of inaccuracy. Among participants with a nonconcurrent partner, 17% were inaccurate; self-reported concurrency and greater partnership duration increased the likelihood of inaccuracy, whereas greater relationship satisfaction decreased the likelihood of inaccuracy.;Conclusions: A recently released partner was associated with STI risk among African-American adolescents. Many pregnant adolescents and their partners had inaccurate perceptions about sexual concurrency; inaccuracy was related to self-reported concurrency and relationship factors. Prevention programs should inform adolescents about partner factors associated with STIs as well as provide adolescents with skills to establish and maintain healthy sexual relationships.