Adolescent partner-type experience: psychosocial and behavioral differences.

CONTEXT: Adolescents behave differently with main and casual sexual partners. These differences in behavior may be due to how adolescents perceive main and casual partners, but may also be informed by which types of partners adolescents have had experience with. METHODS: Data were collected in interviews with 276 sexually experienced STD clinic attendees in 1996-1998. Chi square tests and one-way analyses of variance were conducted to compare risk and protective variables among groups with different types of partner experience (main only, casual only, main and casual). Post hoc analyses determined differences between pairs of groups. RESULTS: Adolescents with different partner-type experiences evidenced different risk and protective factors. For example, adolescents who had had only main partners perceived a greater risk of contracting STDs from both main and casual partners than those who had had both partner types. Women in the casual-only group were the least likely to have been pregnant. Adolescents who had had main and casual partners intended a significantly shorter delay in initiating sex with a new main partner than did those in the main-only group; they also more strongly intended to have a side partner than did those who had had only main partners. CONCLUSIONS: The design of risk reduction and prevention interventions for at-risk sexually experienced adolescents ought to consider adolescents' sexual partner-type experiences and tailor messages to capitalize on associated protective factors and address or minimize associated risk factors.

Adolescent condom use and perceptions of risk for sexually transmitted diseases: a prospective study.

BACKGROUND: The authors' previous research has shown that in cross-sectional analysis, partner-specific perceptions of risk for gonorrhea and chlamydial and HIV infection correlated with partner-specific intentions to use condoms. GOAL: The goal was to determine whether partner-specific measures of perception of risk for STDs (PRSTD) predict partner-specific condom use 6 months later among high-risk and low-risk youth. STUDY DESIGN: Youths aged 14 to 19 years were recruited from an STD clinic (n = 236) and an HMO teen clinic (n = 306) and were interviewed at baseline and at 6 months about PRSTD, attitudes about condoms, self-efficacy, normative expectations, and condom use. RESULTS: PRSTD with a main sex partner was an independent predictor of condom use with a main sex partner in the STD clinic cohort (odds ratio = 2.5; 95% CI = 1.1-6.2). There was no association between PRSTD with a casual sex partner and condom use in this cohort or between PRSTD for main or casual sex partners and condom use in the HMO teen clinic cohort. CONCLUSION: Interventions that target high-risk adolescents should focus on PRSTD with a main sex partner.

A randomized comparison of A-CASI and phone interviews to assess STD/HIV-related risk behaviors in teens.

PURPOSE: To compare response bias associated with a telephone survey of sexually transmitted disease/human immunodeficiency virus (STD/HIV)-related risk behaviors and an in-home self-administered audio computer assisted self interview (A-CASI). METHODS: We randomly assigned an urban household sample of 223 African-American adolescents to a telephone interview or an A-CASI in their home. The sample was previously recruited by telephone for an earlier study regarding STDs and sexual behavior. We queried participants about their STD/HIV-related risk behaviors. We also assessed their perceived comfort, honesty, and accuracy in answering questions in the different modes through a telephone computer-assisted self-interview (T-CASI). RESULTS: There were no significant differences by mode in percentages of participants reporting STD/HIV-related risk behaviors, except more A-CASI participants reported having engaged in sexual intercourse in past 3 months (43.8% vs. 33.3%). There were no differences in perceived comfort, honesty, and accuracy in answering questions in the different modes. These results also did not change after we adjusted for age, household structure, and current school enrollment. CONCLUSIONS: Telephone interviews, a more economical mode, can be employed without much risk of increasing the response bias in the data assessing crude measures of risk.

Relative power between sexual partners and condom use among adolescents.

PURPOSE: To examine how the relative power of adolescent sexual partners in the domain of emotional intimacy is related to condom use. METHODS: Interviewed 228 adolescents who visited an STD clinic in San Francisco. Adolescents were aged 14-19 years, 69% were female, and they were ethnically diverse. We developed a measure of relative power in the domain of emotional intimacy, by adapting five items from existing measures and developing three items ourselves. The partner who had less desire for emotional intimacy was considered to have more power in that domain. We also measured relative decision-making power. Data were analyzed using logistic regression and Student's t-tests. RESULTS: Adolescents who had more power than their partners in the domain of emotional intimacy were more likely to get their way about condom use than adolescents who had less power in this domain. Decision-making power was not related to whether adolescents got their way about condom use. Young men reported greater emotional intimacy power and greater decision-making power than young women. However, gender was not related to getting one's way about condom use. CONCLUSIONS: The results suggest the importance of assessing relative power in the sexual relationships of adolescents when predicting condom use.