Concurrency Among Women Under 25 Years of Age and Men Under 30 Years of Age Screened in Infertility Prevention Project (IPP) Sites in U.S. Public Health Service Region X, 2009 and 2010

Background: To better understand the dynamics of STI transmission, researchers are increasingly examining sexual networks. In January 2009, the Region X IPP began collecting a sexual network measure—sex partner (SP) with concurrent SPs, or SP concurrency—based on the literature, recent research, CDC input and regional interest.

Objectives: 1) Describe concurrency among women age <25 and men age <30 screened in Region X IPP from January 2009-December 2010; 2) Identify implications for service delivery

Methods: Chlamydia (CT) and gonorrhea (GC) positivity (CT+/GC+) were calculated by SP concurrency, client characteristics, individual risk behaviors, CT/GC exposure, symptoms and area-based socioeconomic measures (ABSM) for 209,435 tests from January 2009-December 2010. For the sexual network measure, clients reported their SPs “no, unlikely,” “possibly” or “definitely” had concurrent SPs in the last 12 months. Univariate and multivariate analyses were conducted.

Results: Of 209,435 tests, 80% were female, 54% were 20-24 years, and 67% were non-Hispanic white. Overall CT+/GC+ was 8.5%/0.6%. 16% of women and 22% of men reported their SPs “definitely” had concurrent SPs in the last 12 months. SP concurrency varied modestly by age and race/ethnicity (16-22% and 15-20%, respectively). CT+/GC+ ranged from 9%/0.4% among women and 18%/2% among men who reported their SPs “definitely” had concurrent SPs. CT+/GC+ ranged from 5%/0.2% among women and 16%/0.6% among men who reported their SPs were “no, unlikely” to have had concurrent SPs. SP concurrency was associated with CT+/GC+ (AOR=1.20/1.44, respectively), independent of client characteristics, individual risk behaviors and ABSM.

Conclusions: SP concurrency was a significant predictor of CT+/GC+ beyond other factors, e.g., client characteristics, individual risk behaviors and ABSM.

Implications for Programs, Policy, and Research: Findings confirm the feasibility of collecting data on SP concurrency, importance of assessing network characteristics such as SP concurrency, need to incorporate this sexual network indicator in risk reduction counseling, and potential to use this indicator in empirically based screening decisions.