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P151 A Review of the Evidence: Partner Attributes Associated with Sexually Transmitted Infections (STIs) Among Adolescents

Tuesday, March 13, 2012
Hyatt Exhibit Hall
Andrea Swartzendruber, MPH1, John Zenilman, MD2, Linda Niccolai, PhD3, Trace Kershaw, PhD4, Jennifer L. Brown5, Ralph J. DiClemente, PhD6 and Jessica M. Sales, PhD6, 1Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, 3Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 4Epidemiology, Yale School of Public Health, New Haven, CT, 5Behavioral Sciences and Health Education Department, Rollins School of Public Health, Atlanta, GA, 6Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA

Background:  STI rates are highest among adolescents. Although prevention efforts typically focus on individual behavior, partner characteristics likely contribute to STI risk. 

Objectives: Review published studies to identify associations between sexual partner attributes and STIs among adolescents and summarize implications for STI research and prevention efforts. 

Methods:  We included peer-reviewed studies published 1990-2010 which assessed at least one sexual partner attribute in relation to a biologically-confirmed STI, including HIV, among adolescents (15-24 years).  We searched MEDLINE using the MeSH terms: “Adolescents” AND “Sexually Transmitted Diseases” AND “Sexual Partners” and “Risk Factors” and manually searched included articles. Studies which included adolescents but >50% of the study population or mean or median age was >25 years were excluded.

Results:  Thirty-one studies met eligibility criteria; 71% were cross-sectional, and 87% assessed risk among females.  There was no standard “partner” definition.  Partner attributes associated with increased STI risk in multiple studies included older age, Black race, incarceration history, and STI symptoms.  Partner attributes associated with increased risk in individual studies included: attending a different school, injecting drugs, being high or drunk during sex, perpetrating dating violence, higher education, male, HIV-positive, and foreign-born.

Conclusions: Partner attributes are independently associated with STIs among male and female adolescents and may be as important determinants of STI risk as individual behavior.

Implications for Programs, Policy, and Research: These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote condom use and heighten adolescents’ awareness of partner factors associated with STI risk. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. Research among adolescents should further explore partner-level determinants of STI risk and mechanisms through which they act.  A standard “partner” definition would facilitate interpretation of findings across studies.

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