Background: Sexual concurrency may contribute to increased risk for sexually transmitted diseases (STDs) among youth. Attitudes about gender roles, including power balance within sexual partnerships, may be a driver. We examined the association between attitudes towards relationship power and concurrency among African American youth.
Methods: Data were collected from February, 2011 to May, 2013 through a random household sample of low and middle socioeconomic status (SES) African Americans (N=164), aged 15-24, from Baltimore, MD. Youth reported on 292 heterosexual partnerships via audio-CASI. Weighted bivariate and multivariate logistic regression analyses stratified by sex were conducted to examine whether index partner concurrency in male-reported partnerships and sex partner concurrency in female-reported partnerships were associated with participants’ attitudes towards relationship power within a sexual partnership and to assess whether observed relationships varied by SES and/or partnership type (main vs. casual).
Results: Participants were on average 21 years old, 54% male and 55% low SES. 28% of partnerships were with a main partner. Index partner concurrency was reported in 35% of male-reported partnerships and sex partner concurrency was found in 30% of female-reported partnerships. More equitable beliefs about relationship power were significantly associated with decreased index partner concurrency (age-adjusted OR=0.18; 95%CI=0.05-0.58; p<.01) among middle SES, African American male-reported partnerships and significantly associated with increased sex partner concurrency (age-adjusted OR=6.80; 95%CI=2.19-21.11; p<.01) among low SES, African American female-reported partnerships. Among males and females, observed associations were significant in main but not casual partnerships, after adjusting for age and SES.
Conclusions: Findings suggest attitudes towards relationship power are associated with concurrency among African American youth and that this relationship may manifest differently by SES and partnership type. Implementing targeted interventions that recognize the complex relationship between socioeconomic context, partner dynamics, gender, and sexual behavior is an important step towards reducing STD risk in this vulnerable population.