6B 1 The Influence of Young Men's Sexual Health on Relationship-Based STI Risk Behaviors

Thursday, June 12, 2014: 9:20 AM
Devon J. Hensel, PhD, Department of Sociology, Indiana University Purdue University Indianapolis, Indianapolis, IN and J. Dennis Fortenberry, MD, MS, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN

Background: Although sexual health is a guiding public health paradigm in adolescent adverse sexual outcome prevention, little empirical evidence links adolescent men’s sexual health to relationship-based STI risk behaviors, including intimate partner violence (IPV), sexual coercion, partner concurrency and condom use.

Methods: Data were partner-specific quarterly interviews from a cohort of young men (N=75, 14-17 yrs.) residing in areas of high unintended pregnancy and STI in Indianapolis. Sexual health (WHO, 2002) was an additive, standardized scale (α=0.82) using 12-separate sexual well-being dimensions (relationship quality, partner meets needs, emotional intimacy, sexual autonomy, sexual satisfaction, pregnancy-prevention attitudes, condom-use efficacy, partner sexual-communication, partner-family closeness, shared sexual- and social-decision making; all α≥0.80). Outcomes: IPV (received and/or perpetrated; all 4-pt; never-often: threw something; hit/kicked/punched; pushed/shoved/shook; slapped/pulled hair); sexual coercion (received money for sex/made me have sex [both no/yes], partner gets mad at me/would break up with me if I didn’t want to have sex [4-pt]), sexual partner concurrency (1/2+ partners), condom use during vaginal sex. Analyses were GEE logistic/linear regression (SPSS, 21.0; all p<.05), controlling for age and race/ethnicity. Condom use models were stratified by partner concurrency.

Results: Higher sexual health reduced the odds of young men’s receiving IPV (partner’s throwing something at him, hitting/kicking or pushing/shoving him: OR=0.18- 0.26), or perpetrating IPV (hitting/kicking or pushing/shoving his partner: OR=0.56-0.71). Sexual health also reduced young men’s receipt of sexual coercion (partner mad: OR=0.37), but was not significantly associated with current partner concurrency (p=.654). Higher sexual health predicted more frequent condom use during vaginal sex in both single (b=36.7, p<.001) and multiple-partner (b=4.41, p=.002) relationships.  

Conclusions: Young men’s sexual health has direct links to STI-associated public health indicators. These data empirically support a public health approach to sexual health which both endorses healthy romantic/sexual relationships and maintains attention on preventing sexual risk behaviors occurring in those relationships.