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

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.