Main/casual classification is often used when discussing STI risk behavior, yet this classification may not be relevant for youth who tend to have dynamic/ephemeral partnerships. The purpose of this study was to examine the influence of partnership characteristics on condom use among young African American (AA) women using more detailed classifications.
AA women aged 18-19 living in New Orleans were recruited from the community for a pregnancy prevention program. Women were administered an ACASI survey to elicit detailed behavioral information and asked to classify their partners using 10 categories in a check all that apply manner. Urines were NAAT tested for Chlamydia trachomatis (Ct) and N. gonorrhoeae (GC).
Of 215 sexually active women included, 19.4% had multiple partners, 1.8% engaged in transactional sex, 9.1% had Ct and 2.1% had GC. In the 294 partnerships reported, 50.2% used condoms inconsistently, 31.4% were considered casual and 12.5% were a one-time sexual encounter. Among the 10 partner categories, 81% of partnerships fit one category, while 17.4% were classified in multiple categories. The most common category was boyfriend [BF] (44.9%), followed by ex-BF (15.6%), and friend with benefits [FWB] (17.7%). Women were more likely to report inconsistent condom use if the length of relationship was > 4 months [2.57 (1.50-4.40)] or if she was using non-barrier birth control [2.87 (1.67-4.91)]. Other factors considered but not found to be associated were: main/casual classification, if she thought her partner had concurrent sex partners, if she thought it was very likely/extremely likely that unprotected sex with the partner would lead to her getting an STD, or if she intended to have sex with the partner again.
Main/casual partnership category may not be relevant for young women. Prevention messages should emphasize ongoing risk assessment and reinforce the importance of dual methods for STI/pregnancy prevention.