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Attitudes Towards Power in Relationships and Sexual Concurrency Within Heterosexual Youth Partnerships in Baltimore, MD

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Abstract

Sexual concurrency may increase risk for HIV/STIs among youth. Attitudes about gender roles, including power balances within sexual partnerships, could be a driver. We examined this association among Baltimore youth (N = 352), aged 15–24. Data were collected from February, 2011 to May, 2013. We examined whether index concurrency in male-reported partnerships (N = 221) and sex partner’s concurrency in female-reported partnerships (N = 241) were associated with youth’s attitudes towards relationship power. Males with more equitable beliefs about power were less likely to report index concurrency. Females with more equitable beliefs were more likely to report sex partner’s concurrency. The relationship was significant in main and casual partnerships among females and main partnerships among males. The strongest associations were detected among middle-socioeconomic status (SES) males and low-SES and African American females. Implementing interventions that recognize the complex relationship between socioeconomic context, partner dynamics, gender, and sexual behavior is an important step towards reducing HIV/STI risk among youth.

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References

  1. Potterat JJ, Zimmerman-Rogers H, Muth SQ, et al. Chiamydia transmission: concurrency, reproduction number, and the epidemic trajectory. Am J Epidemiol. 1999;150(12):1331–9.

    Article  CAS  PubMed  Google Scholar 

  2. Rosenberg MD, Gurvey JE, Adler N, Dunlop MBV, Ellen JM. Concurrent sex partners and risk for sexually transmitted diseases among adolescents. Sex Transm Dis. 1999;26(4):208–12.

    Article  CAS  PubMed  Google Scholar 

  3. Morris M, Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS. 1997;11(5):641.

    Article  CAS  PubMed  Google Scholar 

  4. Morris M, Kretzschmar M. Concurrent partnerships and transmission dynamics in networks. Soc Netw. 1995;17(3–4):299–318.

    Article  Google Scholar 

  5. Gorbach PM, Drumright LN, Holmes KK. Discord, discordance, and concurrency: comparing individual and partnership-level analyses of new partnerships of young adults at risk of sexually transmitted infections. Sex Transm Dis. 2005;32(1):7–12.

    Article  PubMed  Google Scholar 

  6. McCreesh N, O’Brien K, Nsubuga RN, et al. Exploring the potential impact of a reduction in partnership concurrency on HIV incidence in rural Uganda: a modeling study. Sexually Transm Dis. 2012;39(6):407–13.

    Article  Google Scholar 

  7. Morris M, Kurth AE, Hamilton DT, Moody J, Wakefield S. Concurrent partnerships and HIV prevalence disparities by race: linking science and public health practice. Am J Public Health. 2009;99(6):1023–31.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kerrigan D, Andrinopoulos K, Chung S, Glass B, Ellen J. Gender ideologies, socioeconomic opportunities, and HIV/STI-related vulnerability among female, African-American adolescents. J Urban Health. 2008;85(5):717–26.

    Article  PubMed Central  PubMed  Google Scholar 

  9. O’Sullivan LF, Hoffman S, Harrison A, Dolezal C. Men, multiple sexual partners, and young adults’ sexual relationships: understanding the role of gender in the study of risk. J Urban Health. 2006;83(4):695–708.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Pleck JH, Sonenstein FL, Ku LC. Masculinity ideology: its impact on adolescent males’ heterosexual relationships. J Soc Issues. 1993;49(3):11–29.

    Article  Google Scholar 

  11. Santana MC, Raj A, Decker MR, La Marche A, Silverman JG. Masculine gender roles associated with increased sexual risk and intimate partner violence perpetration among young adult men. J Urban Health. 2006;83(4):575–85.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Schoeneberger M, Logan T, Leukefeld C. Gender roles, HIV risk behaviors, and perceptions of using female condoms among college students. Popul Res Policy Rev. 1999;18(1–2):119–36.

    Article  Google Scholar 

  13. Shearer CL, Hosterman SJ, Gillen MM, Lefkowitz ES. Are traditional gender role attitudes associated with risky sexual behavior and condom-related beliefs? Sex Roles. 2005;52(5–6):311–24.

    Article  Google Scholar 

  14. Carey MP, Senn TE, Seward DX, Vanable PA. Urban African-American men speak out on sexual partner concurrency: findings from a qualitative study. AIDS Behav. 2010;14(1):38–47.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kerrigan D, Andrinopoulos K, Johnson R, Parham P, Thomas T, Ellen JM. Staying strong: gender ideologies among African-American adolescents and the implications for HIV/STI prevention. J Sex Res. 2007;44(2):172–80.

    Article  PubMed  Google Scholar 

  16. Senn T, Scott-Sheldon L, Seward D, Wright E, Carey M. Sexual partner concurrency of urban male and female STD clinic patients: a qualitative study. Arch Sex Behav. 2011;40(4):775–84.

    Article  PubMed  Google Scholar 

  17. Towner SL, Dolcini MM, Harper GW. Romantic Relationship dynamics of urban african american adolescents: patterns of monogamy, commitment, and trust. Youth Soc. 2012.

  18. Nunn A, Dickman S, Cornwall A, et al. Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study. Sex Health. 2012;9(3):288–96.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Nunn A, Dickman S, Cornwall A, et al. Social, structural and behavioral drivers of concurrent partnerships among African American men in Philadelphia. AIDS Care. 2011;23(11):1392–9.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Ellen JM, Cahn S, Eyre SL, Boyer CB. Types of adolescent sexual relationships and associated perceptions about condom use. J Adolescent Health. 1996;18(6):417–21.

    Article  CAS  Google Scholar 

  21. Katz BP, Fortenberry JD, Zimet GD, Blythe MJ, Orr DP. Partner-specific relationship characteristics and condom use among young people with sexually transmitted diseases. J Sex Res. 2000;37(1):69–75.

    Article  Google Scholar 

  22. Lescano CM, Vazquez EA, Brown LK, Litvin EB, Pugatch D. Condom use with “casual” and “main” partners: what’s in a name? J Adolescent Health. 2006;39(3):443-e1–e7.

  23. Whitehead TL. Urban low-income African American men, HIV/AIDS, and gender identity. Med Anthropol Q. 1997;11(4):411–47.

    Article  CAS  PubMed  Google Scholar 

  24. Secor-Turner M, Sieving R, Garwick A. Social messages, social context and teen sexual health: voices of urban African American youth. Am J Health Behav. 2011;35(2):162–74.

    Article  PubMed  Google Scholar 

  25. Tsui EK, Leonard L, Lenoir C, Ellen JM. Poverty and sexual concurrency: a case study of STI risk. J Health Care Poor Underserved. 2008;19(3):758–77.

    Article  PubMed  Google Scholar 

  26. Rosengard C, Adler NE, Gurvey JE, Ellen JM. Adolescent partner-type experience: psychosocial and behavioral differences. Perspect Sex Repro Health. 2005;37(3):141–7.

    Article  Google Scholar 

  27. Hebert LE, Lilleston PS, Jennings JM, Sherman SG. Individual, partner, and partnership level correlates of anal sex among youth in Baltimore City. Arch Sex Behav. 2015;44(3):619–29.

    Article  PubMed  Google Scholar 

  28. Sherman SG, Gielen AC, McDonnell KA. Brief report: power and attitudes in relationships (PAIR) among a sample of low-income, African-American women: implications for HIV/AIDS prevention. Sex Roles. 2000;42(3):283–94.

    Article  Google Scholar 

  29. Connell R. Gender and power: society, the person, and sexual politics. Redwood City: Stanford University Press; 1987.

    Google Scholar 

  30. Nunnally JC, Bernstein IH. Psychometric theory. New York: McGraw; 1994.

    Google Scholar 

  31. StataCorp. Stata Statistical Software: Release 11. College Station: StataCorp LP.; 2009.

  32. Lenoir CD, Adler NE, Borzekowski DLG, Tschann JM, Ellen JM. What you don’t know can hurt you: perceptions of sex-partner concurrency and partner-reported behavior. J Adolescent Health. 2006;38(3):179–85.

    Article  Google Scholar 

  33. Polk S, Ellen JM, Chung SE, Huettner S, Jennings JM. Discordance between adolescent real and ideal sex partners and association with sexually transmitted infection risk behaviors. J Adolescent Health. 2011;48(6):604–9.

    Article  Google Scholar 

  34. Pleck JH, Sonenstein FL, Ku LC. Masculinity ideology and its correlates. In: Oskamp S, Costanzo M, editors. Gender issues in social psychology. Newbury Park: Sage Publications; 1993.

    Google Scholar 

  35. Kerrigan D, Telles P, Torres H, Overs C, Castle C. Community development and HIV/STI-related vulnerability among female sex workers in Rio de Janeiro, Brazil. Health Educ Res. 2008;23(1):137.

    Article  PubMed  Google Scholar 

  36. Leech TG. Everything’s better in moderation: young women’s gender role attitudes and risky sexual behavior. J Adolescent Health. 2010;46(5):437–43.

    Article  Google Scholar 

  37. Arnett JJ. Conceptions of the transition to adulthood among emerging adults in American ethnic groups. New Dir Child Adolesc Dev. 2003;2003(100):63–76.

    Article  Google Scholar 

  38. Epstein H, Morris M. Concurrent partnerships and HIV: an inconvenient truth. J Int AIDS Soc. 2011;14(1):13.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Ellen JM, Adler N, Gurvey JE, Millstein SG, Tschann J. Adolescent condom use and perceptions of risk for sexually transmitted diseases: a prospective study. Sex Transm Dis. 2002;29(12):756–62.

    Article  PubMed  Google Scholar 

  40. Matson PA, Adler NE, Millstein SG, Tschann JM, Ellen JM. Developmental changes in condom use among urban adolescent females: influence of partner context. J Adolescent Health. 2011;48(4):386–90.

    Article  Google Scholar 

  41. Gorbach PM, Stoner BP, Aral SO, Whittington WL, Holmes KK. “ It Takes a Village”: understanding concurrent sexual partnerships in Seattle, Washington. Sex Transm Dis. 2002;29(8):453.

    Article  PubMed  Google Scholar 

  42. Hess KL, Gorbach PM, Manhart LE, Stoner BP, Martin DH, Holmes KK. Risk behaviours by type of concurrency among young people in three STI clinics in the United States. Sex Health. 2012;9(3):280–7.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Reed SJ, Bangi A, Sheon N, et al. Influences on sexual partnering among African American adolescents with concurrent sexual relationships. Res Hum Dev. 2012;9(1):78–101.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Neaigus A, Jenness SM, Hagan H, Murrill CS, Wendel T. Reciprocal sex partner concurrency and STDs among heterosexuals at high-risk of HIV infection. J Urban Health. 2013;90(5):902–14.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Adimora AA, Schoenbach VJ. Contextual factors and the black-white disparity in heterosexual HIV transmission. Epidemiology. 2002;13(6):707–12.

    Article  PubMed  Google Scholar 

  46. Adimora AA, Schoenbach VJ, Martinson F, Donaldson KH, Stancil TR, Fullilove RE. Concurrent sexual partnerships among African Americans in the rural south. Ann Epidemiol. 2004;14(3):155–60.

    Article  PubMed  Google Scholar 

  47. UNAIDS Reference Group on Estimates, Modelling, and Projections: Working Group on Measuring Concurrent Sexual Partnerships. HIV: consensus indicators are needed for concurrency. Lancet. 2010;375(9715):621–2.

    Article  Google Scholar 

  48. Matson PA, Chung SE, Ellen JM. When they break up and get back together: length of adolescent romantic relationships and partner concurrency. Sex Transm Dis. 2012;39(4):281–5.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Nelson SJ, Manhart LE, Gorbach PM, et al. Measuring sex partner concurrency: it’s what’s missing that counts. Sex Transm Dis. 2007;34(10):801–7.

    PubMed  Google Scholar 

  50. Barker G, Ricardo C, Nascimento M, Olukoya A, Santos C. Questioning gender norms with men to improve health outcomes: evidence of impact. Glob Public Health. 2010;5(5):539–53.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We appreciate the support of the National Institute of Child Health and Human Development (NICHD R01HD057789; PI Sherman) and the Johns Hopkins Center for AIDS Research (JHU CFAR; NIAID 1P30AI094189; PI Chaisson) for funding this study. P.S. Lilleston gratefully acknowledges doctoral support through the National Institutes of Health under Ruth L. Kirschstein National Research Service Award T32A1050056 from the National Institute of Allergy and Infectious Diseases. J.M. Jennings was supported for this work by the National Institute of Drug Abuse (K01 DA022298-01A1).

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Authors and Affiliations

  1. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA

    Pamela S. Lilleston & David R. Holtgrave

  2. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Luciana E. Hebert

  3. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jacky M. Jennings

  4. Department of Pediatrics, All Children’s Hospital, Johns Hopkins University School of Medicine, St. Petersburg, FL, USA

    Jonathan M. Ellen

  5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Susan G. Sherman

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  1. Pamela S. Lilleston
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  2. Luciana E. Hebert
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  3. Jacky M. Jennings
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  4. David R. Holtgrave
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  5. Jonathan M. Ellen
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  6. Susan G. Sherman
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Correspondence to Pamela S. Lilleston.

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Lilleston, P.S., Hebert, L.E., Jennings, J.M. et al. Attitudes Towards Power in Relationships and Sexual Concurrency Within Heterosexual Youth Partnerships in Baltimore, MD. AIDS Behav 19, 2280–2290 (2015). https://doi.org/10.1007/s10461-015-1105-z

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