It takes 2: partner attributes associated with sexually transmitted infections among adolescents

• Type of Material: Article
• Authors: Andrea Swartzendruber, Emory University; Jonathan M. Zenilman, Johns Hopkins School of Medicine; Linda M. Niccolai, Yale School of Public Health; Trace S. Kershaw, Yale School of Public Health; Jennifer L. Brown, Emory University; Ralph Joseph Diclemente, Emory University; Jessica Sales, Emory University
• Language: English
• Date: 2013-05
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013, (C) Copyright 2013 American Sexually Transmitted Diseases Association
• Final Published Version (URL): http://journals.lww.com/stdjournal/pages/articleviewer.aspx?year=2013&issue=05000&article=00006&type=abstract
• Title of Journal or Parent Work: Sexually Transmitted Diseases
• ISSN: 0148-5717
• Volume: 40
• Issue: 5
• Start Page: 372
• End Page: 378
• Grant/Funding Information: Andrea Swartzendruber was supported by National Institute on Alcohol Abuse and Alcoholism grant number F32AA022058.; Jessica M. Sales was supported by the National Institute of Mental Health grant number K01 MH085506.; Jennifer L. Brown was supported by National Institute of General Medical Sciences grant number K12 GM000680.
• Research Categories: Health Sciences, Education; Health Sciences, Public Health

Abstract

Objectives To identify partner attributes associated with sexually transmitted infections (STIs) among adolescents and summarize implications for research and prevention. Design Systematic review. Methods We identified peer-reviewed studies published 1990–2010 which assessed ≥1 partner attribute in relation to a biologically-confirmed STI among adolescents (15–24 years) by searching MEDLINE and included articles. Studies which included adolescents but >50% of the sample or with mean or median age ≥25 years were excluded. Results Sixty-four studies met eligibility criteria; 59% were conducted in high-income countries; 80% were cross-sectional; 91% enrolled females and 42% males. There was no standard “partner” definition. Partner attributes assessed most frequently included: age, race/ethnicity, multiple sex partners and STI symptoms. Older partners were associated with prevalent STIs but largely unrelated to incidence. Black race was associated with STIs but not uniformly. Partners with multiple partners and STI symptoms appear to be associated with STIs predominantly among females. Although significant associations were reported, weaker evidence exists for: other partner sociodemographics; sexual and other behaviors (sexual concurrency, sex worker, intimate partner violence, substance use, travel) and STI history. There were no apparent differences by STI. Conclusions Partner attributes are independently associated with STIs among male and female adolescents worldwide. These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote and address barriers to condom use. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. A standard “partner” definition would facilitate interpretation of findings in future studies.