Brenda K. Cobb

Sexual risk behaviors associated with having older sex partners: a study of black adolescent females.

Background Volunteer black adolescent females from neighborhoods characterized by high rates of unemployment, substance abuse, violence, and sexually transmitted disease were studied to determine the frequency of condom use and unprotected vaginal sex with steady, older partners during various time periods over the previous 6 months. Goal To examine associations between having male sex partners who were typically older (by at least 2 years) and adolescent females’ sexually transmitted disease (STD)/HIV–associated sexual risk behaviors. Study Design In this cross-sectional study, 522 sexually active black adolescent females completed a questionnaire and a structured interview, of which a portion assessed the age difference between the adolescents and their typical sex partners. The adolescents’ ages, length of relationship and their use of hormonal contraception were identified as covariates. Adjusted odds ratios (AOR), their 95% confidence intervals, and respective P values were calculated to detect significant associations. Results Sixty-two percent of the adolescents reported their typical sex partners were at least 2 years older. These adolescents were more likely to report never using condoms during the most recent sexual encounter (AOR = 2.0), during the last five sexual encounters (AOR = 2.0), and during the past month (AOR = 2.2). Similarly, having older partners was associated with greater odds of reporting any unprotected vaginal sex in the past 30 days (AOR = 1.7) or the past 6 months (AOR = 1.5). Conclusion Our findings suggest that many adolescent females have sex partners who are at least 2 years older and that their relationship dynamics do not favor the adoption and maintenance of behavior protective against STD or HIV infection. Prevention programs could include training designed to help adolescent females overcome barriers to safer sex with older male partners.

Condom Use and Correlates of African American Adolescent Females’ Infrequent Communication with Sex Partners about Preventing Sexually Transmitted Diseases and Pregnancy

This study of 522 African American female adolescents, ages 14 to 18, investigated associations between condom use and infrequently communicating with sex partners about sexually transmitted diseases (STDs) and pregnancy prevention. Correlates of infrequent communication were identified. Sexually active adolescents were recruited from schools and adolescent medicine clinics in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a self-administered survey and face-to-face interview. Communication frequency was assessed using a five-item scale. Infrequent communication was significantly associated with lower odds of condom use. Multivariate correlates of infrequent communication were less frequent communication with parents about STD/pregnancy prevention, recent sex with a nonsteady partner, low perceived ability to negotiate condom use and fear of this negotiation, and low motivation to use condoms. Given the importance of partner communication in promoting safer sex behaviors, STD and pregnancy prevention programs may benefit adolescents by addressing the identified psychosocial correlates of infrequent communication with their partners.

Condom carrying is not associated with condom use and lower prevalence of sexually transmitted diseases among minority adolescent females.

Background Most of the studies associated with condom carrying and use have been conducted with adults. Because minority teenage females are particularly at risk for STD/HIV infection, further investigations specifically focusing on this population are warranted. Goal To determine whether observed condom carrying among adolescent females was associated with multiple measures of self-reported condom use, self-reported history of sexually transmitted diseases, and prevalence of biologically confirmed sexually transmitted diseases. Methods For this study, 522 sexually active African American adolescent females were recruited from low-income neighborhoods in Birmingham, Alabama. Measures of self-reported condom use, STD history, and condom carrying were collected. Adolescents were also tested for three prevalent sexually transmitted diseases. Results At the time of the assessment, 8% of the adolescents were observed to have a condom with them. Condom carrying was not found to be significantly associated with condom use and prevalence of sexually transmitted diseases. Conclusion Condom carrying may not be an important outcome of sexually transmitted disease/HIV prevention programs designed to reduce HIV/sexually transmitted disease risk among adolescent females.

Correlates of Casual Sex Among African-American Female Teens

Abstract This study identified correlates of reporting voluntary sex with casual partner (VS-CP) among African American adolescent females. Sexually active African-American female teens (N = 522) were recruited from neighborhoods characterized by high rates of unemployment, substance abuse, violence and STDs. Of the 609 eligible adolescents, 522 (85.7%) agreed to participate in the study. VS-CP was reported by 15.9% of adolescents. Identified correlates of VS-CP were acquiescing to unwanted sex, living with a non-parent relative, never being pregnant, rejecting messages about the value of condoms for disease prevention, low parental supervision, and dissatisfaction with body image. These correlates may be important in the targeting and design of STD/HIV prevention programs for African-American adolescent females.