Condom Use with “Casual” and “Main” Partners: What’s in a Name?
Received 1 August 2005; accepted 16 January 2006. published online 30 June 2006.
Abstract
Objective
This study examined adolescents’ attitudes about and behaviors toward condom use with “casual” vs. “main” sexual partners.
Method
Participants were sexually active adolescents aged 15–21 years (n = 1316) recruited from primary care clinics and through outreach activities in three major cities in the United States. Assessment of condom use within the past 90 days, relevant attitudes, substance use, and demographic data were obtained via audio computer-assisted self-interview (ACASI).
Results
Participants were divided into two groups: the 65% who reported main partners only (MP group) and the 35% who had at least one casual partner (CP group). Adolescents in the MP group were more likely to be female, whereas males were significantly more likely to report casual partners. Race/ethnicity, age, education level, household income, and sexually transmitted infection (STI) history were unrelated to group status (i.e., sexual partner type). Greater substance use and riskier attitudes were reported by teens in the CP group. The number of unprotected sex acts in the past 90 days was substantial and equivalent between the main and casual partner groups (19.2 vs. 21.5, respectively). Regression analyses revealed that perceptions of main partner attitudes toward condom use and condom use expectations were significantly related to condom use with MPs, but that attitudes were not related to condom use with CPs.
Conclusions
Adolescents with either casual or main partners may be at continued risk for contracting human immunodeficiency virus (HIV) and STIs, given high rates of unprotected sex. Interventions that do not target attitudes and practices related to casual partners as compared with main partners may miss an opportunity to change risk behaviors. This study demonstrates the importance of understanding an adolescent’s perception of partner types in order to design effective interventions.
aBradley/Hasbro Children’s Research Center and Brown Medical School, Providence, Rhode Island
bMiriam Hospital and Brown Medical School, Providence, Rhode Island
Address correspondence to: Dr. Celia Lescano, Bradley/Hasbro Children’s Research Center, 1 Hoppin Street, Suite 204, Providence, RI 02903.
c Project SHIELD Group Principal Investigators: Larry Brown, M.D., Rhode Island Hospital, Providence, Rhode Island; Ralph DiClemente, Ph.D., Emory University, Atlanta, Georgia; M. Isabel Fernandez, Ph.D., University of Miami, Miami, Florida; Timothy Flanigan, M.D., Miriam Hospital, Providence, Rhode Island; Deborah Haller, Ph.D., Virginia Commonwealth University, Richmond, Virginia; Lori Leonard, Sc.D., University of Texas, Houston Health Science Center, Houston, Texas; Lydia O’Donnell, Ed.D., Education Development Center, Inc., Newton, Massachusetts; William E. Schlenger, Ph.D., Research Triangle Institute, Research Triangle Park, North Carolina; Barbara J. Silver, Ph.D., Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Project SHIELD Group Site Investigators: Caryl Gay, Ph.D., University of Miami, Miami, Florida; Janet Knisely, Ph.D., Virginia Commonwealth University, Richmond, Virginia; Celia Lescano, Ph.D., Rhode Island Hospital, Providence, Rhode Island; Kevin Lourie, Ph.D., Rhode Island Hospital, Providence, Rhode Island; Louise Masse, Ph.D., University of Texas, Houston Health Science Center, Houston, Texas; Janet O’Connell, MPH, Miriam Hospital, Providence, Rhode Island; David Pugatch, M.D., Miriam Hospital, Providence, Rhode Island; Eve Rose, Ph.D., Emory University, Atlanta, Georgia; Ann Stueve, Ph.D., Columbia School of Public Health, New York, New York; Leah Varga, M.A., University of Miami, Miami, Florida; Sue Vargo, Ph.D., Education Development Center, Inc., Newton, Massachusetts; Gina Wingood, Sc.D., MPH-Emory University, Atlanta, Georgia.
ABSTRACT