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Longitudinal Associations Among Relationship Factors, Partner Change, and Sexually Transmitted Infection Acquisition in Adolescent Women

Ott, Mary A. MD, MA; Katschke, Adrian MS; Tu, Wanzhu PhD; Fortenberry, J. Dennis MD, MS

Sexually Transmitted Diseases: March 2011 - Volume 38 - Issue 3 - p 153-157
doi: 10.1097/OLQ.0b013e3181f2e292
Original Study

Objectives: New sex partners put adolescents at increased risk for sexually transmitted infections (STIs), even when these sex partners are nonoverlapping. Although the risk of partner change is well described, little is known about its antecedents. We prospectively examined associations between relationship characteristics, partner change, and subsequent STI during intervals of “serial monogamy.”

Methods: As part of a longitudinal study, 332 adolescent women were interviewed and tested for gonorrhea, chlamydia, and trichomonas every 3 months for up to just over 6 years. Interviews covered partner-specific relationship characteristics and sexual behaviors. The quarterly interval, a 3-month period bracketed by interviews and STI testing, was the unit of analysis. We examined associations among relationship factors, partner change, and subsequent STI using a series of mixed regression models, controlling for age, STI at Time 1, and condom nonuse.

Results: Age, lower relationship quality, and lower levels of partner closeness to friends and family predicted partner change from Time 1 to Time 2. In turn, partner change was associated with acquisition of a new STI at Time 2. Although relationship factors did not exert a direct effect on STI at Time 2, they improved partner change—STI model fit. Similar patterns were seen with each organism.

Conclusion: Relationship factors drive partner change, which in turn contributes to STI acquisition. STI prevention research may need to focus on the relationship antecedents to partner change, in addition to the partner change itself.

Adolescent sex partner change is associated with sexually transmitted infection. This partner change occurs in the context of a relationship. This study examines the relational antecedents to partner change and subsequent sexually transmitted infection.

From the Section of Adolescent Medicine, Department of Pediatrics, and Section of Biostatistics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.

Correspondence: Mary A. Ott, MD, MA, Section of Adolescent Medicine, 410 West 10th Street, HS1001, Indianapolis, IN 46202. E-mail:

Received for publication February 25, 2010, and accepted July 16, 2010.

© Copyright 2011 American Sexually Transmitted Diseases Association