Concurrent Sexual Partnerships Among Women in the United States

Adimora, Adaora A.; Schoenbach, Victor J.; Bonas, Dana M; Martinson, Francis; Donaldson, Kathryn H; Stancil, Tonya

doi:10.1097/00001648-200205000-00013

Cited by 187 publications

(201 citation statements)

References 30 publications

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“…Despite these null findings, our small sample size precludes us from conclusively excluding the sex ratio as a possible determinant of sexual network position, especially in light of evidence from other sources linking the two. 14,15 In addition to low power, one of the major limitations of our analysis is that we were unable to determine how much of the association we observed between neighborhood poverty and sexual network position was due to context as opposed Odds ratios are from logistic regression models with robust standard errors assuming clustering within CBGs but not between (Stata logistic, cluster () option) to composition. 25 Our a priori hypothesis was that while individual-level income may affect network position, it is living in a neighborhood characterized by poverty that is most important, due to contextual pathways through the sex ratio and norms about sexual behaviors.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13] More recently, Adimora and colleagues have argued that higher rates of poverty among African Americans may lead to higher incarceration and premature mortality rates among African American males that would in turn lead to unbalanced sex ratios that promote concurrency. 14,15 They also argue that long-term monogamy is further undermined in African American communities by the lack of employed and marriageable African American men resulting from the lack of opportunities in poor African American communities. Taken together, these research findings suggest multiple pathways linking high poverty and joblessness to sexual networks that facilitate STI spread, as summarized in the conceptual model presented in Figure 1.…”

Section: Introductionmentioning

confidence: 99%

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Neighborhood Socioeconomic Environment and Sexual Network Position

et al. 2010

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Rates of sexually transmitted infections (STIs) are strongly associated with neighborhood poverty; however, the mechanisms responsible for this association remain unclear. Using a population-based study of sexual networks among urban African American adolescents, we tested the hypothesis that poverty, unemployment, and the sex ratio drive STI rates by affecting sexual network structure. Participants were categorized as being in one of three network positions that had previously been found to be strongly linked to infection with chlamydia and gonorrhea: being in a confirmed dyad (i.e., a monogamous pair), being connected to a larger network through one partner, and being in the center of a larger network. We found that only poverty was statistically significantly associated with sexual network position. Residing in the poorest third of neighborhoods was associated with 85% decreased odds of being in confirmed dyads. There was no association of sexual network position with neighborhood employment. Living in a neighborhood with an unequal number of young men and women appeared to be associated with a higher likelihood of being in a confirmed dyad; however, the differences were not statistically significant. These results suggest that poverty may impact STI rates by shaping sexual network structure, but we did not find any evidence that this association operates through unemployment or the sex ratio.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neighborhood Socioeconomic Environment and Sexual Network Position

et al. 2010

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“…Incarceration destabilizes social ties including primary intimate partnerships, 10-14 some of which appear to be protective against multiple and concurrent partnerships. 53,65 Incarceration physically divides partners, resulting in loneliness and emotional division [10][11][12][13][14] and, in some cases, partnership dissolution. 12,13 After the incarceration, absence of a stable sex partner with stress of reintegration 66 may lead newly released prisoners to engage in increased levels of multiple and concurrent partnerships.…”

Section: Discussionmentioning

confidence: 99%

Incarceration and High-Risk Sex Partnerships among Men in the United States

et al. 2009

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“…43,44 Concurrent sexual partnering, defined as engaging in sex with two or more different people within the same or overlapping time period, is crucial to epidemic propagation via sexual networks [45][46][47][48] and has been shown to be independently associated with heterosexually transmitted HIV. 49 African American men are more likely than white men to report concurrent sexual relationships 50,51 and thus, concurrent partnering explains, in part, why the HIV epidemic spread has been particularly accelerated among heterosexual African Americans. 52,53 In addition to condom use, most HIV prevention interventions have focused on reducing numbers of partners and not on partner concurrency specifically, with recent reports urging such a focus.…”

Section: Introductionmentioning

confidence: 99%

Condom Use and Concurrent Partnering among Heterosexually Active, African American Men: A Qualitative Report

et al. 2012

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African Americans are overrepresented among heterosexual cases of HIV/ AIDS in the USA. Inconsistent condom use and concurrent partnering are two sexual behaviors driving the heterosexual HIV epidemic in the African American community. To inform the development of an HIV prevention behavioral intervention to decrease concurrent partnering and increase condom use among African American heterosexual men, we conducted formative research, including 61 structured interviews, 5 focus groups with 25 men, and 30 in-depth qualitative interviews between July and December 2009. We used a grounded theoretical approach and categorizing strategies to code and analyze the qualitative data. Results around condom use confirmed earlier findings among heterosexual men in general: condoms diminish pleasure, interfere with erection, and symbolize infidelity. Although valued by some as a form of disease prevention and pregnancy prevention, condoms are often used only with specific types of female partners, such as new or casual partners, or due to visual risk assessment. Sex partner concurrency was described as normative and ascribed to men's "natural" desire to engage in a variety of sexual activities or their high sex drive, with little recognition of the role it plays in the heterosexual HIV epidemic. Fatherhood emerged among many men as a crucial life event and compelling motivation for reducing sexual risk behavior. Based on these results, we conclude that existing HIV prevention efforts to improve attitudes towards and motivate use of condoms either have not reached or have not been successful with African American heterosexual men. In designing behavioral interventions to decrease concurrent partnering and increase condom use, addressing negative attitudes towards condoms and partner risk assessment is critical, as is integrating novel motivational approaches related to identity as fathers and men in the African American community.

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Concurrent Sexual Partnerships Among Women in the United States

Abstract: Marital status in particular is strongly related to concurrency; thus, lower marriage rates among blacks and the associated higher concurrency of sexual partners may contribute to racial disparities in STI rates.

Cited by 187 publications

References 30 publications

Neighborhood Socioeconomic Environment and Sexual Network Position

Neighborhood Socioeconomic Environment and Sexual Network Position

Incarceration and High-Risk Sex Partnerships among Men in the United States

Condom Use and Concurrent Partnering among Heterosexually Active, African American Men: A Qualitative Report

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