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Try out PMC Labs and tell us what you think. Learn More. We compared the male sexual partners of teen girls, age 15 - 19 years-old, currently infected with a sexually transmitted infection STI versus the male partners of adult women, age 20 - 41 years-old, with an STI to determine risk factors in these high-risk sexual dy related to the male partner.
Interview of men who were partnered with teen girls and adult women, enrolled in Project Sexual Awareness for Everyone SAFEa randomized controlled trial of behavioral intervention to reduce recurrent STIs. Men partnered with teens were younger and had ificantly more sexual partners per year sexually active, shorter relationship length, and shorter length of monogamy with the index girls. Young age independently predicted STI infection in men. Although all women had an STI at intake, important differences were noted among the male partners of teens versus adults.
Clinicians with similar populations may use this data to understand the characteristics of male partners of teens with STIs, in order to more effectively counsel adult and teen women on partner notification, treatment and STI prevention. Young age is a well-known, independent risk factor for acquisition of sexually transmitted infections STIs 12. In addition, we determined that teen and adult women with STIs exhibited distinct high-risk behaviors which increased their risk of re-infection 5.
Increasingly, public health policies have focused on wide-spread screening of men for CT and other strategies, such as Woman want real sex Briggs Texas partner therapy, to break the cycle of heterosexual STI transmission and re-infection 67. By focusing on the high-risk sexual dyad, rather than the individual diagnosed with an STI, it is likely that a more comprehensive treatment and prevention effort will occur. In this study, we interviewed male partners of teen girls, age 15 - 19 years-old, infected with an STI versus men who are the sexual partners of adult women, age 20 years-old or older.
We hypothesize that teen and adult women who acquire STIs are paired with men who have distinct risk factors, and identifying these male characteristics will help clinicians more Woman want real sex Briggs Texas understand these high risk relationships, in order to assist the infected woman in partner notification, partner treatment and STI prevention. Women were informed, prior to coming to our clinic, that in order to participate in the study, they had to invite their current male sexual partner or a male with whom they have had sexual intercourse within the last 2 months to the initial screening visit.
After informed consent, all male and female participants were interviewed, examined, screened and treated for STIs at intake and 6 and 12 months follow-up. Subject interviews were conducted separately and confidentially by trained research assistants, specific to the participant's gender and ethnicity for the female groups. Participants were encouraged to return to our clinic as needed for any symptoms of infection.
At the intake and each follow-up visit, a physical examination was performed with collection of specimens for microbiologic testing, including GC, CT, Syphilis and TV. Dy were randomized to one of three groups: 1 individual control counseling for both, 2 behavioral intervention for the female and control counseling for the male, or 3 behavioral intervention for both separate male and female groups.
The control counseling lasted approximately 15 minutes and was provided by nurse clinicians according to Centers for Disease Control guidelines 8. This control counseling focused on how STIs are acquired, compliance with treatment, symptoms and possible sequelae of STIs, and prevention of STIs by condom use or avoidance of intercourse with infected partners. The Project SAFE behavioral intervention entailed three, weekly, 3-hour, small-group, multi-component behavioral cognitive interventions 3. We adapted the AIDS Risk Reduction Model to guide intervention development, supplemented with extensive ethnographic data to ensure suitability to our population.
At intervention sessions, we used role-playing, interactive video, handouts, and group discussion to emphasize the preventive strategies of: abstinence, periodic abstinence, mutual monogamy, correct and consistent use of condoms, full compliance with treatment protocols, reduction in the of partners, avoidance of sexual intercourse until the subjects completed treatment, taking time between partners to be selective, avoidance of douching and seeking medical care whenever a subject suspected infection.
Overall goals were to have participants recognize their risk for contracting STIs, including HIV, commit to behavior change, and acquire the necessary skills to effect change. The data for this study were obtained from the intake male and female interviews. We enrolled dy, however intake data from one dyad were missing, leaving dy for the analysis.
During the male intake interview, we asked participants to name all of their sexual partners within the last year. We recorded the approximate dates of first and last intercourse with each partner and defined a concurrent sexual relationship as having sex with 2 or more different partners during the same time period. To estimate the of acts of vaginal intercourse in the last 3 months, we asked men to estimate how many times per week they had vaginal intercourse with the index female. This was multiplied by 12 to calculate a general estimate of of vaginal sex acts in the last 3 months.
If the dyad had been together for less than 3 months, total of vaginal sex acts was calculated based on his estimates. Among men, a score of 13 or lower represented the 70 th percentile or higher and was considered high sensation seeking. We asked both the man and woman to rate the level of closeness, commitment, and satisfaction they felt and that they perceived their partner felt with their relationship on a scale of 1 — 10, with 10 being the highest level of closeness, commitment and satisfaction.
Bivariate relationships between categorical variables were first explored using Pearson's chi-square test and the student t-test was used for continuous variables. There were men partnered with teen girls age 15 — 19 years-old and men who were the sexual partners of adult women age 20 years-old and older. Table 1 outlines the two male cohorts in terms of demographic, sexual and behavioral risk factors.
Many of the demographic differences in the male partners of teens versus adults are explained by the fact that the male partners of teens were ificantly younger than the male partners of adults. The male cohorts differed ificantly in terms of several measures of sexual and behavioral risks including illicit drug use, having an STI at intake, shorter relationship length, shorter length of monogamy and more sexual partners per year sexually active.
However, other measures of sensation seeking were not ificantly different between the male cohorts, including their mean sensation seeking scores and having an overall high composite sensation seeking score. When looking at the 11 individual measures of sensation seeking and sexual impulsivity, the mean score for each question was not ificantly different between the men paired with teens versus the men paired with adults data not shown.
Although the male cohorts were similar in their responses Woman want real sex Briggs Texas what they received from the relationship with the index female, we used principal component analysis with varimax factor rotation and found that the 8 components of the relationship fell into 2 : practical he receives housing, food, other financial help, and drugs and alcohol from the relationship versus emotional factors he receives emotional support, feelings of warmth and closeness, sense of family and belonging and good sex from the relationship.
There was an interaction between this finding and relationship length and marital status, as men paired with adult women were more likely to be married to her and had, on average, longer relationship length. Having concurrent sexual relationships in the last year was reported by The average age of the teen girls was Table 2 examines risky sexual dy, composed of a man and a woman who reported engaging in risky actions or behaviors that would limit communication and respect within the relationship.
We included the variable of reporting that it was important to both him and her that she have his baby because pregnancy intentions are associated with condom use 10 Although all of the dy were high risk, based on the fact that all women had an STI at intake, adult female dy were more likely to be composed of a woman who used douches and a man who preferred that she use douches.
The mean of sexual partners per year sexually active for a teen girl and her male partner combined was ificantly higher than for an adult woman and her male partner combined. Finally, teen girl dy were more likely to be composed of a man and a girl who agreed that having a baby together was very important. Table 3 contrasts the female's perceptions of the man's behavior, versus the actual behavior reported by the man. Because our study focused on risk factors for STI acquisition related to the male, we report on dy where the male is participating in risky behavior, unbeknownst to the female.
Her perceptions versus his reality. Dy composed of a male reporting risky behavior and a woman who thinks that he does not participate in this risky behavior. Table 4 compares the level of closeness, commitment and satisfaction that men and the women reported in their relationship. In addition, we contrast the female's perception of her male partner's report with his actual report.
There was a trend that teen girls and their male partners reported similar levels of closeness, commitment and satisfaction, and the teen girl correctly estimated her male partner's report. In contrast, adult women reported ificantly higher levels of closeness, commitment and satisfaction than their male partners. In addition, adult women ificantly over-estimated the level of closeness and relationship satisfaction reported by their male partners. Finally, we performed logistic regression to describe what variables predicted STI infection in the male at intake.
We found that male partners of teen girls infected with an STI were more likely to be younger, have more sexual partners per year sexually active and were currently using any illegal drugs, as compared to the male partners of adult women infected with a non-viral STI.
Like women, the variable which independently predicted infection in men was young age 12. Our data will assist clinicians in providing age-appropriate and partner-specific counseling to a teen girl or an adult woman diagnosed with an STI. In this analysis, Woman want real sex Briggs Texas found that men partnered with teens, who are ificantly younger, switch partners more rapidly as they begin having intercourse.
As they encounter new sexual partners, their risk of infection is increased 2. We ly reported that teens who had unprotected sex with untreated partners were up to 10 times more likely to become re-infected with an STI 5. While this behavior was associated with re-infection in adults, the association was not as strong 5. It may be that the woman was infected by a man who was not invited to our study. However, all men enrolled in Project SAFE had risky sexual histories, reporting rates of concurrent sexual relationships in the past year that were more than double the rates reported in other national surveys 10 The male partners of teens were more likely to have an STI at intake.
It is known that male-to-female transmission of STIs is generally more efficient than female-to-male transmission 212although confounders such as anal intercourse, circumcision status, and co-morbidities such as immune-suppression and STI co-infections must be considered We initially hypothesized that the differences in male infection rates would be related to exposure frequency.
However, the male cohorts reported similar frequencies of vaginal intercourse with the index female within the last 3 months. The mens' cohorts were also not different in their low rates of consistent condom use. The higher incidence of STI infection among the men partnered with teens may be explained by the fact that these men Woman want real sex Briggs Texas shorter periods of monogamy, and more sexual partners per year sexually active than men paired with adults.
Our data is consistent with work showing that young male age was an independent risk factor for infection with TV Men partnered with teens were ificantly more likely to report using any illegal drug once a month or more. Drug use among young men and women has been associated with STI acquisition, non-use of condoms and multiple sexual partners, likely due to complex interactions including risk disinhibition Our data suggests that clinicians who diagnose teen girls with an STI should discuss the possible contributions of drug use and disinhibition on STI reinfection.
When comparing behavioral surrogates which we ly found to be associated with re-infection 5we found that adult female dy were more likely to be composed of a man who wanted his female partner to use douches and a woman who used douches. Douching has been associated with an increase in STI risk, but may be confounded by the fact that some women use douches in response to STI symptoms 16 Although our study highlights the risk characteristics of the men, we also found that teen dy were characterized by specific risky behaviors.
The mean combined of sexual partners per year sexually active for the teen dy was higher than for the adult dy. Teen dy were more likely to be composed of a male and female who thought it was very important to have children together.
This may be due to the fact that men paired with teens were younger, and had not yet fathered children. Although condom use has been shown to be low even among adolescents who want to avoid pregnancy, vigilance for consistent condom use is markedly decreased among teens who are ambivalent regarding future pregnancy and those desiring pregnancy Furthermore, a teen girl's desire for pregnancy is highly influenced by her male partner's wishes Our data suggests that clinicians counseling teens on STI prevention may want to emphasize the implications of untreated STIs on fertility and pregnancy complications.
It has been shown that teen girls paired Woman want real sex Briggs Texas older men are more likely to not use contraception, to desire pregnancy, drop out of school, use drugs, be diagnosed with an STI and be involved in casual rather than committed relationships with multiple partners 20 — Age difference is a surrogate for power differences and influence in the relationship, as age discordant couples have differences in maturity, sexual and life experiences, financial resources, education and work attainment 27 — Our data are in agreement with Kissinger et al, that although having an older male partner was a marker of various risks for teen girls, infection was most prevalent in young men and most adolescents are paired with young men We found markers of influence by the male partners of teens, for example, they were more likely to be the father of the teen's children and to report that it was very important for the teen to have his baby, which has been associated with sabotaging a teen girl's request for condom use or contraception Our data have several limitations.
The cross sectional de of the study may not reflect ongoing behavior of the dy, particularly dy who received the Project SAFE behavioral intervention. The female had to invite a male sexual partner from within the past 2 months. It is not clear if the man who participated in the study was the man involved in the initial STI exposure.
However, our method of our data collection, in which sexual dy are interviewed separately by a gender matched individual, strengthens of our data. In addition, we have detailed, partner specific information on over high risk sexual dy, where at least one partner the female has a current, laboratory verified STI. The focus of this study was to provide data to help clinicians counsel women with STIs more effectively by describing their male partners and risky relationships.
We certainly understand that women participate in risky behaviors which increase the likelihood of recurrence in themselves or their partners. In conclusion, a clinician who diagnoses an STI in a teen girl should know that her male partner is more likely to be young, infected with an STI, using illegal drugs, and have rapid partner turnover, as demonstrated by having more sexual partners per year sexually active.
These men may exhibit influence over the teen by encouraging pregnancy or being the father of her children. These distinct characteristics are important triage questions to ask, when attempting to effectively counsel the teen on partner notification, partner treatment and STI prevention practices. National Center for Biotechnology InformationU. Sex Transm Dis. Author manuscript; available in PMC Dec 1. Sondra T. Author information Copyright and information Disclaimer. Copyright notice.
The publisher's final edited version of this article is available at Sex Transm Dis. See other articles in PMC that cite the published article. Abstract Objectives We compared the male sexual partners of teen girls, age 15 - 19 years-old, currently infected with a sexually transmitted infection STI versus the male partners of adult women, age 20 - 41 years-old, with an STI to determine risk factors in these high-risk sexual dy related to the male partner.
Conclusions Although all women had an STI at intake, important differences were noted among the male partners of teens versus adults. Keywords: Male partner, sexually transmitted infections, risk behavior. Open in a separate window. Table 2 Dy composed of men and women reporting risky behaviors.
Table 3 Her perceptions versus his reality. Table 4 Level of Closeness, Commitment and Satisfaction within the relationship. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women. N Engl J Med. Prevention of gonorrhea and Chlamydia through behavioral intervention: of a two-year controlled randomized trial in minority women.
Obstet Gynecol. Male Chlamydia Screening Program, Expedited partner therapy in the management of sexually transmitted diseases. Kalichman SC, Rompa D. Sexual sensation seeking and sexual compulsivity scales: Reliability, validity and prediting HIV risk behavior. J Personal Assess.Woman want real sex Briggs Texas
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