The relationship of unsafe sexual behavior and the characteristics of sexual partners of HIV infected and HIV uninfected adolescent females

Purpose: To compare characteristics of sexual relationships in HIV infected and HIV uninfected female adolescents and their association with condom us e. Methods: HIV infected and uninfected subjects, aged 13-19 years, were enrol led in a prospective HIV study from 15 sites in 13 U.S. cities. Baseline da ta on demographic information, substance use, sexual behavior, partner info rmation, and condom use were collected through direct and computer-assisted interviews from currently sexually active females. Univariate, multiple lo gistic regression, and repeated measures analyses were employed. Results: Data from 153 HIV infected and 90 HIV uninfected female subjects s howed, on average, that current partners were 4-6 years older. In multivari ate analysis, HIV infected subjects were older (OR = 1.37; 95% Cl: 1.04-1.8 1), had more lifetime partners (OR = 2.23; 95% CI: 1.03-4.82), initiated co nsensual vaginal sex earlier (OR =.74; 95% CI:.58-.95), perceived partner t o also be HIV infected (OR = 7.46; 95% CI: 3.2-17.4), and had less unprotec ted sex (OR =.27; 95% CI:.16-.45). Length of relationship was associated wi th more unprotected sex for both HIV infected and uninfected subjects (OR = 2.59, 95% CI: 1.27-5.27, OR = 4.13; 95% CI: 1.31-13.05, respectively). Mea n partner age difference was greater among HIV infected than for HIV uninfe cted (OR = 1.06; 95%CI: 1.01-1.12); this greater age difference for HIV inf ected females was associated with less protection (OR = 1.09; 95% CI: 1.03- 1.15). HIV disclosure influenced condom use: without disclosure, less condo m use was reported (OR = 6.8; 95% CI: 2.29-20.24) controlling for perceptio n that partner was also HIV infected (OR = 1.1; 95% CI: 1.02-1.21). Conclusions: Because age differential influenced reported condom use, more research, particularly qualitative, is needed into the dynamics of these re lationships. Prevention efforts must address partners, particularly older o nes. (C) Society for Adolescent Medicine, 2001.