Original article
The role of sequential and concurrent sexual relationships in the risk of sexually transmitted diseases among adolescents

https://doi.org/10.1016/S1054-139X(02)00710-3Get rights and content

Abstract

Purpose

To explore whether patterns of sexual relationships, such as sequential (nonoverlapping in time) or concurrent (overlapping in time), are more important indicators of sexually transmitted disease (STD) risk among adolescents than number of sexual partners.

Methods

Data from 4707 sexually active adolescents from the National Longitudinal Study of Adolescent Health were analyzed based on reported heterosexual relationships during the past 18 months. Adolescents were categorized as engaging in single, sequential, or concurrent sexual relationships. Demographic, behavioral, and social characteristics of each group were compared and multivariate logistic models were fit to determine STD risk associated with sexual relationship patterns and overall number of sexual partners during this same time period.

Results

Thirty-five percent of sexually active teens had more than one partner in the past 18 months, and 40% of these multiple partnerships were overlapping or concurrent in time. Teens in sequential and concurrent relationships reported lower condom use and a higher degree of regret of having sex owing to alcohol use than those in single relationships. Teens in concurrent relationships also reported the lowest self-efficacy to use contraceptives. Teens in sequential or concurrent relationships were more likely to report an STD than single-relationship teens (odds ratio 2.3 and 3.9, respectively); however, they were not statistically different from each other. Number of sexual partners during this same time period was not associated with STD risk once relationship pattern was considered.

Conclusion

Adolescents who engage in sequential or concurrent sexual relationships differ in some important demographic, behavioral, and social characteristics and, when compared with those who engage in single relationships, have a significantly greater risk for STDs over and above the number of sexual partners.

Section snippets

Materials and methods

This study utilized the Wave 1, in-home interview of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative study of health-related behaviors of adolescents in grades 7 through 12, conducted in 1995 [19]. The initial sampling was school-based, with a stratified random subsample of adolescents and their parents (preferably mothers) participating in a face-to-face, in-home interview. The more sensitive questions were asked via an audio-CASI collection

Study description

A total of 13,952 (all data weighted) adolescents aged 15 years and older completed the Wave I in-home interview. Of these, 6781 (48.6%) reported that they had had sexual intercourse in their lifetime. The sample of sexually experienced adolescents was then categorized on the basis of their sexual relationships during the 18 months prior to the interview (Figure 1). Eighty-three percent of respondents (n = 5624) had complete relationship date information, but 17% (n = 1157) contained missing

Discussion

Using Add Health data, this study examined the extent to which adolescents in the general population engage in different types of sexual relationship patterns, as well as potential factors that may influence sexual behaviors within sequential and concurrent heterosexual relationships. We found that more than one-third of sexually active adolescents aged 15 to 18 years had more than one sexual partner in the past 18 months, and more than 40% of these multiple partnerships were overlapping or

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