Abstract
BackgroundConcurrency and serial monogamy may increase risk for STIs when gaps fall within the infectious period. This study examined the association between early sexual debut and concurrent or serial sexual partnering among heterosexual adult women.MethodsWe identified 6,791 heterosexually active women, ages 21–44, from the 2006–2010 National Survey of Family Growth, a multi-stage probability sample of women in the United States. Self-reported age at first intercourse was categorized as <15, 15–17 and ≥18 years (referent). Sexual partnering was defined as concurrency (within the same month), serial monogamy with either a 1–3 month, or ≥4 month gap between partners, or monogamy (referent) in the year prior to interview. Polytomous logistic models provided adjusted odds ratios (aOR) and 95% confidence intervals (CI).ResultsConcurrent partnerships in the year prior to interview were reported by 5.2% of women. Serial monogamy with a 1–3 month gap was reported by 2.5% of women. Compared with women whose sexual debut was ≥18 years, those <15 years at sexual initiation had 3.7 times the odds of reporting concurrent partnerships (aOR: 3.72; 95% CI: 2.46-5.62). Women <15 years of age at sexual debut had twice the odds of serial monogamy with gap lengths of 1–3 months between partners (aOR1–3 months: 2.13; 95% CI 1.15-3.94) as compared to women ≥18 years at sexual debut.ConclusionsSexual debut at <15 years is associated with both concurrency and serial monogamy with 1–3 month gaps between partners in U.S. women aged 21–44.
Highlights
Concurrency and serial monogamy may increase risk for Sexually transmitted Infection(s) (STI) when gaps fall within the infectious period
A 2012 qualitative study of African American women in Philadelphia identified that living in social environments where concurrency is common, where there is a high prevalence of never married women, high rates of incarceration resulting in partnership disruption and women’s economic dependence on others as factors contributing to concurrency [20]
Misclassification of sexual partnering may have attenuated our measures of association; it is likely to have been non-differential with respect to age at sexual debut. These data considered with other research suggest that age at sexual debut is an important distal factor which sets a trajectory of risky sexual behavior including sexual partnering patterns, contraceptive non-use, [12] and multiple unintended pregnancies [13]
Summary
Concurrency and serial monogamy may increase risk for STIs when gaps fall within the infectious period. If a person engages in a series of sexual relationships with short gaps in-between, they can still infect a second partner with certain STIs if the period of infectivity has not ended [16] Those in serially monogamous partnerships with short gaps may be behaviorally monogamous and biologically concurrent [15]. African American adults, young adults, and individuals with early age at sexual debut have been previously shown to have higher rates of concurrent sexual partnerships [17,18,19]. A 2012 qualitative study of African American women in Philadelphia identified that living in social environments where concurrency is common, where there is a high prevalence of never married women, high rates of incarceration resulting in partnership disruption and women’s economic dependence on others as factors contributing to concurrency [20]. Relationship instability and social acceptance of sex with non-committed partners may contribute to the higher prevalence of concurrency [6,21]
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