Greater Number Of Sexual Partners Research Articles

Anal Intercourse and HIV Risk Among Low-Income Heterosexual Women: Findings from Chicago HIV Behavioral Surveillance

Background:Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago.Methods:The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test.Results:In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89).Conclusion:AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty.

HIV/AIDS Risk Behaviors and Substance Use by Young Adults in the United States

The current research assessed the extent to which substance use behaviors (i.e., heavy episodic drinking, marijuana use, and use of illicit drugs other than marijuana) were associated with behaviors that confer risk for HIV infection (i.e., sex with multiple partners, inconsistent condom use, and injection drug use) in a nationally representative sample of young adults. Generalized estimating equations (GEEs) examined patterns in the data from U.S. young adults (N = 7,595), ages 21 to 30, who participated in the Monitoring the Future (MTF) panel study between 2004 and 2009. Fifty-two percent of the participants were female and 70% were White. Time-varying effects indicated that more frequent heavy episodic drinking, marijuana use, and other illicit drug use were associated with a greater number of sex partners. Frequency of marijuana and other illicit drug use was associated with less frequent condom use, and marijuana use was associated with use of injection drugs. Younger individuals (i.e., 21-24 years old versus 25-30 years old) had fewer sexual partners, more frequent condom use, and a stronger association between heavy episodic drinking and number of sexual partners than did older individuals. These effects did not vary across gender. Findings highlight the covariation of substance use with HIV-related risk factors among recent cohorts of young adults in the U. S. and the particularly strong link between heavy episodic drinking and number of sexual partners among individuals aged 21 to 24. Prevention programs should acknowledge the co-occurring risks of substance use and HIV risk behaviors, especially among young adults in their early twenties.

Emergency contraception and risk for sexually transmitted infections among U.S. women.

Since Food and Drug Administration (FDA) licensure of emergency contraception (EC) over-the-counter (OTC) in 2006, this is the first U.S. study to use a nationally representative sample of reproductive-aged women (15-44) to explore the relationship between receipt and use of EC and sexually transmitted infection (STI)-related health services. Using a sample of 6329 women from the National Survey of Family Growth 2006-2008, we examined the relationship between lifetime EC use and recent receipt of EC and demographics, sexual behaviors, and STI-related services. Variables significant at p<0.10 in bivariate analyses were examined using multivariable logistic regression models. Overall, 10% (704) of the sample had ever used EC. Most EC users had received EC from a family planning clinic (51%), drugstore (23%), or doctor's office (17%). In adjusted analyses, demographic factors associated with receipt of EC in the past 12 months included never married (adjusted odds ratio [AOR] 4.0) and living in a metropolitan statistical area (AOR 4.2). Women reporting multiple partners (2+) (AOR 2.4), inconsistent condom use (AOR 3.4), and having recently been tested for chlamydia (AOR 2.0) had higher odds of receiving EC in the past 12 months. Findings among women ever reporting EC use were similar, except women who had 4+ lifetime partners (AOR 2.5) and had recently received a chlamydia diagnosis (AOR 2.2) had higher odds of ever having used EC. EC recipients were no more likely than nonrecipients to have received STI counseling or screening despite greater numbers of sex partners in the past year. This research indicates that women are accessing EC in pharmacies, which may be a missed opportunity for counseling and testing.

Depot medroxyprogesterone acetate use is not associated with risk of incident sexually transmitted infections among adolescent women.

To determine whether depot medroxyprogesterone acetate (DMPA) use is associated with an increased risk of acquisition of sexually transmitted infections (STIs) in a cohort of healthy adolescents, for whom prospective evidence is sparse. Adolescent women aged 14-17 years (n = 342) were recruited from clinical sites in the United States between 1999 and 2005. They returned quarterly for interviews and STI testing. During alternating 3-month periods, participants also completed daily diaries of sexual behaviors and performed weekly vaginal self-obtained swabs to test for STIs. Data collected through 2009 (median follow-up length = 42.2 months) were analyzed. Univariable and multivariable tests of association between STI acquisition during the 3-month diary period and covariates were calculated, using nonlinear mixed-effect logistic regression models to control for repeated measurements. In multivariable analysis, there were no significant associations between DMPA use in the current or previous 3-month period and incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis. The number of total or unprotected sexual events during the diary period was not associated with the risk of STI. Older age was a protective factor for the development of Chlamydia trachomatis (odds ratio = .85; 95% confidence interval = .76-.96). The only factor significantly associated with an increased risk of contracting all three STIs was a greater number of sexual partners during the diary period (odds ratio, range = 1.91-2.62). In this U.S.-based cohort of adolescent women, we found no evidence that DMPA use was associated with increased STI risk. Efforts to curb STI transmission among adolescents should focus on education about the reduced number of sexual partners.

Etiology of male urethral strictures-Evaluation of temporal changes at a single center, and review of the literature

Abstract Objective To evaluate temporal changes in male urethral stricture etiology and socio-demographic features by comparing a contemporary with a previously studied cohort. Patients and methods A total of 125 men with proven urethral strictures were interviewed April 2007 through March 2008 using a structured questionnaire on demographic, socio-economic and clinical aspects. The findings were compared with those reported in 120 urethral stricture patients seen at the same institution during 1991. Statistical analysis was performed using analysis of variance (ANOVA) and Fisher's exact tests ( p Results Compared to the 1991 cohort, the current cohort had a significantly greater proportion with >6 years of schooling (77.5% vs 45.8%), mean number of sex partners (7.3 vs 4.6) and illegal drug use (20.8% vs 10%). Stricture etiology showed a decrease in urethritis (25.6% vs 45%) and external trauma (16.8% vs 28.3%) and an increase in internal (iatrogenic) trauma (36.8% vs 10%). The groups with urethritis and external trauma were significantly younger (mean age 46.1 and 36.3 years) than those with iatrogenic trauma or idiopathic etiology (55.5 and 53.8 years, respectively). Urethritis etiology was associated with a greater number of sex partners, lower education level, previous imprisonment, and illegal drug use. Conclusions Over the past 15 years there was an increase in education levels, illegal drug usage and number of sex partners in men with urethral strictures. There was a decrease in urethritis and external trauma, and an increase in iatrogenic trauma as stricture etiology.

Sexually Transmitted Infections, Sexual Risk Behavior, and Intimate Partner Violence Among African American Adolescent Females With a Male Sex Partner Recently Released from Incarceration

Social networks directly and indirectly influence sexually transmitted infections (STIs) risk. The objective was to explore associations between sex with a male recently released from incarceration and sexual risk and intimate partner violence (IPV) among African American adolescent females. Sociodemographic, psychosocial, and sexual behavior data were collected at baseline, 6, and 12 months from African American females, aged 15-21 years, participating in an HIV/STI prevention trial. Among 653 participants with ≥1 follow-up assessments, generalized estimating equations tested associations during follow-up between having a recently released partner and STI acquisition, sexual risk behaviors, and IPV, adjusting for age, treatment assignment, and corresponding baseline measure. Eighty-three (13.6%) participants had a recently released partner at 6 months and 56 (9.3%) at 12 months. Participants with a recently released partner were more likely to have the following: vaginal (adjusted odds ratio [AOR]: 5.48), anal (AOR: 2.43), and oral (AOR: 1.51) sex, a casual partner (AOR: 1.66), sex while high/drunk (AOR: 1.57) or with a high/drunk partner (AOR: 2.27); use condoms inconsistently (AOR: .58); acquire Chlamydia (AOR: 1.80), and experience emotional (AOR: 4.09), physical (AOR: 2.59), or sexual abuse (AOR: 4.10) by a boyfriend. They had a greater number of sex partners, lower partner communication and refusal self-efficacy, were high/drunk during sex more frequently, and used condoms during oral sex less frequently. A recently released sex partner is associated with sexual risk and IPV among African American adolescent females. Prevention programs should inform adolescents about potential risks associated with recently released partners as well as provide adolescents with skills to establish and maintain healthy sexual relationships.

Dual Process Interaction Model of HIV-Risk Behaviors Among Drug Offenders

This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected.

The Relationship between Borderline Personality Disorder and Number of Sexual Partners

In this study, we examined the number of self-reported lifetime sexual partners between those with and without borderline personality disorder (BPD). Our hypothesis was that, due to the nature of the disorder, those with BPD would exhibit a greater number of lifetime sexual partners. Using a survey methodology in a consecutive sample of internal medicine outpatients (N = 354), we administered two self-report measures for BPD (the borderline personality scale of the Personality Diagnostic Questionnaire-4 and the Self-Harm Inventory), and queried participants, "How many sexual partners have you had in your lifetime?" Correlation coefficients and one-way ANOVAs were conducted to determine the relationship between BPD and the number of sexual partners. According to BPD status with the borderline personality scale of the Personality Diagnostic Questionnaire-4, we found that the mean number of sexual partners among BPD-positive participants was nearly double (p < .001) that of BPD-negative participants; according to BPD status with the Self-Harm Inventory, the mean number of sexual partners among BPD-positive participants was more than double (p < .001) that of BPD-negative participants. Compared to internal medicine outpatients without BPD, those with BPD exhibit a statistically significantly greater number of sexual partners.

Changes in the socio-demographic patterning of late adolescent health risk behaviours during the 1990s: analysis of two West of Scotland cohort studies

BackgroundSubstance use and sexual risk behaviour affect young people's current and future health and wellbeing in many high-income countries. Our understanding of time-trends in adolescent health-risk behaviour is largely based on routinely collected survey data in school-aged adolescents (aged 15 years or less). Less is known about changes in these behaviours among older adolescents.MethodsWe compared two cohorts from the same geographical area (West of Scotland), surveyed in 1990 and 2003, to: describe time-trends in measures of smoking, drinking, illicit drug use, early sexual initiation, number of opposite sex sexual partners and experience of pregnancy at age 18-19 years, both overall and stratified by gender and socioeconomic status (SES); and examine the effect of time-trends on the patterning of behaviours by gender and SES. Our analyses adjust for slight between-cohort age differences since age was positively associated with illicit drug use and pregnancy.ResultsRates of drinking, illicit drug use, early sexual initiation and experience of greater numbers of sexual partners all increased significantly between 1990 and 2003, especially among females, leading to attenuation and, for early sexual initiation, elimination, of gender differences. Most rates increased to a similar extent regardless of SES. However, rates of current smoking decreased only among those from higher SES groups. In addition, increases in 'cannabis-only' were greater among higher SES groups while use of illicit drugs other than cannabis increased more in lower SES groups.ConclusionMarked increases in female substance use and sexual risk behaviours have implications for the long-term health and wellbeing of young women. More effective preventive measures are needed to reduce risk behaviour uptake throughout adolescence and into early adulthood. Public health strategies should reflect both the widespread prevalence of risk behaviour in young people as well as the particular vulnerability to certain risk behaviours among those from lower SES groups.

Evidence of Sexual Selection for Evening Orientation in Human Males: A Cross Cultural Study in Italy and Sri Lanka

Previous research has established the existence of individual differences with regards to individuals` optimum time of well-functioning; specifically in terms of being either morning or evening oriented. An association has also emerged between being more evening, as opposed to morning, oriented and having a greater number of sexual partners. The aim of the present study was to investigate whether eveningness in males is an evolved sexually dimorphic trait consistent across different cultures. A sample of 179 male Sri Lankan men residing in two different cultural and economic settings, Italy and Sri Lanka, were administered the Morningness-Eveningness Questionnaire (MEQ) followed by assessing their sexual behavior history. The results robustly portrayed a highly significant main effect of MEQ types highlighting the twofold sexual success enjoyed by the evening individuals in both regional locations. Morning oriented individuals, showed a stronger preference for going out and partying than evening-types, suggesting that the higher mating success of evening types is not due to their different lifestyles allowing more opportunities to encounter females. However, evening types exhibited a preference for flirtatious behaviors in the later part of the day. Shoulder-to-hip and handgrip strength, as measures of testosterone levels, were not significantly associated with eveningness. The results are discussed in terms of sexual selection and its interplay with human cultural variation.

HIV/STD Risk Behaviors Among In-School Adolescents in Post-conflict Liberia

We conducted a randomized trial to address the health needs of in-school adolescents in Liberia, where we analyzed data from a behavioral survey administered to 820 students from eight urban schools. Our findings suggest that adolescents are at significant risk for HIV and other sexually transmitted diseases (STDs): 36% of respondents were sexually experienced, 34% of those had first sex at ages 14 or younger, 66% of first sexual encounters were unprotected, and 16% were described as "forced." Also, females were more likely to have older boyfriends (Pearson's chi square = 19.2, p = .0001) and sex resulting in pregnancies (Pearson's chi square = 11.5, p = .01), while males were more likely to have a greater number of sexual partners (Pearson's chi square = 5.6, p = .05) in the previous 3 months. We recommend further research to explore challenges associated with implementing behavioral-driven studies in post-conflict environments.

Conocimiento y uso de anticonceptivos entre los jóvenes mexicanos. El papel del género / Contraceptive Knowledge and Use among Young Mexicans: The Role of Gender

Con base en datos provenientes de la Encuesta Nacional sobre Violencia en el Noviazgo, levantada en 2007 entre jóvenes mexicanos de 15 a 24 años de edad, se explora el nivel de conocimiento y uso de anticonceptivos en el contexto de las relaciones de noviazgo. Con este análisis se pretende evidenciar el rol que desempeñan las diversas características sociodemográficas de los jóvenes en el conocimiento y uso de anticonceptivos, con particular atención en el papel que juega el género.En general se observan diferencias importantes entre los factores relacionados conel uso de anticonceptivos alguna vez y los factores asociados al uso del condón en las relaciones con la pareja actual. El uso de anticonceptivos aparece asociado positivamente tanto entre los hombres como entre las mujeres con las condiciones socioeconómicas más favorables, con más conocimientos sobre los anticonceptivos, y con un mayor número de compañeros sexuales (sólo para los varones). Entre las mujeres también el hecho de ser estudiante favorece el uso de anticonceptivos.No obstante, cuando se incorporan al análisis elementos propios de la relación denoviazgo y se circunscribe el análisis a la frecuencia de uso del condón en las relaciones sexuales con la pareja actual, pierden relevancia los factores objetivos y cobran significancia ciertos elementos más subjetivos propios de la relación: la diferencia de edad con la pareja (para hombres y mujeres), la duración del noviazgo (para las mujeres), quién decide cuándo y cómo tener sexo (para los hombres), el apoyo que ofrece la pareja (sólo los hombres), la actitud hacia los roles de género (en el caso de los hombres), y la presencia de violencia emocional (para los hombres) y de violencia física. AbstractUsing data from the National Survey on Violence during Courtship, undertaken in 2007 on young Mexicans aged 15 to 24, the author explores the levels of contraceptive knowledge and use in the context of courtship. This analysis seeks to prove the role played by the various socio-demographic characteristics of young people in contraceptive knowledge and use, with particular emphasis on the role of gender.In general, significant differences are observed between “ever use” of contraceptives and factors associated with condom use in relations with one’s current partner. Contraceptive use appears to be positively associated in both men and women with more favorable socio-economic conditions, greater contraceptive knowledge and a greater number of sexual partners (only among men). Among women, being a student also encourages contraceptive use.However, when characteristics of the courtship are incorporated and the analysis is circumscribed by the frequency of condom use in sexual relations with the current partner, objective relations become less important while certain more subjective features of the relationship become more important. These include: age difference between the partners (for men and women), duration of the courtship (for women), who decides when and how to have sex (for men), support provided by the partner (men only) and attitude towards gender roles (in the case of men) and the presence of emotional violence (for men) and physical violence.

P2-504 Abortion and sexual violence: the vulnerability's context among youth women

IntroductionIllegality of abortion perpetuates socioeconomic inequities in what it is practiced and, like sexual coercion, obscures its consequences for the women's health.PurposeTo investigate the relationship between abortion and experiences of...

Development of the Perceived Risk of HIV Scale

Past studies have used various methods to assess perceived risk of HIV infection; however, few have included multiple items covering different dimensions of risk perception or have examined the characteristics of individual items. This study describes the use of Item Response Theory (IRT) to develop a short measure of perceived risk of HIV infection scale (PRHS). An item pool was administered by trained interviewers to 771 participants. Participants also completed the risk behavior assessment (RBA) which includes items measuring risky sexual behaviors, and 652 participants completed HIV testing. The final measure consisted of 8 items, including items assessing likelihood estimates, intuitive judgments and salience of risk. Higher scores on the PRHS were positively associated with a greater number of sex partners, episodes of unprotected sex and having sex while high. Participants who tested positive for HIV reported higher perceived risk. The PRHS demonstrated good reliability and concurrent criterion-related validity. Compared to single item measures of risk perception, the PRHS is more robust by examining multiple dimensions of perceived risk. Possible uses of the measure and directions for future research are discussed.

P2-S9.03 The sex lives of emergency contraception users in the USA, 2006–2008

BackgroundPrevious research indicates that emergency contraception (EC) users are less likely to have visited a gynaecologist in the past 12 months, and are more likely to report ever having an...

Predictors of alcohol use prior to pregnancy recognition among township women in Cape Town, South Africa

South Africa has the highest prevalence of Fetal Alcohol Spectrum Disorders (FASDs) in the world. The purpose of this study was to identify high risk factors associated with drinking alcohol prior to pregnancy recognition in 24 neighborhoods in the Cape Flats outside Cape Town, South Africa. An interviewer assessed risk among 619 pregnant Black/African women between the ages of 18 and 41 years. Logistic regression analyses explored factors associated with drinking alcohol post conception but prior to pregnancy recognition. Forced multiple logistic regression analysis revealed that drinking prior to pregnancy recognition was associated with being younger, single, having better living conditions, smoking, having a longer gestation prior to pregnancy recognition, having a greater number of sexual partners, and a higher incidence of intimate partner violence. Depressive symptoms tended to be higher among alcohol users. These risk factors were consistent with other research on the characteristics of South African women having children with a diagnosis of Fetal Alcohol Spectrum Disorders and/or of non pregnant women at high risk for an alcohol-exposed pregnancy. These findings highlight the need for women of child-bearing age to be routinely screened for alcohol use and its associated risk factors. Intervention efforts could be integrated into health initiatives already present in South Africa including the prevention and treatment of HIV/AIDS, tuberculosis, and malnutrition. Preconception care is particularly important since pregnancy recognition often occurs several weeks to months following conception and could be implemented by South African community health workers. These endeavors should facilitate national goals of healthier pregnancies and the elimination of FASDs in South Africa.

Uso de preservativo y número de parejas sexuales en hombres que tienen sexo con hombres con sífilis

Background and objectives Recent years have seen a resurgence of syphilis in Spain due to changes in sexual behavior. Here we describe the incidence of the disease in our clinic and investigate its relationship with the sexual habits of men who have sex with men (MSM). Patients and methods A cross-sectional descriptive study of incident cases of syphilis in 2007 and 2008 was performed, followed by a case–control study of sexual behavior in the previous year to compare MSM with and without syphilis. Results We recorded 26 new cases of syphilis, 19 of which were diagnosed at early stages. Eight patients were infected with human immunodeficiency virus and 15 were classed as MSM. Sixty-five MSM without syphilis were selected as a control group. MSM with syphilis had a larger number of sexual partners: odds ratio (OR), 3.98 (95% confidence interval [CI], 0.90–17.46) for the category «2 to 5 sexual partners»; OR, 3.22 (95% CI, 0.84–12.43) for the category «more than 5 sexual partners». The inconsistent use of condoms was significantly more common among MSM with syphilis than among those without syphilis (OR, 3.96; 95% CI, 1.15–13.61; p=0.02). Conclusions Syphilis continues to be a public health problem in our setting, particularly among homosexual and bisexual men. In this study, inconsistent use of condoms and a greater number of sexual partners were risk factors for syphilis in MSM. The development of prevention programs targeting this at-risk population should be considered a priority.

Perceived risk for cancer in an urban sexual minority

Lesbians, gay men, and bisexuals are a sexual minority experiencing elevated cancer risk factors and health disaparites, e.g., elevated tobacco use, disproportionate rates of infection with human immunodeficiency virus. Little attention has been paid to cancer prevention, education, and control in sexual minorities. This study describes cancer risk perceptions and their correlates so as to generate testable hypotheses and provide a foundation for targeting cancer prevention and risk reduction efforts in this high risk population. A cross-sectional survey of affiliates of a large urban community center serving sexual minority persons yielded a study sample of 247 anonymous persons. The survey assessed demographics, absolute perceived cancer risk, cancer risk behaviors, desired lifestyle changes to reduce cancer risk, and psychosocial variables including stress, depression, and stigma. Univariate and multivariate nonparametric statistics were used for analyses. The sample was primarily white non-Hispanic, middle-aged, and > 80% had at least a high school education. Mean values for absolute perceived cancer risk (range 0-100% risk), were 43.0 (SD = 25.4) for females, and for males, 49.3 (SD = 24.3). For females, although the multivariate regression model for absolute perceived cancer risk was statistically significant (P < .05), no single model variable was significant. For men, the multivariate regression model was significant (P < .001), with endorsement of "don't smoke/quit smoking" to reduce personal cancer risk (P < .001), and greater number of sexual partners (P = .054), positively associated with absolute perceived risk for cancer. This study provides novel data on cancer risk perceptions in sexual minorities, identifying correlates of absolute perceived cancer risk for each gender and several potential foci for cancer prevention interventions with this at-risk group.

Sexual behaviour and borderline personality disorder among female psychiatric inpatients

Objective. The objective of the present study was to explore various facets of sexual behaviour in those with borderline personality disorder (BPD). Method. Using a cross-sectional approach and a sample of convenience, we surveyed 126 female psychiatric inpatients regarding their sexual histories as well as BPD symptoms on two self-report measures. Results. Compared to participants who were not positive on both measures of BPD (the nonBPD group; n = 52), those who were positive on both measures (the BPD group; n = 70) reported a greater number of sexual partners, and were more likely to report having been raped by a stranger and having been coerced to have sex. There were no between-group differences with regard to age at menarche, age of first intercourse, total number of times treated for a sexually transmitted disease, having experienced date rape or rape by a partner, or having had homosexual experiences. Conclusions. The psychological themes associated with the positive findings in this study appear to reflect both impulsivity and victimization – psychological themes that are evident in other behaviours in those with BPD.

Identity, Peer Relationships, and Adolescent Girls' Sexual Behavior: An Exploration of the Contemporary Double Standard

The idea of a sexual double standard emphasizes that men have more sexual freedom, whereas women are subject to social sanctions for the same behaviors. This research uses a sample of adolescent women to examine the social consequences of reporting a greater number of sex partners. The research explores whether there are broader social costs and feelings of low self-worth associated with a high number of sex partners, and also focuses on characteristics of the adolescents' close friends. The analyses of quantitative data (n = 600) provide support for the emphasis on the adolescents' immediate network of friends: Friends' attitudes and behaviors were significant predictors of respondents' own sexual experiences, while those reporting a higher number of sex partners did not report a lack of popularity, desire for more friends, or lower self-esteem. In-depth relationship history narratives collected from a subset of respondents (n = 46) provide additional context. Women often recognized the existence of a double standard on a societal or school level, but support or acceptance provided by the more immediate network of similarly situated friends serves as a buffer against such negative attributions. The findings suggest that programs targeting sexual behaviors should focus on how peer norms influence girls' sexual choices.