Rural Center for AIDS/STD Prevention

RAP Time

(Volume 1, No. 2, December 5, 1997)

Issue Contents

Female Teens Who First Have Sex with Older Males Are at Higher Risk for HIV Infection

Compared with teenagers whose first partner had been about their same age, female adolescents with older first sex partners were found to be less likely to use a condom at first intercourse, last intercourse, or to use condoms consistently over their lifetime or in the previous six months, according to a recently published study. These findings are the conclusions of data from the Family Adolescent Risk Behavior and Communication Study, which examined HN risk behavior among minority female and male adolescents in 1993 and 1994.

Collection of Data
Study participants were 150 Black and Hispanic female and male 14 to 17-year-olds recruited from public high schools.

Analyses were based on data from female adolescents who provided information on the age of their partner when they first had voluntary sexual intercourse. Coitus was defined as occurring when 'a boy or man inserted his penis in your vagina.

Face-to-face interviews in either English or Spanish were conducted with each adolescent, using a structured questionnaire. An older - partner was defined as someone who exceeded the female adolescent's age by three or more years.

Study Outcomes
Thirty-five percent of the sample had first intercourse with an older partner and 65 percent with a peer-age partner.

Major findings of the research project include:

  • Respondents who had an older first partner were significantly younger at first intercourse than were those who had a peer-age partner (13.8 years vs. 14.6 years).
  • Respondents who had an older first partner were significantly less likely to use a condom during first intercourse than those who had a peer-age partner (63% vs. 82*0).
  • For females having an older partner, levels of consistent condom use over lifetime were significantly lower (37% vs. 56*0) than for respondents having a peerage partner.
  • For females having an older partner, levels of condom use during the past six months were significantly lower (44% vs. 66%) than for respondents having a peer age partner.
  • Teenagers who had an older partner at first intercourse had been sexually active longer than those with a peer-age first partner (1.8 years vs. 1.0), but the average number of lifetime partners did not differ between the two groups.
  • Those with an older first partner were considerably more likely than those with a peer-age partner ever to have been pregnant (38% vs. 12%), but no more likely ever to have been told by a doctor or nurse that they had an STD.

Implications for Prevention
Teenage women may not have the negotiation skills needed to promote self-protective behavior during sexual encounters, particularly with older experienced partners. Educational interventions need to focus on increasing women's communication skills, including assertiveness and negotiation. Teenage women should also be informed that older males may not use condoms.

This study supports the protective value of young females dating peer-age partners.

SOURCE: Miller, K. S., Clark, L. F., & Moore,J. S. (1997).Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Family Planning Perspectives, 29, 212-214.

Study of Last Sexual Encounters Shows STD Risk

Data from street interviews with 400 persons indicated that 30 percent and 40 percent of women and men, respectively, were drunk or high on drugs during their last sexual encounter. Interviews were in areas of Houston, Texas, registering high prevalence rates of syphilis.

Four and eleven percent of the women and men, respectively, reported engaging in ana sex during last sexual encounter, with none of the women and 59 percent of the men indicating condom use. There were no gender differences for use of condoms during vaginal and oral sex, with the percent using condoms ranging from 27 percent to 36 percent. Both genders were more likely to use condoms with new partners than with familiar partners.

About one-quarter indicated that their last sexual encounter was with a new partner and was in a hotel or motel room.

The researchers concluded that hotel/motel rooms be a focus point for community-based education and that greater attention be given to prevention needs of women.

SOURCE: Leonard,L.,& Ross, M. W. (1997). The last sexual encounter: the contextualization of sexual risk behaviour. International Journal of STD & AIDS, 8, 643-645.

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Sex with Injection Drug User Most Common HIV Risk Behavior

A recent report of 6871 persons attending 25 STD clinics in the United States indicated that sex with an injection drug user IDU) was the most common risk behavior for HIV infection.

Ninety-seven percent of men and 77 percent of women reported sex with an IDU either as their only risk or in addition to other risk behaviors. Women were more likely to report an IDU as their steady partner. Three percent of men and women reported having sex with someone they knew was HIV positive as their only risk factor for HIV infection.

Men reported more sex partners since 1978 and more sex partners in the past year than did women. Thirty-five percent of the men and 43 percent of the women reported never using condoms for sex in the past year.

The researchers concluded that HIV prevention needs to be targeted to all sexually active persons, particularly in areas where injection drug use and HIV are prevalent.

SOURCE: McCombs, S. B., & et al. (1997). Behaviors of heterosexual sexually transmitted disease clinic patients with sex partners at risk for human immunodeficiency virus infection. Sexually Transmitted Diseases, 24, 461-468.

HPV Infection Common among United States Women

In a study of 220 HIV positive and 231 HIV negative women, 83 percent and 62 percent, respectively, of these women tested positive for Human Papillomavirus infection (HPV) over a two-year period. Prevention education should include information concerning the strong association of some strains of HPV and cervical cancer.

SOURCE: Sun, X., et al. (1997). Human Papillomavirus infection in women infected with the human immunodeficiency virus. The New England Journal of Medicine, 337, 1343-1349.

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HIV Transmission Linked to Oral Sex

A recent report of HIV infection as a probable result of oral sex describes the history of two gay men each having no other risk factors for HIV seroconversion. Partner tracing and subsequent analysis of HIV genetic types supported the probable route of oral-genital transmission.

SOURCE: Bratt, G. A. & et al. (1997). Two cases or oral-to-genital HIV-1 transmission. International Journal of STD & AIDS, 8, 522-525.