Partner age not associated with recurrent Chlamydia trachomatis infection, condom use, or partner treatment and referral among adolescent women

Abstract

Purpose: Among adolescent women, having older sexual partners has been associated with initial Chlamydia trachomatis (Ct) infection and high-risk behaviors. This study evaluates the role of older partners in the risk of three outcomes: recurrent Ct, lack of condom use, and nonadherence with partner management (PM) strategies.

Methods: Female participants aged 14 to 18 years enrolled in a randomized clinical trial of patient-delivered partner treatment (PDPT) with at least one follow-up visit were included in this secondary analysis. Patient- and partner-level data were collected at baseline, one, and four months follow-up. Generalized estimating equations (GEE) and logistic regression were used to examine unadjusted and adjusted associations.

Results: The majority of the 496 women were African-American (63.3%), aged 16 to 18 years (62.3%), and asymptomatic for Ct (66.7%). At baseline, all of the women had laboratory-demonstrated Ct and were treated; they had 622 partners during the last 60 days, 21.4% reported having more than one partner with a mean (SD) of 1.5 (.78) partners per woman, and 46.3% of the partners were at least three years older than the woman. Over follow-up, 16.1% of the women experienced Ct recurrence, in 41.9% of the partnerships a condom was not used at last sex, and 80.6% of women reported giving PM. After adjusting for confounders, having a partner at least three years older was not associated with increased risk of Ct recurrence, lack of condom use, or nonadherence to PM strategies.

Conclusions: Risk of Ct recurrence, lack of condom use, and nonadherence to PM strategies was not higher among adolescent women with older partners.