Condom use and duration of concurrent partnerships among men in the United States

Abstract

Objectives: Concurrent partnerships accelerate dissemination of STIs. Most investigations of the features of concurrent partnerships have focused on higher risk subpopulations.

Goal: To assess condom use and the duration of concurrent sexual partnerships among men in the United States.

Study design: Analysis of concurrent sexual partnerships among men in the 2002 National Survey of Family Growth. We classified pairs of concurrent partnerships into 3 types: transitional, contained, and experimental concurrency, and assessed the duration of overlap. We also report the distribution of condom use at the last sexual intercourse with neither, one or both concurrent partners of each pair and characteristics of men more likely to have used condoms with neither sex partner.

Results: The duration of overlap was <1 month in 32%, 1 to 3 months in 19%, and >12 months in 25% of concurrency pairs. Half (55%) of the pairs (whites, 64%; blacks, 41%) involved unprotected sex at the last sexual intercourse with at least 1 partner. The 35% of men who were more likely to use condoms with neither sex partner at the last sexual intercourse were older, white (48%), married/cohabitating (55%), and during the previous 12 months were incarcerated (49%), or used crack/cocaine (51%).

Conclusions: Although blacks generally experience higher rates of STIs and HIV, in this representative sample of men in the United States, blacks in concurrent partnerships seemed to use the only available protection (condoms) against infection (apart from abstinence) more than other racial/ethnic groups. Continued investigation of features of sexual partnership patterns is critical for curbing STI and HIV transmission.

Figure 1. Schematic of types of concurrent partnerships

|---| represents one month 1: The second partnership begins before an earlier one ends and continues after the first relationship ends. 2: One partnership lasts for at least one month, beginning and ending during the course of another partnership. 3: The dates of first and last sex with one partner occurred within the same month during the course of a second partnership. 4: The respondent had sex with one partner only once during the course of a second partnership.

Figure 2

Distribution of condom use by type (2a) and duration of overlap (2b) in concurrent partnership pairs from the previous 12 months