The growing proportion of newly diagnosed human immunodeficiency virus (HIV) infections among adolescents and young adults engaging in heterosexual relations indicates that, despite widespread prevention efforts, this group faces continuing risk. African Americans, representing 16% of U.S. teenagers, accounted for 69% of new AIDS cases reported among 13-to 19-year-olds in 2005. For Latinos, although new AIDS cases in the same age group reflected their proportion of the population (17%), young adults (ages 20-24) accounted for 22% of new AIDS cases but only 18% of the population (Kaiser Family Foundation, 2008
). A multitude of complex factors is believed to contribute to the rising rates of infection. One important issue is communication between intimate partners about their personal histories, including past risky behaviors. Another is current engagement in risky behaviors within and outside of the relationship. Research findings show that couple communication and accurate assessment of partners’ risk behaviors can influence sexual decision-making to avoid risky partners, or to adopt protective strategies (e.g., consistent and correct condom use) to reduce risk of sexually transmitted infections (STIs), including HIV (Rojas-Guyler, Ellis, & Sanders, 2005
; Stoner et al., 2003
Unfortunately, little is known concerning the accuracy of adolescent couples’ perceptions about each other’s past histories of risky behaviors and concurrent relations, or the agreement between partners in reporting shared sexual behaviors, particularly among youth of color. Further, the influence of relationship quality on interpartner concordance of adolescents has not been investigated.
There is a scarcity of research on adolescent parents in couple relationships, despite evidence that young mothers and fathers represent a subset of youth at increased risk for HIV because of their sexual behaviors, drug/alcohol use, and needle sharing for body piercing or tattoos (Koniak-Griffin & Brecht, 1997
; Koniak-Griffin et al., 2003
; Lesser, Tello, Koniak-Griffin, Kappos, & Rhys, 2001
). A history of incarceration is frequently reported among young fathers (Lesser et al., 2001
). HIV seroprevalence is substantially higher among people with a history of incarceration than among those without such a history (CDC, 2006
). The investigation reported here examines what adolescent parents report about shared sexual behaviors, relationship characteristics, and their beliefs about each other in relation to their self-report about HIV risk-related factors (i.e., concurrent sexual relations, history of substance use and incarceration, and HIV testing). The data were collected as part of the baseline assessments conducted in an HIV prevention study involving a sample of young parents.
Three unique aspects of this study are the focus on hard-to-reach, predominantly Latino youth (14-25 years of age), the inclusion of young parents only, and the examination of the influence of dyadic factors on perceptions of partners’ overall HIV-related risk factors. Individuals’ perceptions about their partners’ risky behaviors (outside of the relationship) and their self-reports about shared sexual behaviors (e.g., sexual intercourse and condom use) have been examined within the context of couple relationships of men having sex with men (Carballo-Dieguez, Remien, Dolezal, & Wagner, 1999
; Coates et al., 1988
; Seage, Mayer, Horsburgh, Cai, & Lamb, 1992
) and HIV discordant heterosexual adult couples (Bennetts et al., 1999
; de Boer et al., 1998
; Padian, 1990
). A limited number of studies have involved heterosexual adult couples recruited from sexually transmitted infection (STI) and family planning clinics (Drumright, Gorbach, & Holmes, 2004
; Ellen, Vittinghoff, Bolan, Boyer, & Padian, 1998
; Ellish, Weisman, Celentano & Zenilman, 1996
; Stoner et al., 2003
; Upchurch et al., 1991
). The extent of agreement between adult partners on questions related to shared sexual behaviors and condom use has been found to vary with sample size and composition, nature of questions asked, and analysis techniques (Upchurch, Lillard, Aneshensel, & Fang, 2002
). Concordance about condom use has been observed to be poorer among adult couples of lower socioeconomic status (SES) and for younger couples (Padian, Aral, Vranizan, & Bolan, 1995
A small number of investigations have examined interpartner concordance for frequency of sex and past condom use and perceptions about each other’s HIV-related risk behaviors in samples of adolescents and young adults. For example, in a study involving Black and Hispanic heterosexual young adults, Harvey and associates (Harvey, Bird, Henderson, Beckmann & Huszti, 2004
) found substantial agreement about condom use in the last 90 days and during the most recent sex episodes. There was slightly less agreement that condoms were used than that they were not used during the most recent vaginal sex episode based upon conditional probability indices. Couples were highly concordant about relationship characteristics. Dating college students of diverse ethnic backgrounds also have been found to have moderate to high concordance for sexual behaviors (Seal, 1997
). However, only fair to moderate concordance on reports of concurrent sexual behaviors has been found across studies. Among African American adolescents who perceived their sexual partner to be monogamous, 37% of the women’s male partners and 16% of the men’s female partners reported having other partners (Lenoir, Adler, Borzekowski, Tschann, & Ellen, 2006
). Those in partnerships for more than 6 months and characterizing their relationship as emotionally close were almost twice as likely to agree on sex-partner concurrency compared with couples who were less emotionally close. Other researchers have similarly found higher agreement between young adult men’s perceptions and their female partners’ reports of having sex with someone else, than between women’s perceptions and their male partners’ reports (Harvey et al., 2004
). Low rates of agreement for partners having other partners (kappa = 0.29) also have been reported for heterosexual patients with a diagnosed STI (Stoner et al., 2003
Other potential HIV risk-related behaviors, such as substance use, have not been examined in studies comparing adolescents’ perceptions of their partners’ risks with those same partners’ self-reported risks. However, a moderate to substantial degree of concordance has been found between African American and white heterosexual adults’ perceptions about their sex partners’ risk behaviors and their main sex partners’ reported risk (Ellen et al., 1998
). Behaviors examined included use of “crack” cocaine in the last 3 months and lifetime injection drug use. Stoner and colleagues (2003)
found that agreement was moderate for injection drug use by the partner, partner history of incarceration, and condom use within the partnership. In general, age, race/ethnicity, and gender did not affect partner agreement. In contrast, Witte and associates (Witte, El-Bassel, Gilbert, Wu, & Chang, 2007
) found poor to fair agreement on reports of drug and alcohol use between adult partners of African American and Latino backgrounds. Couples in which the female partner had lower relationship satisfaction and those in longer relationships were more likely to have discordant reports on female partners’ use of drugs. Higher discordant reports on male partners’ use of drugs were not found among couples in which the male partner reported lower relationship satisfaction.
In summary, studies examining sexual behaviors within relationships and perceptions of partner risks have been conducted with largely adult samples. Few studies have specifically targeted youth of ethnic minority background, and adolescent parents have not been investigated. In general, greater concordance has been found between partners’ reports of shared sexual behaviors than their reports of risky behaviors outside the relationship. Dyadic influences on adolescents’ perceptions of their partners’ HIV-risk-related behaviors have not been examined. Thus, the major purposes of this study were to determine predominantly Latino young mothers’ and fathers’ 1) concordance in reports about relationship characteristics and shared sexual behaviors; and 2) perceptions about their partners’ HIV-related risk factors (e.g., concurrent sexual relations, methamphetamine use) in comparison to actual reported behaviors. The study also examined differences in relationship quality and length between concordant and discordant couples.