American adolescents: Sexual mixing patterns, bridge partners, and concurrency

Background: American adolescents have a high incidence of sexually transmitted infections. Patterns of sexual partner choice influence the transmission of infections in this population. Goal: To examine patterns of sexual mixing, bridging, and concurrency in American adolescents and the association of these characteristics with condom use. Study Design: This project used the AddHEALTH survey data. The survey selected a sample of schools, then conducted in-home interviews with 18,984 students in 1995. A second wave of data collection was conducted 2 years later. The data on sexual relationships collected in the study were analyzed. Results: Respondents ranged in age from 13 to 17 years. Sex partnerships with persons of differing age groups were very common in this population (45% of sexual partnerships). Relationships with persons of different ethnicity were more common among Latinos (42%) than among white (14%) and black (15%) respondents. A large proportion of the sample reported more than two partners (56%). Among these persons, a large proportion reported partners in two different age groups (69%) and ethnic groups (35%) as well as concurrent partners (54%). Condom use was lower among persons with partners in different age groups and among persons with a larger number of partners. Conclusions: The large number of adolescents who have sexual relationships with persons of different characteristics creates bridges for infections between different groups. Counseling of sexually active adolescents should include discussion on issues of power and communication in these relationships.