Paradox: less condom use among people who believe their partners are not monogamous

  • Copen CE & al.
  • Sex Transm Dis
  • 1 Nov 2019

  • International Clinical Digest
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Takeaway

  • Both women and men reporting perceived partner nonmonogamy (PPNM), multiple past-year sexual partnerships are less likely to use condoms but still pursue sexually transmitted infection (STI) testing.

Why this matters

  • Emphasise condoms for STI prevention, especially among patients with multiple partners, PPNM.
  • Consider point-of-care testing for earlier STI test results.

Key results

  • 5868, 5330 women, men, respectively.
  • 39.4%, 48.3%, women, men, respectively, reported multiple partners, 23.4%, 24.0%, respectively, PPNM.
  • Women reporting 1 partner, PPNM less likely to use condom vs women with 1 partner, no PPNM (29.3% [95% CI, 22.5-36.2] vs 39.3% [95% CI, 36.6-41.9]).
    • Adjusted prevalence ratio (aPR): 0.78; 95% CI, 0.62-0.98.
  • Similar results noted for women, men with ≥2 partners, PPNM vs 1 partner, no PPNM: aPR, 0.71; 95% CI, 0.60-0.85 (women), aPR, 0.68; 95% CI, 0.59-0.78 (men).
  • Women, men with ≥2 sex partners, PPNM were 1.5 (95% CI, 1.34-1.56) times, 2 (95% CI, 1.81-2.35) times more likely to seek STI testing in past year, respectively.

Study design

  • Retrospective analysis of prevalence of multiple, past-year sexual partnerships, PPNM, association with recent condom use and STI testing among unmarried, noncohabitating men, women, ages 15-44 years, 2011-2017.
  • Database: National Survey of Family Growth.
  • Funding: None disclosed.

Limitations

  • Cross-sectional.
  • Social desirability bias.
  • Under-/overestimated PPNM.