Sexual partner concurrency among STI clinic patients with a steady partner: correlates and associations with condom use

Objectives: Partner concurrency facilitates the transmission of HIV and other sexually transmitted infections (STIs). In this study, we sought to (1) determine the correlates of concurrency among patients with a steady partner, and (2) identify correlates of condom use among patients reporting concurrent steady and non-steady partners. Methods: Patients recruited from an STI clinic (n = 973; 48% female; 68% African-American) completed a survey that assessed demographic characteristics, substance use, sexual partnerships and sexual behaviour, including condom use. Patients reporting a steady sexual partner for 3 months or longer were included in the analyses. Those who also reported a non-steady partner in the past 3 months, in addition to a steady partner, were considered to have engaged in concurrency. Results: Nearly two-thirds (64%) of patients reported both steady and non-steady partners in the past 3 months. Steady/non-steady concurrency was associated with being male, not cohabitating with a partner, use of alcohol and other drugs, and thinking their steady partner was monogamous. Patients with steady and non-steady partners reported that they seldom used condoms consistently with steady (5%) or non-steady (24%) partners. Compared to patients who did not report concurrency, patients who reported steady/non-steady concurrency reported more episodes of unprotected sex in the past 3 months. Among patients reporting concurrency, consistent condom use with non-steady partners was more likely among individuals who (a) used less alcohol and (b) thought that their steady partner was non-monogamous. Conclusions: To reduce risk for HIV and other STIs, behavioural interventions need to address partner concurrency and its correlates, including alcohol and other drug use.