, Volume 56, Issue 2, pp 549–572 | Cite as

Sexual Concurrency and Contraceptive Use Among Young Adult Women

  • Abigail WeitzmanEmail author
  • Jennifer Barber
  • Yasamin Kusunoki


Leveraging 2.5 years of weekly data from the Relationship Dynamics and Social Life Study, we investigate the relationship between young women’s sexual concurrency and their contraceptive behavior. Specifically, we (1) examine whether young women changed their contraceptive use when switching from one to multiple concurrent sexual partners in the same week; (2) explore the uniformity of contraceptive responses to concurrency across relationship context; and (3) compare the contraceptive behaviors of never-concurrent women with those of ever-concurrent women in weeks when they were not concurrent. Nearly one in five sexually active young women had sex with two or more people in the same week. When they were concurrent, these women’s odds of using any contraception increased threefold, and their odds of using condoms increased fourfold. This pattern of contraceptive adjustments was the same across relationship characteristics, such as duration and exclusivity. Yet when they were not concurrent, ever-concurrent women were less likely to use any contraception and used condoms less consistently than women who were never concurrent. We discuss these findings in the context of ongoing debates about the role of sexual concurrency in STI transmission dynamics.


Sexual concurrency Contraception Sexual health 



This research was made possible with three grants from the National Institute for Child Health and Development (R03HD087422-01, PI Weitzman; and R01HD050329 and R01HD050329-S1, PI Barber); with two population center grants from the National Institute for Child Health and Human Development to the Population Research Center at the University of Texas at Austin (P2CHD042849) and the Population Studies Center at the University of Michigan (R24HD041028); and with a training grant (T32AG000221) from the National Institute for Child Health and Human Development administered through the Population Studies Center at the University of Michigan, where Abigail Weitzman was a postdoctoral fellow. The authors thank Julia Behrman, Monica Caudillo, Yiwen Wang, Elizabeth Ela, and Heather Gatny for their insightful feedback and support of this manuscript along the way.

Supplementary material

13524_2019_762_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 15.5 kb)


  1. Adimora, A. A., Schoenbach, V. J., Taylor, E. M., Khan, M. R., & Schwartz, R. J. (2011). Concurrent partnerships, nonmonogamous partners, and substance use among women in the United States. American Journal of Public Health, 101, 128–136.CrossRefGoogle Scholar
  2. Andrinopoulos, K., Kerrigan, D., & Ellen, J. M. (2006). Understanding sex partner selection from the perspective of inner-city black adolescents. Perspectives on Sexual and Reproductive Health, 38, 132–138.CrossRefGoogle Scholar
  3. Barber, J. S. (2001). Ideational influences on the transition to parenthood: Attitudes toward childbearing and competing alternatives. Social Psychology Quarterly, 64, 101–127.CrossRefGoogle Scholar
  4. Barber, J. S., Gatny, H., & Kusunoki, Y. (2012). The results of an experiment: Effects of intensive longitudinal data collection on pregnancy and contraceptive use (PSC Research Report 12-781). Ann Arbor: Population Studies Center, University of Michigan.Google Scholar
  5. Barber, J. S., Gatny, H. H., & Yarger, J. (2010, April). Relationship characteristics predicting unintended pregnancies reported in an online weekly survey: Preliminary results. Paper presented at the annual meeting of the Population Association of America, Dallas, TX.Google Scholar
  6. Barber, J. S., Kusunoki, Y., & Gatny, H. H. (2016a). Relationship Dynamics and Social Life (RDSL) Study [Genesee County, Michigan], 2008–2012 [Public and highly restricted-use data]. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor].
  7. Barber, J., Kusunoki, Y., Gatny, H., & Schulz, P. (2016b). Participation in an intensive longitudinal study with weekly web surveys over 2.5 years. Journal of Medical Internet Research, 18(6), e105. CrossRefGoogle Scholar
  8. Barber, J. S., Kusunoki, Y., Gatny, H. H., & Yarger, J. (2013). Young women’s relationships, contraception and unintended pregnancy in the United States. In A. Buchanan & A. Rotkirch (Eds.), Fertility rates and population decline: No time for children? (pp. 121–140). London, UK: Palgrave Macmillan.CrossRefGoogle Scholar
  9. Bearak, J. M. (2014). Casual contraception in casual sex: Life-cycle change in undergraduates’ sexual behavior in hookups. Social Forces, 93, 483–513.CrossRefGoogle Scholar
  10. Blower, S. M., & Boe, C. (1993). Sex acts, sex partners, and sex budgets: implications for risk factor analysis and estimation of HIV transmission probabilities. Journal of Acquired Immune Deficiency Syndromes, 6, 1347–1352.Google Scholar
  11. Boily, M.-C., Alary, M., & Baggaley, R. F. (2012). Neglected issues and hypotheses regarding the impact of sexual concurrency on HIV and sexually transmitted infections. AIDS and Behavior, 16, 304–311.CrossRefGoogle Scholar
  12. Brady, S. S., Tschann, J. M., Ellen, J. M., & Flores, E. (2009). Infidelity, trust, and condom use among Latino youth in dating relationships. Sexually Transmitted Diseases, 36, 227–331.CrossRefGoogle Scholar
  13. Clark, A. (2018). The role of residential mobility in reproducing socioeconomic stratification during the transition to adulthood. Demographic Research, 38, 169–196. CrossRefGoogle Scholar
  14. Crosby, R. A., DiClemente, R. J., Wingood, G. M., Salazar, L. F., Head, S., Rose, E., & McDermott-Sales, J. (2008). Sexual agency versus relational factors: A study of condom use antecedents among high-risk young African American women. Sexual Health, 5, 41–47.CrossRefGoogle Scholar
  15. Eaton, J. W., Hallett, T. B., & Garnett, G. P. (2011). Concurrent sexual partnerships and primary HIV infection: A critical interaction. AIDS and Behavior, 15, 687–692.CrossRefGoogle Scholar
  16. England, P., Caudillo, M. L., Littlejohn, K., Bass, B. C., & Reed, J. (2016). Why do young, unmarried women who do not want to get pregnant contracept inconsistently? Mixed-method evidence for the role of efficacy. Socius: Sociological Research for a Dynamic World, 2, 1–15. Google Scholar
  17. Finer, L. B., & Zolna, M. R. (2014). Shifts in intended and unintended pregnancies in the United States, 2001–2008. American Journal of Public Health, 104(Suppl. 1), S43–S48.CrossRefGoogle Scholar
  18. Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75, 3–17.CrossRefGoogle Scholar
  19. Ford, K., Sohn, W., & Lepkowski, J. (2002). American adolescents: Sexual mixing patterns, bridge partners, and concurrency. Sexually Transmitted Diseases, 29, 13–19.CrossRefGoogle Scholar
  20. Freeman, E. E., Weiss, H. A., Glynn, J. R., Cross, P. L., Whitworth, J. A., & Hayes, R. J. (2006). Herpes simplex virus 2 infection increases HIV acquisition in men and women: Systematic review and meta-analysis of longitudinal studies. AIDS, 20, 73–83.CrossRefGoogle Scholar
  21. Gaydosh, L., Reniers, G., & Helleringer, S. (2013). Partnership concurrency and coital frequency. AIDS and Behavior, 17, 2376–2386.CrossRefGoogle Scholar
  22. Gelman, A., & Hill, J. (2007). Data analysis using regression and multilevel/hierarchical models. Cambridge, UK: Cambridge University Press.Google Scholar
  23. Glynn, J. R., Dube, A., Kayuni, N., Floyd, S., Molesworth, A., Parrott, F., . . . Crampin, A. C. 2012. Measuring concurrency: An empirical study of different methods in a large population-based survey and evaluation of the UNAIDS guidelines. AIDS, 26, 977–985.CrossRefGoogle Scholar
  24. Goldenberg, T., Finneran, C., Andes, K. L., & Stephenson, R. (2015). “Sometimes people let love conquer them”: How love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making. Culture, Health & Sexuality, 17, 607–622.CrossRefGoogle Scholar
  25. Gorbach, P. M., Drumright, L. N., & Holmes, K. K. (2005). Discord, discordance, and concurrency: Comparing individual and partnership-level analyses of new partnerships of young adults at risk of sexually transmitted infections. Sexually Transmitted Diseases, 32, 7–12.CrossRefGoogle Scholar
  26. Gorbach, P. M., & Holmes, K. K. (2003). Transmission of STIs/HIV at the partnership level: Beyond individual-level analyses. Journal of Urban Health, 80, iii15–iii25.CrossRefGoogle Scholar
  27. Gorbach, P. M., Stoner, B. P., Aral, S. O., Whittington, L. H., & Holmes, K. K. (2002). “It takes a village”: Understanding concurrent sexual partnerships in Seattle, Washington. Sexually Transmitted Diseases, 29, 453–462.CrossRefGoogle Scholar
  28. Halpern-Meekin, S., Manning, W. D., Giordano, P. C., & Longmore, M. A. (2013). Relationship churning, physical violence, and verbal abuse in young adult relationships. Journal of Marriage and Family, 75, 2–12.CrossRefGoogle Scholar
  29. Helleringer, S., & Kohler, H.-P. (2007). Sexual network structure and the spread of HIV in Africa: Evidence from Likoma Island, Malawi. AIDS, 21, 2323–2332.CrossRefGoogle Scholar
  30. Helleringer, S., Kohler, H.-P., & Kalilani-Phiri, L. (2009). The association of HIV serodiscordance and partnership concurrency in Likoma Island (Malawi). AIDS, 23, 1285–1287.Google Scholar
  31. Helleringer, S., Kohler, H.-P., Kalilani-Phiri, L., Mkandawire, J., & Armbruster, B. (2011). The reliability of sexual partnership histories: Implications for the measurement of partnership concurrency during surveys. AIDS, 25, 503–511.CrossRefGoogle Scholar
  32. Helleringer, S., Mkandawire, J., & Kohler, H.-P. (2014). A new approach to measuring partnership concurrency and its association with HIV risk in couples. AIDS and Behavior, 18, 2291–2301.CrossRefGoogle Scholar
  33. Hess, K. L., Gorbach, P. M., Manhart, L. E., Stoner, B. P., Martin, D. H., & Holmes, K. K. (2012). Risk behaviours by type of concurrency among young people in three STI clinics in the United States. Sexual Health, 9, 280–287.CrossRefGoogle Scholar
  34. Higgins, J. A., Tanner, A. E., & Janssen, E. (2009). Arousal loss related to safer sex and risk of pregnancy: Implications for women’s and men’s sexual health. Perspectives on Sexual and Reproductive Health, 41, 150–157.CrossRefGoogle Scholar
  35. Javanbakht, M., Gorbach, P. M., Amani, B., Walker, S., Cranston, R. D., Datta, S. D., & Kerndt, P. R. (2010). Concurrency, sex partner risk, and high-risk human papillomavirus infection among African American, Asian, and Hispanic women. Sexually Transmitted Diseases, 37, 68–74.CrossRefGoogle Scholar
  36. Kalichman, S. C., Ntseane, D., Nthomang, K., Segwabe, M., Phorano, O., & Simbayi, L. C. (2007). Recent multiple sexual partners and HIV transmission risks among people living with HIV/AIDS in Botswana. Sexually Transmitted Infections, 83, 371–375.CrossRefGoogle Scholar
  37. Kelley, S. S., Borawski, E. A., Flocke, S. A., & Keen, K. J. (2003). The role of sequential and concurrent sexual relationships in the risk of sexually transmitted diseases among adolescents. Journal of Adolescent Health, 32, 296–305.CrossRefGoogle Scholar
  38. Koumans, E. H., Farley, T. A., Gibson, J. J., Langley, C., Ross, M. W., McFarlane, M., . . . St. Louis, M. E. (2001). Characteristics of persons with syphilis in areas of persisting syphilis in the United States: Sustained transmission associated with concurrent partnerships. Sexually Transmitted Diseases, 28, 497–503.CrossRefGoogle Scholar
  39. Kretzschmar, M., & Caraël, M. (2012). Is concurrency driving HIV transmission in sub-Saharan African sexual networks? The significance of sexual partnership typology. AIDS and Behavior, 16, 1746–1752.CrossRefGoogle Scholar
  40. Kretzschmar, M., & Morris, M. (1996). Measures of concurrency in networks and the spread of infectious disease. Mathematical Biosciences, 133, 165–195.CrossRefGoogle Scholar
  41. Kretzschmar, M., White, R. G., & Caraël, M. (2010). Concurrency is more complex than it seems. AIDS, 24, 313–315.CrossRefGoogle Scholar
  42. Kusunoki, Y. (Forthcoming). The dynamics of relationships and contraception during emerging adulthood. Journal of Marriage and Family. Google Scholar
  43. Kusunoki, Y., Barber, J. S., Gatny, H. H., & Melendez, R. (2018). Physical intimate partner violence and contraceptive behaviors among young women. Journal of Women’s Health, 27, 1016–1025.CrossRefGoogle Scholar
  44. Kusunoki, Y., & Upchurch, D. M. (2011). Contraceptive method choice among youth in the United States: The importance of relationship context. Demography, 48, 1451–1472.CrossRefGoogle Scholar
  45. Lear, D. (1995). Sexual communication in the age of AIDS: The construction of risk and trust among young adults. Social Science & Medicine, 41, 1311–1323.CrossRefGoogle Scholar
  46. Lesthaeghe, R. J., & Neidert, L. (2006). The second demographic transition in the United States: Exception or textbook example? Population and Development Review, 32, 669–698.CrossRefGoogle Scholar
  47. Lichtenstein, B., Desmond, R. A., & Schwebke, J. R. (2008). Partnership concurrency status and condom use among women diagnosed with trichomonas vaginalis. Women’s Health Issues, 18, 369–374.CrossRefGoogle Scholar
  48. Macaluso, M., Demand, M. J., Artz, L. M., & Hook, E. W., III. (2000). Partner type and condom use. AIDS, 14, 537–546.Google Scholar
  49. Manhart, L. E., Aral, S. O., Holmes, K. K., & Foxman, B. (2002). Sex partner concurrency: Measurement, prevalence, and correlates among urban 18–39-year-olds. Sexually Transmitted Diseases, 29, 133–143.CrossRefGoogle Scholar
  50. Manlove, J., Ryan, S., & Franzetta, K. (2007). Contraceptive use patterns across teens’ sexual relationships: The role of relationships, partners, and sexual histories. Demography, 44, 603–621.CrossRefGoogle Scholar
  51. Manning, W. D., Flanigan, C. M., Giordano, P. C., & Longmore, M. A. (2009). Relationship dynamics and consistency of condom use among adolescents. Perspectives on Sexual and Reproductive Health, 41, 181–190.CrossRefGoogle Scholar
  52. Manning, W. D., Giordano, P. C., & Longmore, M. A. (2006). Hooking up the relationship contexts of “nonrelationship” sex. Journal of Adolescent Research, 21, 459–483.CrossRefGoogle Scholar
  53. Manning, W. D., Giordano, P. C., Longmore, M. A., & Flanigan, C. M. (2012). Young adult dating relationships and the management of sexual risk. Population Research and Policy Review, 31, 165–185.CrossRefGoogle Scholar
  54. Manning, W. D., Longmore, M. A., Copp, J., & Giordano, P. C. (2014). The complexities of adolescent dating and sexual relationships: Fluidity, meaning(s), and implications for young adults’ well-being. New Directions for Child and Adolescent Development, 2014(144), 53–69.Google Scholar
  55. McGrath, N. (2010). HIV: Consensus indicators are needed for concurrency. Lancet, 375, 621–622.CrossRefGoogle Scholar
  56. Mishra, V., & Bignami-Van Assche, S. (2009). Concurrent sexual partnerships and HIV infection: Evidence from national population-based surveys (DHS Working Paper No. 62). Calverton, MD: Macro International.Google Scholar
  57. Morris, M. (2010). Barking up the wrong evidence tree. Comment on Lurie & Rosenthal, “Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited.” AIDS and Behavior, 14, 31–33.Google Scholar
  58. Morris, M., Epstein, H., & Wawer, M. (2010). Timing is everything: International variations in historical sexual partnership concurrency and HIV prevalence. PLoS ONE, 5(11), e14092. CrossRefGoogle Scholar
  59. Morris, M., & Kretzschmar, M. (1997). Concurrent partnerships and the spread of HIV. AIDS, 11, 641–648.CrossRefGoogle Scholar
  60. Nelson, S. J., Manhart, L. E., Gorbach, P. M., Martin, D. H., Stoner, B. P., Aral, S. O., & Holmes, K. K. (2007). Measuring sex partner concurrency: It’s what’s missing that counts. Sexually Transmitted Diseases, 34, 801–807.Google Scholar
  61. Nunn, A., MacCarthy, S., Barnett, N., Rose, J., Chan, P., Yolken, A., . . . Riggins, R. (2014). Prevalence and predictors of concurrent sexual partnerships in a predominantly African American population in Jackson, Mississippi. AIDS and Behavior, 18, 2457–2468.CrossRefGoogle Scholar
  62. Paul, E. L., McManus, B., & Hayes, A. (2000). “Hookups”: Characteristics and correlates of college students’ spontaneous and anonymous sexual experiences. Journal of Sex Research, 37, 76–88.CrossRefGoogle Scholar
  63. Potterat, J. J., Zimmerman-Rogers, H., Muth, S. Q., Rothenberg, R. B., Green, D. L., Taylor, J. E., . . . White, H. A. (1999). Chlamydia transmission: Concurrency, reproduction number, and the epidemic trajectory. American Journal of Epidemiology, 150, 1331–1339.CrossRefGoogle Scholar
  64. Reniers, G., & Tfaily, R. (2012). Polygyny, partnership concurrency, and HIV transmission in sub-Saharan Africa. Demography, 49, 1075–1101.CrossRefGoogle Scholar
  65. Reniers, G., & Watkins, S. (2010). Polygyny and the spread of HIV in Sub Saharan Africa: A case of benign concurrency. AIDS, 24, 299–307.CrossRefGoogle Scholar
  66. Riehman, K. S., Wechsberg, W. M., Francis, S. A., Moore, M., & Morgan-Lopez, A. (2006). Discordance in monogamy beliefs, sexual concurrency, and condom use among young adult substance-involved couples: Implications for risk of sexually transmitted infections. Sexually Transmitted Diseases, 33, 677–682.CrossRefGoogle Scholar
  67. Rosenberg, M. D., Gurvey, J. E., Adler, N., Dunlop, M. B. V., & Ellen, J. M. (1999). Concurrent sex partners and risk for sexually transmitted diseases among adolescents. Sexually Transmitted Diseases, 26, 208–212.CrossRefGoogle Scholar
  68. Rosengard, C., Adler, N. E., Gurvey, J. E., & Ellen, J. M. (2005). Adolescent partner-type experience: Psychosocial and behavioral differences. Perspectives on Sexual and Reproductive Health, 37, 141–147.CrossRefGoogle Scholar
  69. Sangi-Haghpeykar, H., Poindexter, A. N., Young, A., Levesque, J. E., & Horth, F. (2003). Extra-relational sex among Hispanic women and their condom-related behaviours and attitudes. AIDS Care, 15, 505–512.CrossRefGoogle Scholar
  70. Sassler, S. (2010). Partnering across the life course: Sex, relationships, and mate selection. Journal of Marriage and Family, 72, 557–575.CrossRefGoogle Scholar
  71. Sawers, L., Isaac, A. G., & Stillwaggon, E. (2011). HIV and concurrent sexual partnerships: Modelling the role of coital dilution. Journal of the International AIDS Society, 14, 44. CrossRefGoogle Scholar
  72. Sawers, L., & Stillwaggon, E. (2010). Concurrent sexual partnerships do not explain the HIV epidemics in Africa: A systematic review of the evidence. Journal of the International AIDS Society, 13, 34. CrossRefGoogle Scholar
  73. Senn, T. E., Carey, M. P., Vanable, P. A., Coury-Doniger, P., & Urban, M. (2009). Sexual partner concurrency among STI clinic patients with a steady partner: Correlates and associations with condom use. Sexually Transmitted Infections, 85, 343–347.CrossRefGoogle Scholar
  74. Sterk, C. E., Klein, H., & Elifson, K. W. (2004). Predictors of condom-related attitudes among at-risk women. Journal of Women’s Health, 13, 676–688.CrossRefGoogle Scholar
  75. Tavory, I., & Swidler, A. (2009). Condom semiotics: Meaning and condom use in rural Malawi. American Sociological Review, 74, 171–189.CrossRefGoogle Scholar
  76. Udry, J. R., & Billy, J. O. G. (1987). Initiation of coitus in early adolescence. American Sociological Review, 52, 841–855.CrossRefGoogle Scholar
  77. Washington, C., Ding, L., Gorbach, P., Rosen, B., & Kahn, J. (2018). Individual and partner-level characteristics associated with vaccine-type and non-vaccine-type human papillomavirus infection in young women after vaccine introduction. Journal of Adolescent Health, 62(Suppl. 2), S2.Google Scholar
  78. Weitzman, A., Barber, J. S., Kusunoki, Y., & England, P. (2017). Desire for and to avoid pregnancy during the transition to adulthood. Journal of Marriage and Family, 79, 1060–1075.CrossRefGoogle Scholar
  79. Wilkins, A. C., & Dalessandro, C. (2013). Monogamy lite: Cheating, college, and women. Gender & Society, 27, 728–751.CrossRefGoogle Scholar

Copyright information

© Population Association of America 2019

Authors and Affiliations

  • Abigail Weitzman
    • 1
    • 2
    Email author
  • Jennifer Barber
    • 3
    • 4
  • Yasamin Kusunoki
    • 3
    • 5
  1. 1.Population Research CenterUniversity of Texas at AustinAustinUSA
  2. 2.Department of SociologyUniversity of Texas at AustinAustinUSA
  3. 3.Population Studies CenterUniversity of MichiganAnn ArborUSA
  4. 4.Department of SociologyUniversity of MichiganAnn ArborUSA
  5. 5.Department of NursingUniversity of MichiganAnn ArborUSA

Personalised recommendations