Sexual Concurrency and Contraceptive Use Among Young Adult Women

Abstract

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.

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Notes

  1. 1.

    Using a sexual network survey, Helleringer et al. (2009) found that concurrent partnerships are more likely to be HIV sero-discordant than serial partnerships in sub-Saharan Africa. From this, they concluded that concurrent partnerships are at greater risk of transmission.

  2. 2.

    Although we are primarily interested in the relationship between concurrency and condom use, we refer to contraceptive use more broadly because condom use may be determined jointly with use of other methods, depending on whether individuals are additionally concerned about unwanted pregnancy.

  3. 3.

    The response rate for the baseline survey was 84 %. Women who were temporarily residing outside the county in order to attend school or to acquire job training were also included.

  4. 4.

    Attrition rates differed by race and education at baseline. African American respondents and respondents who had never attended college completed an average of 11 and 12 fewer weekly surveys, respectively, than did white respondents and respondents who had at least some college education.

  5. 5.

    These relationships ranged from an online boyfriend to a one-night stand to a husband, and everything in between.

  6. 6.

    This was the case in one-third (32 %) of weeks in which women reported having sex with two or more people.

  7. 7.

    Respondents were first asked about sexual intercourse at the second journal. Our inclusion of one-week lagged variables in our final models, as described later, necessitates having completed three or more journals.

  8. 8.

    The survey asked about only heterosexual vaginal intercourse.

  9. 9.

    We also test two- and four-week lagged measures of concurrency. The results lead to substantively similar conclusions (available upon request).

  10. 10.

    Nontransitioning weeks include weeks when the respondent had either the same primary partner in the immediately preceding and following weeks, no partner in the immediately preceding and following weeks, or some combination thereof.

  11. 11.

    For relationships that were ongoing at baseline, this measure includes time together before RDSL participation.

  12. 12.

    For example, 37 % and 59 % of ever- and never-concurrent women (respectively) used some form of contraception every week that they had sex; 2 % and 3 % of ever- and never-concurrent women (respectively) never used any form of contraception in weeks when they had sex; 6 % of ever-concurrent women and 28 % of never-concurrent women used condoms every week that they had sex and used contraception; and 10 % of ever-concurrent women and 15 % of never-concurrent women never used condoms in weeks when they had sex and used contraception.

  13. 13.

    Because cheating may occur as part of relationship transitioning, we also test a three-way interaction term among concurrency, exclusivity, and transitioning. The coefficients on this interaction term are null, and the interaction is therefore not included in the final models (results not shown).

  14. 14.

    Transitioning partners indicates that a woman reported a distinct primary partner in the immediately preceding or immediately succeeding week (or both). The reference category is that she reported the same primary partner or no partner (or a combination) in those adjacent weeks.

  15. 15.

    Accordingly, we also do not include indicators of whether the respondent was in a relationship last week or had the same primary partner last week.

  16. 16.

    The one exception is that we do not control for number of prior weeks she has had sex with her current partner.

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Acknowledgments

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.

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Weitzman, A., Barber, J. & Kusunoki, Y. Sexual Concurrency and Contraceptive Use Among Young Adult Women. Demography 56, 549–572 (2019). https://doi.org/10.1007/s13524-019-00762-w

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Keywords

  • Sexual concurrency
  • Contraception
  • Sexual health