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Patterns of Age Mixing and Sexually Transmitted Infections. Julie Kraut-Becher University of Pennsylvania Sevgi O. Aral Division of STD Prevention, CDC. Age Mixing. Population-level determinant Spread of HIV Africa Gay men Individual-level risk factor Risky behavior
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Patterns of Age Mixing and Sexually Transmitted Infections Julie Kraut-Becher University of Pennsylvania Sevgi O. Aral Division of STD Prevention, CDC
Age Mixing • Population-level determinant • Spread of HIV • Africa • Gay men • Individual-level risk factor • Risky behavior • Unprotected vaginal sex • Lack of consistent condom use
Age Mixing • Increase STI incidence • Directly • Exposure to partner pools with higher STI prevalence • Indirectly • Partnerships marked by power imbalance • Practice of safer sex is difficult
Objectives • Describe age mixing patterns • Nationally representative sample of reproductive age, sexually-active U.S. women • Relate these patterns to self-reported STI history • STI diagnosis or testing or treatment
Methods • Data • 1995 National Survey of Family Growth (NSFG) • Sample • N = 9,272 sexually-active women 15-44 years of age • Valid birth date information for themselves and their partner
Methods • Age Difference • Computed for current or most recent partnership • Age difference < 0 • Younger male partner • Age difference > 0 • Older male partner
Methods • Assess extent of age mixing • Describe patterns of age mixing • Sociodemographic and socioeconomic characteristics • STI history • Examine association between age mixing and STI test, treatment, and diagnosis • Nationally representative sample • Sample weights
Results • 15-17 year-old females
Results • 18-19 year-old females
Results • 20-24 year-old females
Results • 25-29 year-old females
Results • 30-34 year-old females
Results • 35-39 year-old females
Results • 40-44 year-old females
Limitations • Self reports of STI information • STI diagnoses not temporally defined • Cannot determine the causal nature of association between partnership characteristics and STI
Conclusions • Large extent of age mixing • Age mixing varies over the life course • The effect of age mixing on STI varies over the life course
Conclusions • Future research • Biomarkers vs. self-reports • Specific infections • Race/ethnicity specific • Program • Ask about age mixing with current sex partners • Screening parameter • Target interventions