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The role of feelings of intimacy on perceptions of risk for a sexually transmitted disease and condom use in the sexual relationships of adolescent African–American females
  1. Pamela A Matson1,
  2. Shang-en Chung1,
  3. Petra Sander2,
  4. Susan G Millstein3,
  5. Jonathan M Ellen1
  1. 1Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  2. 2Department of Epidemiology, Harvard University School of Public Health, Boston, Massachusetts, USA
  3. 3Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Pamela Matson, 5200 Eastern Avenue, Suite 4200, Mason F. Lord Building, Center Tower, Baltimore, MD 21224, USA; pmatson1{at}


Objectives A core construct targeted by behavioural interventions is the perception that one is at risk for acquiring a sexually transmitted disease (STD). The objective of this analysis was to examine the role of intimacy on perceptions of risk for an STD (PRSTD) and condom use within late adolescent females' main relationships.

Methods A clinical sample of African–American women aged 14–19 years at enrolment were followed prospectively for 3 years. At each semiannual interview, participants reported their partner-specific PRSTD, feelings of intimacy, perceptions of partner's concurrency and condom use at last sex for each of their main sex partners.

Results A total of 285 individuals reported 724 main relationships. Using generalised estimating equations, intimacy was negatively associated with risk perception, after adjusting for perceptions of partner concurrency (OR: 0.68; 95% CI 0.60 to 0.76). PRSTD was no longer associated with condom use after adjusting for intimacy (OR: 1.30; 95% CI 0.83 to 2.02.

Conclusions Intimacy was found to be associated with risk perception and condom use within adolescent main relationships. Adolescents may not view their intimate partners as sources of infection. The success of individual-level STD prevention efforts, such as condom promotion, might be limited as condoms may be in conflict with adolescents' expectations about intimate relationships.

  • Intimacy
  • relationships
  • condoms
  • cohort studies
  • adolescents

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  • Funding This research was supported by the National Institute of Allergy and Infectious Diseases (R01-AI36986), the National Institute on Drug Abuse (F31-DA019822) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD058309).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Johns Hopkins University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.