Background Sexual health identifies both individual and partner-specific factors as important elements in public health approaches to STI prevention among adolescents, yet little empirical evidence links them to specific STI-related health outcomes.

Method Data were individual and partner-specific quarterly interviews from a cohort of young women in Indianapolis (N = 387, 14–17 yrs.). Using an existing sexual health definition (WHO, 2002) we created two standardised, multi-item sexual health scales: individual sexual health (sexual positivity, absence of genital pain, family communication, family connexion) and partner-specific sexual health (relationship satisfaction, sexual satisfaction, condom use self-efficacy, pregnancy prevention attitudes, sexual communication, partner’s connexion to family) (both α ≥ 0.85). Outcomes were: used a condom at last sex (no/yes), ratio of condom-protected coital events, any sexual coercion (no/yes), current number sex partners (2+/1), future number of sex partners (next 90-days: 2+/1). Analyses were multi-level logistic and linear regression (HLM, 7.0; all p < 0.05), overall and by current number of sexual partners.

Results Individual (OR = 1.22) and partner-specific (OR = 1.87) sexual health predicted condom use at last sex; partner-specific sexual health predicted no sexual coercion (OR = 0.69), a higher ratio of condom-protected coital events (b = 0.12), as well as having one sexual partner currently and for the anticipated future. Higher partner-specific sexual health predicted condom use at last sex in currently single (OR = 1.70) and in currently multiple partner relationships (OR = 2.22), a higher ratio of condom protected coital events in currently single (b = 0.15) and in currently multiple partner relationships (b = 3.66), and absence of sexual coercion (OR = 0.19) in currently multiple-partner relationships.

Conclusion Individual and partner-specific sexual health are separately linked to key STI-related public health indicators. These data suggest that different elements may require emphasis to more fully support effective sexual health approaches to reducing STI in adolescents.