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Do young women engage in greater sexual risk behaviour with biological fathers of their children?
  1. Michele R Decker1,
  2. Shang-En Chung2,3,
  3. Jonathan M Ellen4,5,
  4. Susan G Sherman4
  1. 1Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  3. 3Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  4. 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5All Childrens Hospital, Johns Hopkins Medicine, St Petersburg, Florida, USA
  1. Correspondence to Dr Michele R Decker, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E4142, Baltimore, MD 21212, USA; mdecker{at}


Objectives Qualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as ‘baby daddy’ relationships, enable risk for pregnancy and STI/HIV. Our study compared partner characteristics and sexual risk within dyads based on BFR, among a sample of young women in Baltimore, Maryland, USA.

Methods We conducted secondary analysis of survey data collected in 2011–2013 from heterosexually experienced youth ages 15–24 in Baltimore, Maryland, USA. Analyses are limited to women with at least one recent (past 6 months) sex partner (n=171 participants, reporting on 271 relationships). Using generalised estimating equations with logit function for correlated binary responses, we evaluate associations of BFR with partner characteristics, sexual risk behaviour and contraceptive non-use.

Results At least one BFR partner was reported by 25.2%. Male partners in BFRs were more likely to have been incarcerated or arrested. BFRs were more often characterised by women as ‘main’ versus ‘casual’ partners (adjusted OR (AOR) 3.92, 95% CI 1.19 to 12.9). In adjusted analyses, BFR was associated with condom non-use for vaginal (AOR 12.3, 95% CI 3.92 to 38.7) and anal (AOR 3.32, 95% CI 1.34 to 8.22) intercourse. While BFR was associated with contraceptive non-use (AOR 2.21, 95% CI 1.01 to 4.84), this association attenuated to non-significance after adjusting for partnership type (AOR 2.06, 95% CI 0.91 to 4.67).

Conclusions While few differences in BFR partner characteristics emerged, significantly greater risk for unprotected intercourse was identified within BFR relationships. Findings suggest that the relationship context of a shared child heightens sexual risk for the young women most affected by STI.


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