1. Adolescents in Love: Mutuality of commitment in adolescent couples
Dana Watnick, MPH, MSSW, Laurie Bauman, PhD, Ellen Silver, PhD,
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
Background
For the past few decades, HIV prevention research has focused on individual-level predictors of risk behavior, such as HIV knowledge and skills. However, risky sexual behavior occurs in the context of a dyad, and condom use may be influenced by couple-level variables such as love and trust. We hypothesized that adolescents in love would use condoms less often, and boys would report being in love less often than girls. Until recently, no studies have interviewed both partners within adolescent couples to determine whether being in love is mutual, or if boys sexualize their relationships.
Results
There was a considerable amount of concordance between partners. Being ‘in love' was reported by 89% of girls and 85% of boys (80% of couples agreed). The relationship was reported as “very” or “extremely important” to 91% of girls and 87% of boys (83% of couples agreed). 74% of boys and 78% of girls reported being in a serious committed relationship with 68% of couples agreeing that the relationship was serious and committed. Sexual monogamy was reported by over 90% of both boys and girls.
Relationship Characteristics
Boys
(n=139)
Girls
Couples
In love
85%
88%
80%
Together forever
50%
55%
37%
Expect monogamy
69%
78%
57%
Actual Monogamy
93%
94%
Serious and Committed
74%
68%
Trust
49%
29%
Aims
To describe couple-level characteristics of sexually active heterosexual adolescent couples in the Bronx, NY;
(2) To examine the relationship between couple characteristics and condom use;
(3) To test the hypothesis that girls are more likely to be in love than boys
Conclusions
Both boys and girls demonstrated high concordance on being in a loving, serious, and monogamous relationship. Youth in these relationships also reported high levels of unprotected and uncontracepted sex. In teen couples where the relationship is characterized by love, future commitment, expectation of monogamy, and seriousness, love is a barrier to condom use and is likely to prove resistant to traditional HIV/STI risk reduction interventions. In future work we must address relationship characteristics of the dyad which put teens at greater risk as well as the complexity of recommending condom use with a partner they love.
Methods
Data were collected for a longitudinal panel study of 139 heterosexual adolescent couples who had been together for 4+ weeks, and had had oral, anal or vaginal sex within the last 6 months. We first recruited ‘index' participants aged from billing records of outpatient medical practices in the Bronx, NY and then recruited their current sexual partner who was older than 14 years and no more than four years older than the index partner. Following eligibility screening, both partners completed computer-assisted self-administered surveys at five time points over the course of a 1 year period. Once teens were deemed eligible for study participation, 83% of couples enrolled in the study. Results shown here are from baseline data.
Couple Background Characteristics
Ethnicity:
Black Couples 25%
Hispanic Couples 47%
Mixed Couples 27%
Boys Girls
Age in Years (SD): (1.3) (1.1)
Relationship Length (Yrs): (1.3) 1.1 (0.9)
Risky Sex Behavior:
Condoms were used consistently in fewer than 31% of couples where both partners agreed they were in love.
In only 15% of couples did both partners report using condoms at last sex.
Within the last 3 months, boys reported that 62% of vaginal sex episodes with their partner were protected vs. 54% for girls.
One quarter of couples did not use any modern contraceptive method at last sex
Acknowledgements
Teen Connections was funded by a NIMH grant (R01 MH A1) to Laurie J. Bauman, Ph.D. We are grateful for the assistance of the Teen Lifestyle Survey staff who recruited the participants and helped collect the data, and also want to thank the adolescents who contributed their experiences to the study.