Magnus Manya, Schillinger Julia A, Fortenberry J Dennis, Berman Stuart M, Kissinger Patricia
Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC 20037, USA.
J Adolesc Health. 2006 Sep;39(3):396-403. doi: 10.1016/j.jadohealth.2006.01.005. Epub 2006 Jul 10.
Among adolescent women, having older sexual partners has been associated with initial Chlamydia trachomatis (Ct) infection and high-risk behaviors. This study evaluates the role of older partners in the risk of three outcomes: recurrent Ct, lack of condom use, and nonadherence with partner management (PM) strategies.
Female participants aged 14 to 18 years enrolled in a randomized clinical trial of patient-delivered partner treatment (PDPT) with at least one follow-up visit were included in this secondary analysis. Patient- and partner-level data were collected at baseline, one, and four months follow-up. Generalized estimating equations (GEE) and logistic regression were used to examine unadjusted and adjusted associations.
The majority of the 496 women were African-American (63.3%), aged 16 to 18 years (62.3%), and asymptomatic for Ct (66.7%). At baseline, all of the women had laboratory-demonstrated Ct and were treated; they had 622 partners during the last 60 days, 21.4% reported having more than one partner with a mean (SD) of 1.5 (.78) partners per woman, and 46.3% of the partners were at least three years older than the woman. Over follow-up, 16.1% of the women experienced Ct recurrence, in 41.9% of the partnerships a condom was not used at last sex, and 80.6% of women reported giving PM. After adjusting for confounders, having a partner at least three years older was not associated with increased risk of Ct recurrence, lack of condom use, or nonadherence to PM strategies.
Risk of Ct recurrence, lack of condom use, and nonadherence to PM strategies was not higher among adolescent women with older partners.
在青春期女性中，拥有年龄较大的性伴侣与沙眼衣原体（Ct）初发感染及高危行为有关。本研究评估年龄较大的伴侣在三种结局风险中的作用：Ct复发、不使用避孕套以及未坚持伴侣管理（PM）策略。
本二次分析纳入了年龄在14至18岁、参与患者主导的伴侣治疗（PDPT）随机临床试验且至少有一次随访的女性参与者。在基线、1个月和4个月随访时收集患者及伴侣层面的数据。使用广义估计方程（GEE）和逻辑回归来检验未调整和调整后的关联。
496名女性中大多数为非裔美国人（63.3%），年龄在16至18岁（62.3%），且Ct无症状（66.7%）。基线时，所有女性的Ct经实验室确诊并接受了治疗；在过去60天里她们有622名伴侣，21.4%报告有多个伴侣，每位女性平均（标准差）有1.5（0.78）名伴侣，46.3%的伴侣比女性至少大3岁。在随访期间，16.1%的女性经历了Ct复发，在41.9%的伴侣关系中最后一次性行为未使用避孕套，80.6%的女性报告进行了伴侣管理。在调整混杂因素后，有至少大三岁的伴侣与Ct复发风险增加、不使用避孕套或不坚持PM策略无关。
有年龄较大伴侣的青春期女性中，Ct复发、不使用避孕套和不坚持PM策略的风险并不更高。
