title: It takes 2: partner attributes associated with sexually transmitted infections among adolescents.
abstract: OBJECTIVE
  The aims of this study were to identify partner attributes associated with sexually transmitted infections (STIs) among adolescents and to summarize implications for research and prevention.
  
  
  METHODS
  The design of this study was systematic review.
  
  
  METHODS
  We identified peer-reviewed studies published in 1990 through 2010 that assessed 1 or more partner attributes in relation to a biologically confirmed STI among adolescents (15-24 years) by searching MEDLINE and included articles. Studies that included adolescents but more than 50% of the sample or with mean or median age of 25 years or greater were excluded.
  
  
  RESULTS
  Sixty-four studies met the eligibility criteria; 61% were conducted in high-income countries; 80% were cross sectional; and 91% enrolled females and 42% enrolled males. There was no standard "partner" definition. Partner attributes assessed most frequently included the following: age, race/ethnicity, multiple sex partners, and STI symptoms. Older partners were associated with prevalent STIs but largely unrelated to incidence. Black race was associated with STIs but not uniformly. Partners with multiple partners and STI symptoms seem to be associated with STIs predominantly among females. Although significant associations were reported, weaker evidence exists for the following: other partner sociodemographics, sexual and other behaviors (sexual concurrency, intimate partner violence, substance use, travel), and STI history. There were no apparent differences by STI.
  
  
  CONCLUSIONS
  Partner attributes are independently associated with STIs among male and female adolescents worldwide. These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote and address barriers to condom use. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. A standard partner definition would facilitate the interpretation of findings in future studies.
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA. alswart@emory.edu
authors.forename: Andrea
authors.initials: A
authors.lastname: Swartzendruber
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Zenilman
authors.forename: Linda M
authors.initials: LM
authors.lastname: Niccolai
authors.forename: Trace S
authors.initials: TS
authors.lastname: Kershaw
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Diclemente
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D047568:Unsafe Sex; D055815:Young Adult