Partnership dynamics and sexual health risks among male adolescents in the Favelas of Recife, Brazil.

Context: Adolescents' past and current partnerships influence their sexual health risks. Males' responsibilities and needs in terms of sexual health have long received less attention than females'. It is important to examine male adolescent sexual and contraceptive patterns within the broader context of partnership dynamics.

Methods: In May 2000, 1,438 males aged 13-19 living in the urban shantytowns of Recife, Brazil, were surveyed. Adolescents gave detailed partnership, sexual and contraceptive history data in the form of month-by-month calendars for the prior two years. Logistic regression analyses were used to examine the associations between prior and current partnership experience and contraceptive use.

Results: Overall, 76% of respondents reported having had at least one partnership in the past two years; 49% of partnerships involved intercourse. On average, steady and casual partnerships lasted 4.7 months and 1.6 months, respectively. Respondents typically had spent 2.8 months of the past two years in a sexual partnership, 1.2 months of which were unprotected by contraceptive use. Of those with a recent partnership, having had a prior sexual partner was associated with elevated odds of being sexually active in the current or most recent partnership (odds ratio, 4.0). Of sexually active adolescents, having used contraceptives at first sex or in a former sexual partnership was associated with elevated odds of having used a condom in the current or most recent sexual partnership (7.9 and 6.5, respectively).

Conclusions: Prevention programs need to have an accurate portrait of adolescent partnership dynamics, an adequate understanding of adolescent sexuality and a realistic estimation of actual exposure to risk, so interventions and messages can be tailored to adolescents' realities.