Understanding sex partner selection from the perspective of inner-city black adolescents.

Persistently high rates of HIV and other STDs have a profound impact on the health of adolescent populations in the United States. (1) Some populations-black youth (2) and inner-city residents, (3) for example-disproportionately suffer the burden of these infections. Social and environmental factors are important determinants of disparities in rates of infection; (4) key among these factors are the patterns of exposure to STDs created by an individual's sexual network. (5)

A growing body of literature suggests that in addition to individual behavior, characteristics of one's sex partner and sexual network significantly influence an individual's STD risk. (6) For example, individuals who have nonmonogamous sex partners are at increased risk for STDs relative to those with monogamous partners. (7) Additionally, adolescents who have older sex partners have a greater risk of infection than individuals whose partners are their own age. (8)

Furthermore, macro-level social and economic forces drive racial differences in sexual network formation in ways that promote and sustain elevated STD rates within black populations in the United States. (9) Because of racism, racial segregation and poverty, blacks are more likely than others to form partnerships with members of their own race. Because of incarceration, violence and a subsequent imbalance in the sex ratio, sexual networks within black populations are more likely than others to include individuals with varying levels of risk in terms of STD transmission, and more likely to include individuals who have overlapping (nonmonogamous) partnerships. The mechanisms by which these contextual factors influence sex partner selection and dynamics within sexual relationships, however, are not clear.

Over the past several decades, sociologists and psychologists have developed numerous theories to explain sexual behavior, mating patterns and sex partner selection. Most early theories describe motivations for "mate" selection and characteristics that people tend to look for in a lifetime romantic partner in the context of marriage. For example, one theory is that people seek mates who are similar to themselves in characteristics as diverse as height, weight, personality, intelligence and values; (10) another suggests that people seek mates who they believe will provide equity in the exchange of valuable resources in the relationship. (11) Distance or propinquity theories suggest that people simply mate with others with whom they tend to come in contact. (12) Critics of these theories contend that their descriptions of the qualities that determine mate selection are vague, and that they fail to differentiate between selection strategies for women and men and selection of partnerships of varying duration (for example, nonmarital sex partnerships). (13)

In response, Buss suggests a more comprehensive theory for understanding sex partner selection, for both short-term and long-term relationships, from a biological perspective based in evolutionary psychology. (14) This theory suggests that sex partner selection is a strategic process motivated by a desire to achieve reproductive success, and that particular selection patterns have developed as an adaptive response to problems our ancestors encountered during evolution. According to Buss, men and women pursue different mating strategies oriented toward reproduction because of the disparity between the levels of parental investment required of each sex due to biological differences: Men are more likely than women to adopt short-term, overlapping sexual partnerships and to seek fertile partners, to increase the probability that they will successfully reproduce. In contrast, women's reproductive success is linked to their ability to access external resources for themselves and their children, and thus women look for partners who can provide these resources through long-term partnerships.

Buss depicts the sex partner selection strategies included in his model as universal, but dependent on contextual factors. Adaptation to these factors is described in relation to the goal of successful reproduction without consideration of other social needs that may influence interactions within sexual relationships. In relation to successful reproduction, factors such as access to economic resources and the sex ratio are important to sex partner selection. (15)

Limited research has examined the ways in which contextual factors shape sex partner selection beyond their influence on reproduction. Additionally, research and, in turn, theories that challenge reproduction as the goal of sex partner selection and reflect contemporary motivations and the social environment surrounding at-risk adolescents are sorely lacking. Furthermore, theories that focus on mate selection within the context of long-term marital relationships may not be applicable to adolescents. Thus, to inform an effective public health response to inner-city black adolescents' risk for STDs, our study was designed to gain a better understanding of the psychosocial processes related to sex partner selection in this population.

METHODS

Study participants were recruited during the summer and fall of 2002 from among enrollees in the Baltimore-based Perceived Risk of Sexually Transmitted Diseases (PRSTD) cohort study. The PRSTD cohort consists of adolescents who live in Baltimore and have sought reproductive health services at a public STD or general adolescent health clinic in the eastern region of the city, a lower income area. We employed purposive sampling (16) to recruit participants from among those who had visited a clinic…