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Partner Age Difference, Power, Intimate Partner Violence, and Sexual Risk In Adolescent Girls. Ellen M. Volpe, PhD, FNP, Thomas Hardie , EdD , PMHCNS-BC , Catherine Cerulli , PhD, JD, Marilynn S. Sommers , PhD, RN, FAAN, and Dianne Morrison- Beedy , PhD, RN, FAAN. - PowerPoint PPT Presentation
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Partner Age Difference, Power, Intimate Partner Violence, and Sexual Risk In Adolescent Girls Ellen M. Volpe, PhD, FNP, Thomas Hardie, EdD, PMHCNS-BC , Catherine Cerulli, PhD, JD, Marilynn S. Sommers, PhD, RN, FAAN, and Dianne Morrison-Beedy, PhD, RN, FAAN
Funding Acknowledgments
National Institutes of Mental Health
F31MH082646-01A2 (PI E.Volpe, Sponsor: D. Morrison-Beedy)
National Institutes of Nursing Research
T32NR007100, (PI M. Sommers)
Sigma Theta Tau, Epsilon Chapter
Susan B. Anthony Institute
Background
Adolescent girls with older male partners at increased risk for HIV/STIs (e.g. Seth et al., 2010, Ryan et al., 2008, Senn et al., 2011)
Relationship power assumed to be the theoretical link between older partners and sexual risk behaviors (e.g. DiClemente et al., 2002; Teitelman et al., 2011)
Intimate Partner Violence (IPV) has been linked to sexual risk behavior ( e.g. Halpern et al., 2009, Howard et al., 2007, Seth et al. 2010)
Partner Age Difference as a Predictor of Relationship Power, IPV, and Consistent Condom use in Adolescent Girls
Individuals’ social and economic characteristics
Demographic characteristics
Family/household characteristics
Community characteristics
Gender-based power
in sexual relationships
Access to and use of sexual
& reproductive
services
Reproductive health domains:
Consistent Condom Use
Violence: Physical IPV/
Psychological IPV
Relationship characteristics:• Partner Age Difference
Specific Aims
1. Examine the proposed model: Partner Age Difference as a Predictor of Relationship Power, IPV, and Consistent Condom use in Adolescent Girls
2. Estimate the direct effects of partner age difference on consistent condom
3. Analyze the indirect effects of that relationship through proposed mediators, relationship power and IPV
Methods
Design Cross-sectional, descriptive survey
Setting School-based health center, mid-size city
Sample 155 sexually-active, low-income adolescent
girls (ages 14-18) in reported “boyfriend” relationship
Procedures Anonymous, computer assisted self-
interview (CASI): Promote Health
Methods: Measures
Partner age difference
Sexual Relationship Power Scale (Pulerwitz et al., 2002)
Relationship Power
Decision-making Dominance
Conflict Tactics Scale (Straus & Douglas, 2004)
Severity of physical and psychological IPV
Consistent condom use
Methods: Analyses
Descriptives
Bivariate correlations
Multiple mediation models to estimate direct and indirect effects (Preacher & Hayes, 2008)
Results
Table 1: Sample Characteristics (n=155)
n (%) M (SD)Range (min;
max)
Participant Age 16.1 years (1.3) 14;18 yearsPartner’s Age 17.8 years (2.6) 14;33 years
Partner Age Difference 1.6 years (2.2) -1;15 years
Race Category • African American/ Black 108 (69%) • Caucasian 10 (7%) • Race >1 28 (18%) Hispanic 30 (19%) Low SES 125 (81%)
Results: Condom Use
Average of 24.5 episodes of vaginal sex, and 7.9 episodes of unprotected sex in 3 months
Only 24% of adolescent girls reported consistent condom use
Results: Relationship Power
An average of 2.9 on relationship power scale (1-4)
Almost 2/3rds fell into high relationship power level
Relationship control inversely correlated with IPV severity
Decision-making Dominance positively correlated with consistent condom use
Results: IPV
Adolescent girls reported high frequency of victimization Physical: 18% minor only, 18% severe Psychological: 47% minor only; 35% severe
Results: Direct and Indirect Effects
Partner age difference
Gender-based power in
sexual relationships
Consistent Condom Use
Severity of Psychological IPV
Severity of Physical IPV
.012
.651
-.429*
.000
.007 -.095
-.357
-.442*
*= p< .05
Discussion
Partner age difference was negatively correlated with consistent condom use
Not explained by any of the proposed mediators: relationship power, severity of physical and psychological IPV
Alternative explanations: Emotional manipulation not identified in relationship
power Clustering of adolescent risk behavior Complexity of condom use decision-making in
relationships
Discussion
Prevalence of physical and psychological IPV severity
Discreet constructions of relationship power Relationship control: inversely
related to IPV Decision-making dominance:
consistent condom use
Limitations
Cross-sectional design
Lack of variability in partner age difference
Lack of context for violence or measure of sexual risk
Implications
Elucidate the degree of partner age difference that predicts low relationship power
Investigate alternative explanations to explain partner age difference’s relationship to condom use
Examine implications of high relationship power among adolescent girls
Incorporate partner age, relationship control, and decision-making dominance in interventions
ReferencesDiClemente, R. J., Wingood, G. M., Crosby, R. A., Sionean, C., Cobb, B. K., Harrington, K., . . . Oh, M. K. (2002). Sexual risk behaviors associated with having older sex partners: A study of black adolescent females. Sexually Transmitted Diseases, 29(1), 20-24.
Halpern, C. T., Spriggs, A. L., Martin, S. L., & Kupper, L. L. (2009). Patterns of intimate partner violence victimization from adolescence to young adulthood in a nationally representative sample. Journal of Adolescent Health, 45(5), 508-516.
Howard, D. E., Wang, M. Q., & Yan, F. (2007). Psychosocial factors associated with reports of physical dating violence among U.S. adolescent females. Adolescence, 42(166), 311-324.
Pulerwitz, J., Gortmaker, S. L., & DeJong, W. (2000). Measuring sexual relationship power in HIV/STD research. Sex Roles, 42(7), 637-660.
Preacher, K. J. & Hayes, A. F., (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40 (3), 879-891.
References (continued)
Ryan, S., Franzetta, K., Manlove, J. S., & Schelar, E. (2008). Older sexual partners during adolescence: Links to reproductive health outcomes in young adulthood. Perspectives on Sexual & Reproductive Health, 40(1), 17-26.
Senn, T. E., & Carey, M. P. (2011). Age of partner at first adolescent intercourse and adult sexual risk behavior among women. Journal of Women's Health, 20(1), 61-66.
Seth, P., Raiford, J. L., Robinson, L. S., Wingood, G. M., & Diclemente, R. J. (2010). Intimate partner violence and other partner-related factors: Correlates of sexually transmissible infections and risky sexual behaviours among young adult African American women. Sexual Health, 7(1), 25-30.
Straus, M. A., & Douglas, E. M. (2004). A short form of the revised Conflict Tactics Scales, and typologies for severity and mutuality. Violence and Victims, 19(5), 507-520.
Teitelman, A. M., Tennille, J., Bohinski, J. M., Jemmott, L. S., & Jemmott, J. B. I. (2011). Unwanted unprotected sex: Condom coercion by male partners and self-silencing of condom negotiation among adolescent girls. Advances in Nursing Science, 34(3).