A Case Control Study of Women With Multiple Sexual Partners

Both population based surveys and more focused research studies indicate that increased
numbers of sexual partners and partner concurrency contribute to increased risk for
acquisition of sexually transmitted infection (STI), including HIV infection. However,
unlike for men, both national and sub-population-based studies consistently find that the
great majority of women with or without STIs report only 1-2 sex partners in the preceding
year and that a minority of women acknowledge > 3 sex partners over the same period,
suggesting that this relatively small proportion of women with higher numbers of sex
partners play a disproportionate role in sustaining community STI rates. Despite these
observations, surprisingly little is known about women with increased numbers of sexual
partners, the factors which contribute to increased partner number, and the potential for
those factors to be intervened upon to reduce risk for STI. The implications of these facts
for STI/HIV prevention efforts are profound. For instance, interventions that include the
implication that target audiences have multiple sex partners might be dismissed as
irrelevant by those with single partners. Conversely, interventions targeting women with
multiple sex partners may be based on assumptions derived from data which, while
representative of the general target audience, may not reflect relevant circumstances for
the subset of women with higher numbers of partners.

This study will begin to generate data that will provide critical information on this topic
and help inform future development of STI/HIV interventions tailored to womens' individual
circumstances and contexts. The investigators hypothesize that women with 4 or more sexual
partners during the past year will report higher rates of depression and substance abuse
(alcohol and drugs), higher rates of intimate partner violence, less social support, more
non-vaginal sex, more same-sex contacts, and higher rates of STIs than women reporting only
one sexual partner during the past year.