Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 41, Number 2, June 2009

Sexual Risk-Taking Among Adult Dating Couples In the United States

By John O. G. Billy, William R. Grady and Morgan E. Sill

CONTEXT: Knowledge of sexual and contraceptive behaviors as risk factors for STDs is largely based on women's or men's separate reports of their attitudes and behaviors. Little research has been based on couples.

METHODS: Data from the 2005–2006 National Couples Survey were used to examine the sexual risk-taking behavior of 335 dating couples. Associations between each partner's characteristics and the couple's probability of recently having had anal sex and of having done something to protect themselves from STDs were assessed using logistic regression analyses. Models included measures of power dynamics and partners' perceptions of who controls sexual and contraceptive decisions.

RESULTS: Couples in which the female partner reported that her male partner made the decisions about sex and contraception had increased probability of having had anal sex during the four weeks prior to the interview. In addition, partners' relationship power and their perception of control over sex and contraception moderated associations between couples' behavior and partners' characteristics, experiences and beliefs. For example, although couples in which the male partners had known someone with AIDS were less likely than others to engage in anal sex, that association was much greater for males with high income—and thus greater power—than for those with low income.

CONCLUSIONS: Sexual behaviors are not controlled by any one individual in a relationship; characteristics of each partner are important. Couples-based interventions that take into consideration relationship—especially power—dynamics may enable individuals to initiate and sustain safer-sex practices.




John O. G. Billy is director, Battelle Centers for Public Health Research and Evaluation, Arlington, VA. William R. Grady is director, population group, Battelle Centers for Public Health Research and Evaluation, Seattle. Morgan E. Sill is technical officer, Research Resource Development, Family Health International, Durham, NC.