"Selective avoidance" does not reduce STD risk

By Amy Norton

NEW YORK (Reuters Health) - A new study suggests that many African- American girls try to lower their risk of sexually transmitted diseases by being selective about their sex partners -- but the strategy does not seem to work.

The study of 715 African-American teens and young women found that more than one third had recently used "selective avoidance" as a way to protect themselves from STDs. More than one quarter said they used the tactic to lower their chances of transmitting an STD to a partner.]

Selective avoidance refers to the practice of not having sex in certain situations because of STD concerns -- often out of worry that a partner might have a sexually transmitted infection. Some people, particularly teenagers, may see it as a legitimate choice over consistent condom use or complete abstinence.

In the new study, researchers found that selective avoidance was a common tactic among young black women, but not an effective one.

The prevalence of STDs, such as chlamydia and gonorrhea, was similar among girls and women who used selective avoidance and those who did not, the researchers report in the Archives of Pediatrics & Adolescent Medicine.

"Girls do not have a good way of differentiating risky from non-risky partners," lead researcher Dr. Ralph J. DiClemente, of Emory University in Atlanta, told Reuters Health.

"They think they do," he explained, "but the data indicate that while they may be more 'selective' in choosing who to have as a sex partner, the outcome of getting an STD is the same."

The findings suggest that young women need to be discouraged from using selective avoidance, and encouraged to "use condoms consistently and correctly with all male sexual partners," DiClemente and his colleagues write.

Many girls may also need to learn how to be assertive in their relationships and insist on condoms, the findings suggest. Study participants who had the highest levels of "fear" about negotiating condom use were more likely to turn to selective avoidance to try to lower their STD risk.

Other research suggests that strengthening young women's negotiation skills and overall knowledge of STD prevention may help. In an earlier study, DiClemente and his colleagues found that such a program increased condom use among African-American teenage girls and lowered their likelihood of taking on new sexual partners.

SOURCE: Archives of Pediatrics & Adolescent Medicine, January 2008.