Interpersonal modes of sexual health communication and how they promote or inhibit effective sexual health decisions

Sexual negotiation and communication promote positive sexual health outcomes, but more research is needed before the link is clearly mapped.  Little research has examined partner communication outside of disclosure models. The study explored reports of partners communication around high risk (i.e. multiple and concurrent partners) and prevention behaviors (i.e. STI testing) among heterosexually active emerging adult women.  The aim was to document how conversations promote or inhibit effective decision-making and how people then negotiate interpersonally these decisions about their sexual risk. Twenty-five women ages 18-24 years participated in a semi-structured interview around three topic domains: partner interactions, contraceptive use, and STI prevention.  Analysis followed a critical inquiry qualitative orientation. The majority of participants did not discuss STIs, or STI testing, with partners.  For many participants, conversations about sexual history, specifically the affirmation of virginity, annulled the perceived need to discuss STIs. Similarly, most did not discuss sexual concurrency with partners, but held strong fidelity expectations.  No participant said conversations led to condom use, and many women mentioned conversations leading to nonuse or discontinuation. Broadly promoting sexual health communication may hinder sexual health decision making.  Rather, public health campaigns need to promote concrete guidelines and tools around sexual health conversations that are tailored to relationship status. Campaigns should also aim to normalize sexual health conversations with partners.