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CONTEXT: Individuals’ accurate assessment of their exposure to the risk of HIV and other STDs requires awareness of their sexual partners’ risk behaviors and disease status.

METHODS: In a sample of 217 couples enrolled in a risk intervention trial in 1997–2002, both partners reported on their own risk behaviors and their perceptions of their partner's behavior; concordance of partners’ reports was examined using kappa statistics. Individual and relationship characteristics predicting lack of awareness of a partner's risk behavior were explored using multivariate logistic regression.

RESULTS: Three percent of women and 14% of men were unaware that their partner had recently had a concurrent partner. Eleven percent and 12%, respectively, were unaware that their partner had ever injected drugs; 10% and 12% were unaware that their partner had recently received an STD diagnosis; and 2% and 4% were unaware that their partner was HIV-positive. Women's lack of awareness of partner risk was associated with increasing age (odds ratio, 1.1), being of a race or ethnicity other than black or Latina (15.8) and having a Latino partner (3.7); it was positively associated with a man's report that he was married (4.4) and with relationship satisfaction as reported by both the woman and her partner (1.2 for each). Among men, lack of awareness was positively associated with partner's age (1.1) and with having a partner who was formerly married (8.2).

CONCLUSIONS: Couple-based interventions that assess each partner's awareness of the other's risk behavior may help programs better target couples’ STD prevention needs.