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AIDS and Behavior

, Volume 16, Issue 2, pp 404–411 | Cite as

Relationship Factors Associated with HIV Risk Among a Sample of Gay Male Couples

  • Jason W. Mitchell
  • S. Marie Harvey
  • Donna Champeau
  • David W. Seal
Original Paper

Abstract

More HIV prevention research is needed to better understand how relationship factors may affect sexual risk behaviors among gay male couples. Our cross-sectional study collected dyadic data from 144 gay male couples to examine which relationship factors and characteristics were associated with men having UAI with a secondary sex partner. We targeted male couples by using a variety of recruitment strategies. Multilevel random-effects logistic regression modeling was used to examine which factors were predictive of men in gay couples who had UAI with a secondary sex partner. Analyses revealed that men were less likely to have had UAI with a secondary sex partner if they reported being in a strictly monogamous relationship, receiving an HIV test within the previous 3 months, and being committed to their sexual agreement. Future HIV prevention interventions must consider how relationship factors may influence sexual risk behaviors among gay male couples.

Keywords

Gay male couples Dyads HIV risk UAI Relationship factors Relationship characteristics 

Resumen

Mas investigación de prevención de VIH es necesario para entender mejor como los factores de relaciones de pareja pueden afectar los comportamientos de riesgo sexual en parejas de hombres gay. Nuestro estudio de diseño transversal recogió datos diádicos en una muestra de 144 parejas gay para examinar que factores y características de relación de pareja están asociadas con hombres gay teniendo sexo anal desprotegido con parejas secundaria. Nosotros encontramos parejas de hombres gay usando varias estrategias de reclutamiento. Modelaje con una regresión logística a multinivel para efectos al azar fue usado para examinar los factores que predicen los hombres en relaciones de pareja gay que tienen sexo anal desprotegido con una pareja sexual secundaria. El análisis revelo que era menos probable que los hombres tuvieran sexo anal desprotegido con parejas sexuales secundarias si ellos reportaban ser estrictamente monógamos en sus relaciones de pareja, haber recibido una prueba de VIH en los últimos tres meses o estar comprometidos al acuerdo sexual con su pareja principal. Futuras intervenciones para la prevención de VIH deben considerar la forma en que factores de pareja pueden influir el comportamiento de riesgo sexual en parejas de hombres gay.

Notes

Acknowledgments

This manuscript was supported by the center (P30-MH52776) and NRSA (T32-MH19985) grants from the National Institute of Mental Health. Special thanks are extended to the participants for their time and effort.

Supplementary material

10461_2011_9976_MOESM1_ESM.doc (28 kb)
Supplementary material 1 (DOC 28 kb)

References

  1. 1.
    CDC. HIV in the United States: an overview. 2010. http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm. Accessed 7 July 2010.
  2. 2.
    Coates TJ. What is to be done? AIDS. 2008;22:1079–80.PubMedCrossRefGoogle Scholar
  3. 3.
    CDC. CDC analysis provides new look at disproportionate impact of HIV and syphilis among U.S. gay and bisexual men. 2010. http://www.cdc.gov/nchhstp/newsroom/msmpressrelease.html. Accessed 10 March 2010.
  4. 4.
    Curran JW, Jaffe HW, Hardy AM, Morgan WM, Selik RM, Dondero TJ. Epidemiology of HIV infection and AIDS in the United States. Science. 1988;239:610–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Sullivan PS, Wolitski RJ. HIV infection among gay and bisexual men. In: Wolitski RJ, Stall R, Valdiserri RO, editors. Unequal opportunity. Oxford: Oxford University Press; 2008. p. 220–47.Google Scholar
  6. 6.
    Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis. 2002;29(10):38–43.PubMedGoogle Scholar
  7. 7.
    Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.PubMedCrossRefGoogle Scholar
  8. 8.
    Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. AIDS. 2004;16:775–80.Google Scholar
  9. 9.
    Halkitis PN, Zade DD, Shrem M, Marmor M. Beliefs about HIV non-infection and risky sexual behavior among MSM. AIDS Educ Prev. 2004;16:448–58.PubMedCrossRefGoogle Scholar
  10. 10.
    Kelly JA, Hoffman RG, Rompa D, Gray M. Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex. AIDS. 1998;12:F91–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Koblin BA, Perdue T, Ren L, et al. Attitudes about combination HIV therapies: the next generation of gay men at risk. J Urban Health. 2003;80:510–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Remien RH, Wagner G, Carballo-Dieguez A, Dolezal C. Who may be engaging in high-risk sex due to medical treatment advances? AIDS. 1998;12:1560–1.PubMedCrossRefGoogle Scholar
  13. 13.
    Sullivan PS, Drake AJ, Sanchez TH. Prevalence of treatment optimism-related risk behavior and associated factors among men who have sex with men in 11 states, 2000–2001. AIDS Behav. 2006;11:123–9.CrossRefGoogle Scholar
  14. 14.
    Vanable PA, Ostrow DG, McKirnan DJ, Taywaditep KJ, Hope BA. Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men. Health Psychol. 2000;19:134–45.PubMedCrossRefGoogle Scholar
  15. 15.
    CDC. Meeting summary: consultation on serosorting practices among men who have sex with men. 2009. http://www.cdc.gov/hiv/topics/research/resources/other/serosorting.htm. Accessed 10 April 2010.
  16. 16.
    Suarez T, Miller J. Negotiating risks in context: a perspective on unprotected anal intercourse and barebacking among men who have sex with men—Where do we go from here? Arch Sex Behav. 2001;30:287–300.PubMedCrossRefGoogle Scholar
  17. 17.
    CDC. Factsheet: HIV/AIDS among men who have sex with men. 2010. http://www.cdc.gov/hiv/topics/msm/resources/factsheets/msm.htm. Accessed 2 October 2010.
  18. 18.
    Mansergh G, Colfax GN, Marks G, Rader M, Guzman R, Buchbinder S. The Circuit Party Men’s Health Survey: findings and implications for gay and bisexual men. Am J Public Health. 2001;91:953–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Ostrow DG, Stall R. Alcohol, tobacco, and drug use among gay and bisexual men. In: Wolitski RJ, Stall R, Valdiserri RO, editors. Unequal opportunity. Oxford: Oxford University Press; 2008. p. 121–58.Google Scholar
  20. 20.
    Stall R, Paul JP, Greenwood G, et al. Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction. 2001;96:1589–601.PubMedCrossRefGoogle Scholar
  21. 21.
    Wolitski R. The emergence of barebacking among gay men in the United States: a public health perspective. J Gay Lesbian Psychother. 2005;9:13–38.Google Scholar
  22. 22.
    Benotsch EG, Kalichman S, Cage M. Men who have met sex partners via the Internet: prevalence, predictors, and implications for HIV prevention. Arch Sex Behav. 2002;31:177–83.PubMedCrossRefGoogle Scholar
  23. 23.
    Liau A, Millet G, Marks G. Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sex Transm Dis. 2006;33:576–84.PubMedCrossRefGoogle Scholar
  24. 24.
    LaSala MC. Extradyadic sex and gay male couples: comparing monogamous and nonmonogamous relationships. Fam Soc. 2004;85(3):405–12.Google Scholar
  25. 25.
    LaSala MC. Monogamy of the heart: extradyadic sex and gay male couples. J Gay Lesbian Soc Serv. 2004;17(3):1–24.CrossRefGoogle Scholar
  26. 26.
    Appleby PR, Miller LC, Rothspan S. The paradox of trust for male couples: when risking is a part of loving. Pers Relatsh. 1999;6:81–93.CrossRefGoogle Scholar
  27. 27.
    Blais M. Vulnerability to HIV among regular male partners and the social coding of intimacy in modern societies. Cult Health Sex. 2006;8(1):31–44.PubMedCrossRefGoogle Scholar
  28. 28.
    Davidovich U, de Wit JBF, Stroebe W. Behavioral and cognitive barriers to safer sex between men in steady relationships: implications for prevention strategies. AIDS Educ Prev. 2004;16(4):304–14.PubMedCrossRefGoogle Scholar
  29. 29.
    de Vroome EMM, Stroebe W, Sandfort TGM, de Wit JBF, Van Griensven GJP. Safer sex in social context: individualistic and relational determinants of AIDS-preventive behavior among gay men. J Appl Soc Psychol. 2000;30(11):2322–40.CrossRefGoogle Scholar
  30. 30.
    Fitzpatrick R, Dawson J, McKechnie R, et al. Regular partners and risky behaviour: why do gay men have unprotected intercourse? AIDS Care. 1994;6(3):331–41.PubMedCrossRefGoogle Scholar
  31. 31.
    McNeal JL. The association of idealization and intimacy factors with condom use in gay male couples. J Clin Psychol Med Settings. 1997;4(4):437–51.PubMedCrossRefGoogle Scholar
  32. 32.
    Worth H, Reid A, McMillan K. Somewhere over the rainbow: love, trust in monogamy in gay relationships. J Sociol (Melb). 2002;38(3):237–53.CrossRefGoogle Scholar
  33. 33.
    Davidovich U, de Wit JBF, Stroebe W. Relationship characteristics and risk of HIV infection: Rusbult’s investment model and sexual risk behavior of gay men in steady relationships. J Appl Soc Psychol. 2006;36(1):22–40.CrossRefGoogle Scholar
  34. 34.
    Boulton M, McLean J, Fitzpatrick R, Hart G. Gay men’s accounts of unsafe sex. AIDS Care. 1995;7:619–30.PubMedCrossRefGoogle Scholar
  35. 35.
    McLean J, Boulton M, Brookes M, et al. Regular partners and risky behaviour: Why do gay men have unprotected intercourse? AIDS Care. 1994;6:331–41.PubMedCrossRefGoogle Scholar
  36. 36.
    Misovich SJ, Fisher JD, Coates TJ. Close relationship and elevated risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1:72–107.CrossRefGoogle Scholar
  37. 37.
    Crawford I, Hammack PL, McKirnan DJ, et al. Sexual sensation seeking, reduced concern about HIV and sexual risk behaviour among gay men in primary relationships. AIDS Care. 2003;15(4):513–24.PubMedCrossRefGoogle Scholar
  38. 38.
    Davidovich U, de Wit JBF, Stroebe W. Assessing sexual risk behaviour of young gay men in primary relationships: the incorporation of negotiated safety and negotiated safety compliance. AIDS. 2000;14(6):701–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Prestage G, Mao L, McGuigan D, et al. HIV risk and communication between regular partners in a cohort of HIV-negative gay men. AIDS Care. 2006;18(2):166–72.PubMedCrossRefGoogle Scholar
  40. 40.
    Prestage G, Jin F, Zablotska I, et al. Trends in agreements between regular partners among gay men in Sydney, Melbourne and Brisbane, Australia. AIDS Behav. 2008;12:513–20.PubMedCrossRefGoogle Scholar
  41. 41.
    Elford J, Bolding G, Maguire M, Sherr L. Sexual risk behaviour among gay men in a relationship. AIDS. 1999;13(11):1407–11.PubMedCrossRefGoogle Scholar
  42. 42.
    Davidovich U, de Wit JBF, Albrecht N, Geskus R, Stroebe W, Coutinho R. Increase in the share of steady partners as a source of HIV infection: a 17-year study of seroconversion among gay men. AIDS. 2001;15(10):1303–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010;39(3):774–87.PubMedCrossRefGoogle Scholar
  44. 44.
    Hoff CC, Chakravarty D, Beougher SC, Darbes LA, Dadasovich R, Neilands TB. Serostatus differences and agreements about sex with outside partners among gay male couples. AIDS Educ Prev. 2009;21(1):25–38.PubMedCrossRefGoogle Scholar
  45. 45.
    Kippax S, Slavin S, Ellard J, et al. Seroconversion in context. AIDS Care. 2003;15(6):839–52.PubMedCrossRefGoogle Scholar
  46. 46.
    Xiridou M, Geskus R, de Wit J, Coutinho R, Kretzschmar M. The contribution of steady and causal partnerships to the incidence of HIV infection among homosexual men in Amsterdam. AIDS. 2003;17(7):1029–38.PubMedCrossRefGoogle Scholar
  47. 47.
    Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: differences by agreement type and couple serostatus. AIDS Care. 2010;22(7):827–35.PubMedCrossRefGoogle Scholar
  48. 48.
    Kippax S, Noble J, Prestage G, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11(12):191–7.PubMedCrossRefGoogle Scholar
  49. 49.
    Crawford JM, Rodden P, Kippax S, Van de Ven P. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS. 2001;12(3):164–70.PubMedCrossRefGoogle Scholar
  50. 50.
    Rempel JK, Holmes JG, Zanna MP. Trust in close relationships. J Pers Soc Psychol. 1985;49(1):95–112.CrossRefGoogle Scholar
  51. 51.
    Rusbult CE, Martz JM, Agnew CA. The investment model scale: measuring commitment level, satisfaction level, quality of alternatives, and investment size. Pers Relatsh. 1998;5:357–91.CrossRefGoogle Scholar
  52. 52.
    Neilands TB, Chakravarty D, Darbes LA, Beougher SC, Hoff CC. Development and validation of the Sexual Agreement Investment Scale. J Sex Res. 2010;47(1):24–37.PubMedCrossRefGoogle Scholar
  53. 53.
    Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990;108:339–62.PubMedCrossRefGoogle Scholar
  54. 54.
    Acock AC. Working with missing values. J Marriage Fam. 2005;67:1012–28.CrossRefGoogle Scholar
  55. 55.
    Le B, Agnew CR. Commitment and its theorized determinants: a meta-analysis of the Investment Model. Pers Relatsh. 2003;10:37–57.CrossRefGoogle Scholar
  56. 56.
    Rusbult CE. Commitment and satisfaction in romantic associations: A test of the investment model. J Exp Soc Psychol. 1980;16:172–86.CrossRefGoogle Scholar
  57. 57.
    Arriaga XB, Agnew CR. Being committed: Affective, cognitive, and conative components of relationship commitment. Pers Soc Psychol Bull. 2001;27:1190–203.CrossRefGoogle Scholar
  58. 58.
    Rusbult CE, Buunk BP. Commitment processes in close relationships: An interdependent analysis. J Soc Pers Relat. 1993;10:175–204.CrossRefGoogle Scholar
  59. 59.
    Kenny D, Kashy D, Cook W. Dyadic data analysis. New York: Guilford Press; 2006.Google Scholar
  60. 60.
    Rabe-Hesketh S, Skrondal A. Multilevel and longitudinal modeling using Stata. College Station: Stata Press; 2008.Google Scholar
  61. 61.
    Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med. 1998;17:1623–34.PubMedCrossRefGoogle Scholar
  62. 62.
    Parsons JT, Schrimshaw EW, Wolitski RJ, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19:S13–25.PubMedCrossRefGoogle Scholar
  63. 63.
    Van De Ven P, Kippax S, Crawford J, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care. 2002;14:471–80.PubMedCrossRefGoogle Scholar
  64. 64.
    Eaton L, West T, Kenny D, Kalichman S. HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection. AIDS Behav. 2009;13(2):185–95.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jason W. Mitchell
    • 1
  • S. Marie Harvey
    • 2
  • Donna Champeau
    • 2
  • David W. Seal
    • 1
  1. 1.Center for AIDS Intervention ResearchMedical College of WisconsinMilwaukeeUSA
  2. 2.Department of Public HealthOregon State UniversityCorvallisUSA

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