AIDS and Behavior

, Volume 17, Issue 4, pp 1499–1514 | Cite as

Open, Closed, or In Between: Relationship Configuration and Condom Use Among Men Who Use the Internet to Seek Sex with Men

  • Sonya S. Brady
  • Alex Iantaffi
  • Dylan L. Galos
  • B. R. Simon Rosser
Original Paper


Nearly 70 % of HIV+ men who have sex with men (MSM) are estimated to have contracted HIV from a main partner. We examine whether condom use varies by relationship configuration, including open relationships with and without cheating. 656 MSM in committed relationships were recruited through a sexually explicit social networking website. Of the 55 % of MSM who had anal sex with a non-main partner in the past 90 days, two-thirds did not use a condom. Adjusting for covariates, MSM in relationships characterized as open with cheating versus monogamous were more likely to have unprotected anal sex with both main and non-main partners. MSM who perceived that their partner played around or cheated were more likely to have unprotected anal sex with a non-main partner. Prevention messages should attempt to reduce cheating and increase personal responsibility for protecting partners from HIV. Messages should be tailored to reflect open and monogamous relationships.


Condom Men who have sex with men (MSM) Relationship Infidelity Internet 



This study was undertaken as part of “Structural Interventions to Lower Alcohol-related STI/HIV-Risk” (SILAS), grant number R01AA01627001, funded by the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA). We gratefully acknowledge the assistance of Daniel Holsinger, SILAS Project Coordinator, and Gudrun Kilian, Program Manager of the HIV/STI Intervention & Prevention Studies (HIPS) Program.


  1. 1.
    Hall HI, Song R, Rhodes R, Prejean J, An Q, Lee LM, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300:520–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Kaiser Family Foundation. AIDS at 25: an overview of major trends in the U.S. epidemic. 2006.
  3. 3.
    Centers for Disease Control and Prevention. HIV among gay, bisexual and other men who have sex with men (MSM). 2010.
  4. 4.
    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 Behav. 2009;23:1153–62.Google Scholar
  5. 5.
    Ritchie A, Barker M. ‘There aren’t words for what do or how we feel so we have to make them up’: constructing polyamorous languages in a culture of compulsory monogamy. Sexualities. 2006;9:584–601.CrossRefGoogle Scholar
  6. 6.
    Barker M, Langdridge D. Whatever happened to non-monogamies? Critical reflections on recent research and theory. Sexualities. 2011;13:748–72.CrossRefGoogle Scholar
  7. 7.
    Shernoff M. Negotiated nonmonogamy and male couples. Fam Process. 2006;45:407–18.PubMedCrossRefGoogle Scholar
  8. 8.
    Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010;39:774–87.PubMedCrossRefGoogle Scholar
  9. 9.
    Gass K, Hoff CC, Stephenson R, Sullivan PS. Sexual agreements in the partnerships of Internet-using men who have sex with men. AIDS Care: Psychological and Socio-medical aspects of AIDS/HIV. Available online.Google Scholar
  10. 10.
    Parsons JT, Starks TJ, DuBois S, Grov C, Golub SA. Alternatives to monogamy among gay male couples in a community survey: Implications for mental health and sexual risk. Arch Sex Behav. Available online.Google Scholar
  11. 11.
    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;21:25–38.PubMedCrossRefGoogle Scholar
  12. 12.
    Gomez AM, Beougher SC, Chakravarty D, Neilands TB, Mandic CG, Darbes LA, Hoff CC. Relationship dynamics as predictors of broken agreements about outside sexual partners: Implications for HIV prevention among gay couples. AIDS Behav. Available online.Google Scholar
  13. 13.
    Solomon SE, Rothblum ED, Balsam KF. Money, housework, sex, and conflict: same-sex couples in civil unions, those not in civil unions, and heterosexual married siblings. Sex Roles. 2005;52:561–75.CrossRefGoogle Scholar
  14. 14.
    Blumstein P, Schwartz P. American couples: money, work, sex. New York: William Morrow; 1983.Google Scholar
  15. 15.
    Adam BD. Relationship innovation in male couples. Sexualities. 2006;9:5–26.CrossRefGoogle Scholar
  16. 16.
    Burton J, Darbes LA, Operario D. Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS Behav. 2010;14:1–10.PubMedCrossRefGoogle Scholar
  17. 17.
    Wu E, El-Bassel N, McVinney LD, Hess L, Remien RH, Charania M, Mansergh G. Feasibility and promise of a couple-based HIV/STI preventative intervention for methamphetamine-using, black men who have sex with men. AIDS Behav. 2011;15:1745–54.PubMedCrossRefGoogle Scholar
  18. 18.
    McFarlane M, Bull SS, Rietmeijer CA. The internet as a newly emerging risk environment for sexually transmitted diseases. JAMA. 2000;284:443–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Kaiser Family Foundation. Inside-out: a report on the experiences of lesbians, gays and bisexuals in America and the public’s views on issues and policies related to sexual orientation. 2001.
  20. 20.
    Mays VM, Cochran SD. Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. Am J Public Health. 2001;91:1869–76.PubMedCrossRefGoogle Scholar
  21. 21.
    Klausner JD, Wolf W, Fischer-Ponce L, Zolt I, Katz MH. Tracing a syphilis outbreak through cyberspace. J Am Med Assoc. 2000;284:447–9.CrossRefGoogle Scholar
  22. 22.
    Rosser BRS, Oakes JM, Horvath KJ, Konstan JA, Danilenko GP, Peterson JL. HIV sexual risk behavior by men who use the internet to seek sex with men: results of the men’s internet sex study-II (MINTS-II). AIDS Behav. 2009;13:488–98.PubMedCrossRefGoogle Scholar
  23. 23.
    Tashima KT, Alt EN, Harwell JI, Fiebich-Perez DK, Flanigan TP. Internet sex-seeking leads to acute HIV infection: a report of two cases. Int J STD AIDS. 2003;14:285–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in urban and rural areas of the United States, 2006. HIV/AIDS Surveillance Supplemental Report. 2010. p. 13.Google Scholar
  25. 25.
    Catania JA, Osmond D, Stall RD, Pollack L, Paul JP, Blower S, et al. The continuing HIV epidemic among men who have sex with men. Am J Public Health. 2001;91:907–14.PubMedCrossRefGoogle Scholar
  26. 26.
    Wolitski RJ, Bailey CJ, O’Leary A, Gomez CA, Parsons JT. Self-perceived responsibility of HIV-positive men who have sex with men for preventing HIV transmission. AIDS Behav. 2003;7:363–72.PubMedCrossRefGoogle Scholar
  27. 27.
    Rosser BRS, Gurak L, Horvath KJ, Oakes JM, Konstan J, Danilenko G. The challenges of ensuring participant consent in internet-based sex studies: a case study of the MINTS I & II studies. J Comput Mediated Commun. 2009;13:746–56.Google Scholar
  28. 28.
    Konstan JA, Rosser BRS, Ross MW, Stanton J, Edwards WM. The story of subject naught: a cautionary but optimistic talk of internet survey research. J Comput Mediated Commun. 2005;10(2): article 11.Google Scholar
  29. 29.
    Collins LM, Lanza ST. Latent class and latent transition analysis: with applications in the social, behavioral, and health sciences. Hoboken, NJ: Wiley; 2010.Google Scholar
  30. 30.
    Grov C, Starks TJ, Rendina J, Parsons J. Rules about casual sex partners, relationship satisfaction, and HIV risk in partnered gay and bisexual men. J Sex Marital Ther. in press, Accepted author version posted online: 22 May 2012.Google Scholar
  31. 31.
    Lo Y, Mendell N, Rubin DB. Testing the number of components in a normal mixture. Biometrika. 2001;88:767–78.CrossRefGoogle Scholar
  32. 32.
    Ross MW, Rosser BRS. Monogamy is …. Genitounin Med. 1988;64:65–6.Google Scholar
  33. 33.
    Golden MR, Stekler J, Hughes JP, Wood RW. HIV serosorting in men who have sex with men: Is it safe? Epidemiol Soc Sci. 2008;49:212–8.Google Scholar
  34. 34.
    Penke L, Asendorpf JB. Beyond global sociosexual orientations: a more differentiated look at sociosexuality and its effects on courtship and romantic relationships. J Pers Soc Psychol. 2008;95:1113–35.PubMedCrossRefGoogle Scholar
  35. 35.
    Theodore PS, Duran REF, Antoni MH, Fernandez MI. Intimacy and sexual behavior among HIV-positive men-who-have-sex-with-men in primary relationships. AIDS Behav. 2004;8:321–31.PubMedCrossRefGoogle Scholar
  36. 36.
    Crepaz N, Marks G, Liau A, Mullins MM, Aupont LW, Marshall KJ, Jacobs ED, Wolitski RJ. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23:1617–29.PubMedCrossRefGoogle Scholar
  37. 37.
    Crossley M. Making sense of “barebacking”: gay men’s narratives, unsafe sex and the “resistance habitus”. Br J Soc Psychol. 2004;43:225–44.PubMedCrossRefGoogle Scholar
  38. 38.
    Lightfoot M, Song J, Rotheram-Borus MJ, et al. The influence of partner type and risk status on the sexual behavior of young men who have sex with men living with HIV/AIDS. J Acquir Immune Defic Syndr. 2005;38:61–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Conley TD, Collins BE. Differenced between condom users and condom nonusers in their multidimensional condom attitudes. J Appl Soc Psychol. 2005;35:603–20.CrossRefGoogle Scholar
  40. 40.
    Shernoff M. Condomless sex: gay men, barebacking, and harm reduction. Soc Work. 2006;51:106–13.PubMedCrossRefGoogle Scholar
  41. 41.
    Sullivan P, Stephenson R. Couples voluntary HIV counseling and testing for men who have sex with men. Treatment Issues. 2011. Gay Men’s Health Crisis (GMHC). Retrieved 17 June 2012.
  42. 42.
    Lenhart A, Horrigan J, Rainie L, Allen K, Boyce A, Madden M, O’Grady E. The ever-shifting Internet population: a new look at Internet access and the digital divide. 2003. Pew Internet & American Life Project. Retrieved 11 Jan 2012.
  43. 43.
    Turner CF, Ku L, Rogers SM, Lindberg LD, Pleck JH, Sonenstein FL. Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science. 1998;280:867–73.PubMedCrossRefGoogle Scholar
  44. 44.
    Mustanski B, Newcomb ME, Clerkin EM. Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychol. 2011;30:597–605.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sonya S. Brady
    • 1
  • Alex Iantaffi
    • 1
  • Dylan L. Galos
    • 1
  • B. R. Simon Rosser
    • 1
  1. 1.Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisUSA

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