Advertisement

AIDS and Behavior

, Volume 18, Issue 7, pp 1401–1411 | Cite as

A Cause for Concern: Male Couples’ Sexual Agreements and Their Use of Substances with Sex

  • Jason W. MitchellEmail author
  • Carol Boyd
  • Sean McCabe
  • Rob Stephenson
Original Paper

Abstract

Substance use is strongly associated with HIV risk among gay men. Many gay couples establish sexual agreements. However, little is known about gay couples’ use of substances with sex, and whether substance use is associated with couples’ agreements. The present study assessed whether gay couples’ use of substances with sex was associated with their establishment of, type of, and adherence to, a sexual agreement. Dyadic data from 275 HIV-negative US gay couples were collected online in a nation-wide, cross-sectional study, and analyzed at the couple-level. Findings revealed that couples with an established agreement, and a recently broken agreement, were more likely to have used amyl nitrates and marijuana with sex within their relationship. This same trend was also noted, but for alcohol use with sex outside of couples’ relationships. Further research is urgently needed to examine the fluidity of HIV-negative gay male couples’ sexual agreements and substance use with sex.

Keywords

Substance use with sex Gay male couples Aspects of sexual agreements Concordantly HIV-negative Dyadic data 

Resumen

El consumo de sustancias está fuertemente asociada con el riesgo de VIH entre los hombres homosexuales. Muchas parejas gays establecen acuerdos sexuales. Sin embargo, poco se sabe acerca de las parejas homosexuales “uso de sustancias con el sexo, y si el consumo de sustancias se asocia con parejas acuerdos. El presente estudio evaluó si el uso de las parejas homosexuales “de las sustancias con el sexo se relacionó con la creación de, forma de, y la adhesión a un acuerdo sexual. Datos diádicas de 275 parejas de homosexuales estadounidenses VIH-negativos fueron recogidas en línea en un estudio a nivel nacional, transversal, y se analizaron a nivel pareja. Los resultados revelaron que las parejas con un acuerdo establecido, y un acuerdo recientemente roto, tenían más probabilidades de haber usado los nitratos de amilo y marihuana con el sexo en su relación. Esta misma tendencia se observó también, pero para el consumo de alcohol con el sexo fuera de las relaciones de pareja. Más investigación se necesita con urgencia para examinar la fluidez de los acuerdos sexuales gay parejas masculinas VIH y el consumo de sustancias con el sexo.

Notes

Acknowledgments

Data collected for the research described in the present study 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.

References

  1. 1.
    CDC. HIV among gay and bisexual men. 2013. http://www.cdc.gov/hiv/topics/msm/pdf/msm.pdf. Accessed 15 Aug 2013.
  2. 2.
    Goodreau SM, Carnegie NB, Vittinghoff E, et al. What drives the US and Peruvian epidemics in men who have sex with men (MSM)? PLoS ONE. 2012;7(11):e50522.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    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;23:1153–62.PubMedCrossRefGoogle Scholar
  4. 4.
    Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010;39(3):774–87.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Mitchell JW. Characteristics and allowed behaviors of gay male couples’ sexual agreements. J Sex Res. 2013. doi: 10.1080/00224499.2012.727915.
  6. 6.
    Kippax S, Crawford J, Davis M, Rodden P, Dowsett G. Sustaining safer sex: a longitudinal study of a sample of homosexual men. AIDS. 1993;7:257–63.PubMedCrossRefGoogle Scholar
  7. 7.
    Kippax S, Nobel J, Prestage G, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11:191–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Jin F, Crawford J, Prestage GP, et al. HIV risk reductions behaviors on gay men: unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23(2):243–52.PubMedCentralPubMedCrossRefGoogle 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. 2012;24(10):1255–63.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Gomez AM, Beougher SC, Chakravarty D, et al. Relationship dynamics as predictors of broken agreements about outside sexual partners: implications for HIV prevention among gay couples. AIDS Behav. 2012;16(6):1584–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: differences by agreement types and couples serostatus. AIDS Care. 2010;22(7):827–35.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Hoff CC, Chakravarty D, Beougher SC, Neilands TB, Darbes LA. Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient Care STDS. 2012;26(12):738–45.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Hoff CC, Chakravarty D, Beougher SC, et al. Serostatus differences and agreements about sex with outside partners among gay male couples. AIDS Educ Prev. 2009;21(1):25–38.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    LaSala MC. Extradyadic sex and gay male couples: comparing monogamous and nonmonogamous relationships. Fam Soc. 2004;85(3):405–12.CrossRefGoogle Scholar
  15. 15.
    LaSala MC. Monogamy of the heart: extradyadic sex and gay male couples. J Gay Lesbian Soc Serv. 2004;17(3):1–24.CrossRefGoogle Scholar
  16. 16.
    Mitchell JW, Harvey SM, Champeau D, Moskowitz DA, Seal DW. Relationship factors associated with gay male couples’ concordance on aspects of their sexual agreements: establishment, type, and adherence. AIDS Behav. 2012;16(6):1560–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Mitchell JW, Harvey SM, Champeau D, Seal DW. Relationship factors associated with HIV risk among a sample of gay male couples. AIDS Behav. 2012;16(2):404–11.PubMedCrossRefGoogle Scholar
  18. 18.
    Mitchell JW, Petroll AE. Factors associated with men in HIV-negative gay couples who practiced UAI within and outside of their relationship. AIDS Behav. 2012;17(4):1329–37.CrossRefGoogle Scholar
  19. 19.
    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. 2013;42(2):303–12.PubMedCrossRefGoogle Scholar
  20. 20.
    Parsons JT, Starks TJ, Gamarel KE, Grov C. Non-monogamy and sexual relationship quality among same-sex male couples. J Fam Psychol. 2012;26(5):669–77.PubMedCrossRefGoogle Scholar
  21. 21.
    Wheldon CW, Pathak EB. Masculinity and relationship agreements among male same-sex couples. J Sex Res. 2010;47(5):460–70.PubMedCrossRefGoogle Scholar
  22. 22.
    Carey JW, Mejia R, Bingham T, et al. Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS Behav. 2009;13(6):1084–96.PubMedCrossRefGoogle Scholar
  23. 23.
    Dirks H, Esser S, Borgmann R, et al. Substance use and sexual risk behavior among HIV-positive men who have sex with men in specialized out-patient clinics. HIV Med. 2012;13(9):533–40.PubMedGoogle Scholar
  24. 24.
    Heath J, Lanoye A, Maisto SA. The role of alcohol and substance use in risky sexual behavior among older men who have sex with men: a review and critique of the current literature. AIDS Behav. 2012;16(3):578–89.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Hirschfield A, Remien RH, Humberstone M, Walavalkar I, Chiasson MA. Substance use and high-risk sex among men who have sex with men: a national online study in the USA. AIDS Care. 2004;16(8):1036–47.CrossRefGoogle Scholar
  26. 26.
    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(6):953–8.PubMedCentralPubMedGoogle Scholar
  27. 27.
    Mansergh G, Flores SA, Koblin B, Hudson SM, McKirnan DJ, Colfax GN. Alcohol and drug use in the context of anal sex and other factors associated with sexually transmitted infections: results from a multi-city study of high-risk men who have sex with men in the USA. Sex Transm Infect. 2008;84(6):509–11.PubMedCrossRefGoogle Scholar
  28. 28.
    Prestage G, Grierson J, Bradley J, Hurley M, Hudson J. The role of drugs during group sex among gay men in Australia. Sex Health. 2009;6(4):310–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Prestage G, Jin F, Kippax S, Zablotska I, Imrie J, Grulich A. Use of illicit drugs and erectile dysfunction medications and subsequent HIV infection among gay men in Sydney, Australia. J Sex Med. 2009;6(8):2311–20.PubMedCrossRefGoogle Scholar
  30. 30.
    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(11):1589–601.PubMedCrossRefGoogle Scholar
  31. 31.
    Prestage G, Degenhardt L, Jin F, et al. Predictors of frequent use of amphetamine type stimulants among HIV-negative gay men in Sydney, Australia. Drug Alcohol Depend. 2007;91(2–3):260–8.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Aguinaldo JP, Myers T, Ryder K, Haubrich DJ, Calzavara L. Accounts of HIV seroconversion among substance-using gay and bisexual men. Qual Health Res. 2009;19(10):1395–406.PubMedCrossRefGoogle Scholar
  33. 33.
    Koblin BA, Husnik MJ, Colfax G, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(5):731–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Ostrow DG, Plankey MW, Cox C, et al. Specific sex drug combinations contribute to the majority of recent HIV seroconversions among MSM in the MACS. J Acquir Immune Defic Syndr. 2009;51(3):349–55.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    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.Google Scholar
  36. 36.
    Santos GM, Das M, Colfax GN. Interventions for non-injection substance use among US men who have sex with men: what is needed? AIDS Behav. 2001;15(Suppl 1):S51–6.Google Scholar
  37. 37.
    Mitchell JW. Aspects of sexual agreements vary by gay male couples’ relationship length. AIDS Care. 2014. doi: 10.1080/09540121.2014.882491.
  38. 38.
    Mitchell JW. Between and within couple-level factors associated with gay male couples’ investment in a sexual agreement. AIDS Behav. 2013. doi: 10.1007/s10461-013-0673-z.
  39. 39.
    Mitchell JW, Horvath K. Factors associated with regular HIV testing among a sample of US MSM with HIV-negative main partners. J Acquir Immune Defic Syndr. 2013;64(4):417–23.PubMedCrossRefGoogle Scholar
  40. 40.
    Mitchell JW. Gay male couples’ attitudes toward using couples-based voluntary HIV counseling and testing. Arch Sex Behav. 2014;43(1):161–71.PubMedCrossRefGoogle Scholar
  41. 41.
    Mitchell JW. HIV-negative and HIV-discordant gay male couples’ use of HIV risk-reduction strategies: differences by partner type and couples’ HIV-status. AIDS Behav. 2013;17(4):1557–69.PubMedCrossRefGoogle Scholar
  42. 42.
    Higa DH, Crepz N, Marshall KL. A systematic review to identify challenges of demonstrating efficacy of HIV behavioral interventions for gay, bisexual, and other men who have sex with men. AIDS Behav. 2013;17(4):1231–44.PubMedCrossRefGoogle Scholar
  43. 43.
    Jenkins RA. Recruiting substance-using men who have sex with men into HIV prevention research: current status and future directions. AIDS Behav. 2013;16(6):1411–9.CrossRefGoogle Scholar
  44. 44.
    Knight KR, Das M, DeMicco E, et al. A roadmap for adapting an evidence-based HIV prevention intervention: personal cognitive counseling (PCC) for episodic substance-using men who have sex with men. Prev Sci. 2013. doi: 10.1007/s11121-013-0364-z.
  45. 45.
    Kurtz SP, Stall RD, Buttram ME, Surratt HL, Chen M. A randomized trial of a behavioral intervention for high risk substance-using MSM. AIDS Behav. 2013;17(9):2914–26.PubMedCrossRefGoogle Scholar
  46. 46.
    Mansergh G, Koblin BA, McKirnan DJ, et al. An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group. PLoS Med. 2010;7(8):e1000329.PubMedCentralPubMedCrossRefGoogle Scholar
  47. 47.
    Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav. 2012;16(6):1394–410.PubMedCrossRefGoogle Scholar
  48. 48.
    Zuckerman M. Behavioral expressions and biosocial bases of sensation seeking. Cambridge: Cambridge University Press; 1994.Google Scholar
  49. 49.
    Newcomb ME, Clerkin EM, Mustanski B. Sensation seeking moderates the effects of alcohol and drug use prior to sex on sexual risk in young men who have sex with men. AIDS Behav. 2011;15(3):565–75.PubMedCrossRefGoogle Scholar
  50. 50.
    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):1–10.PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    El-Bassel N, Gilbert L, Witte S, et al. Couples-based HIV prevention in the United States: advantages, gaps and future directions. J Acquir Immune Defic Syndr. 2010;55(2):S98–101.PubMedCrossRefGoogle Scholar
  52. 52.
    Herbst JH, Beeker C, Mathew A, et al. The effectiveness of individual-, group-, and community-level HIV behavioral risk-reduction interventions for adult men who have sex with men. Am J Prev Med. 2007;32:38–67.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Jason W. Mitchell
    • 1
    • 2
    Email author
  • Carol Boyd
    • 1
    • 3
  • Sean McCabe
    • 3
    • 4
  • Rob Stephenson
    • 5
  1. 1.School of NursingUniversity of MichiganAnn ArborUSA
  2. 2.Center for AIDS Intervention ResearchMedical College of WisconsinMilwaukeeUSA
  3. 3.Institute for Research on Women and GenderUniversity of MichiganAnn ArborUSA
  4. 4.Substance Abuse Research CenterUniversity of MichiganAnn ArborUSA
  5. 5.Rollins School of Public HealthEmory UniversityAtlantaUSA

Personalised recommendations