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


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.


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


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.



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.


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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

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