AIDS and Behavior

, Volume 20, Issue 6, pp 1284–1294 | Cite as

Developmental Change in the Effects of Sexual Partner and Relationship Characteristics on Sexual Risk Behavior in Young Men Who Have Sex with Men

Original Paper


Young men who have sex with men are substantially impacted by HIV/AIDS, and most new infections occur in serious romantic dyads. Young people experience substantial psychosocial and neurocognitive change between adolescence and emerging adulthood which impacts engagement in risk behaviors. We aimed to examine developmental change in the association between sexual partnership characteristics and condomless anal intercourse (CAI). Data were taken from an analytic sample of 114 young adult MSM from a longitudinal study of lesbian, gay, bisexual and transgender youth with 4-year follow-up. Rates of CAI were approximately 12 times higher in serious compared to casual partnerships, but this effect diminished in size over time. Partner age differences and violence were associated with more CAI, and these associations strengthened across development. Characteristics of serious relationships (e.g., power dynamics) were also examined. We discuss the need for HIV prevention strategies that address dyadic influences on CAI during this critical developmental period.


Young men who have sex with men, HIV/AIDS Romantic relationships Developmental change 



This research was supported by a Grant from the National Institute of Mental Health (R21MH095413; PI: Mustanski), National Institute on Drug Abuse (U01DA036939), an American Foundation for Suicide Prevention grant (PI: Mustanski), the William T. Grant Foundation Scholars Award (PI: Mustanski), and the David Bohnett Foundation (PI: Mustanski). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.


  1. 1.
    Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2011. HIV Surveillance Report. vol. 23, 2013.Google Scholar
  2. 2.
    Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006-2009. PLoS One. 2011;6:e17502.CrossRefPubMedPubMedCentralGoogle 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.CrossRefPubMedGoogle Scholar
  4. 4.
    Mustanski B, Parsons JT. Introduction to the special section on sexual health in gay and bisexual male couples. Arch Sex Behav. 2014;43:17–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48:218–53.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Crepaz N, Marks G, Mansergh G, et al. Age-related risk for HIV infection in men who have sex with men: examination of behavioral, relationship, and serostatus variables. AIDS Educ Prev. 2000;12:405–15.PubMedGoogle Scholar
  7. 7.
    Dudley MG, Rostosky SS, Korfhage BA, Zimmerman RS. Correlates of high-risk sexual behavior among young men who have sex with men. AIDS Educ Prev. 2004;16:328–40.CrossRefPubMedGoogle Scholar
  8. 8.
    Hays RB, Kegeles SM, Coates TJ. Unprotected sex and HIV risk taking among young gay men within boyfriend relationships. AIDS Educ Prev. 1997;9:314–29.PubMedGoogle Scholar
  9. 9.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Newcomb ME, Ryan DT, Garofalo R, Mustanski B. The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men. Arch Sex Behav. 2014;43:61–72.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Greene GJ, Andrews R, Kuper L, Mustanski B. Intimacy, monogamy, and condom problems drive unprotected sex among young men in serious relationships with other men: a mixed methods dyadic study. Arch Sex Behav. 2014;43:73–87.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Centers for Disease Control and Prevention. HIV among gay, bisexual, and other men who have sex with men: Unites States Department of Health and Human Services, 2013.Google Scholar
  13. 13.
    Jessor R. Risk behavior in adolescence: a psychosocial framework for understanding and action. Dev Rev. 1992;12:374–90.CrossRefGoogle Scholar
  14. 14.
    Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000;55:469–80.CrossRefPubMedGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States, 2011. MMWR. 2012;61:1–162.Google Scholar
  16. 16.
    Steinberg L. A social neuroscience perspective on adolescent risk-taking. Dev Rev. 2008;28:78–106.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Corbin WR, Fromme K. Alcohol use and serial monogamy as risks for sexually transmitted diseases in young adults. Health Psychol. 2002;21:229–36.CrossRefPubMedGoogle Scholar
  18. 18.
    Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1:72–107.CrossRefGoogle Scholar
  19. 19.
    Robles TF, Kiecolt-Glaser JK. The physiology of marriage: pathways to health. Physiol Behav. 2003;79:409–16.CrossRefPubMedGoogle Scholar
  20. 20.
    Waite LJ, Gallagher M. The case for marriage: why married people are happer, healthier, and better off financially: Doubleday Books, 2000.Google Scholar
  21. 21.
    House JS, Umberson D, Landis KR. Structures and processes of social support. Ann Rev Sociol. 1988;14:293–318.CrossRefGoogle Scholar
  22. 22.
    Turner RJ, Brown RL. Social support and mental health. New York: Cambridge University Press; 2010.Google Scholar
  23. 23.
    Drasin H, Beals KP, Elliott MN, et al. Age cohort differences in the developmental milestones of gay men. J Homosex. 2008;54:381–99.CrossRefPubMedGoogle Scholar
  24. 24.
    Eccles TA, Sayegh MA, Fortenberry JD, Zimet GD. More normal than not: a qualitative assessment of the developmental experiences of gay male youth. J Adolesc Health. 2004;35(425):e411–28.Google Scholar
  25. 25.
    Rosario M, Schrimshaw EW, Hunter J. Different patterns of sexual identity development over time: implications for the psychological adjustment of lesbian, gay, and bisexual youths. J Sex Res. 2011;48:3–15.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Rosario M, Schrimshaw EW, Hunter J. Predicting different patterns of sexual identity development over time among lesbian, gay, and bisexual youths: a cluster analytic approach. Am J Community Psychol. 2008;42:266–82.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Mustanski B, Birkett M, Greene GJ, Hatzenbuehler ML, Newcomb ME. Envisioning an America without sexual orientation inequities in adolescent health. Am J Public Health. 2014;104:218–25.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Macapagal KR, Greene GJ, Rivera Z, Mustanski B. Relationship stages and processes among same-sex couple in emerging adulthood. (under review).Google Scholar
  29. 29.
    Mustanski B, Newcomb ME. Older sexual partners may contribute to racial disparities in HIV among young men who have sex with men. J Adolesc Health. 2013;52:666–7.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Joseph HA, Marks G, Belcher L, et al. Older partner selection, sexual risk behaviour and unrecognised HIV infection among black and Latino men who have sex with men. Sex Transm Infect. 2011;87:442–7.CrossRefPubMedGoogle Scholar
  31. 31.
    Newcomb ME, Mustanski B. Racial differences in same-race partnering and the effects of sexual partnership characteristics on HIV Risk in MSM: a prospective sexual diary study. J Acquir Immune Defic Syndr. 2013;62:329–33.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data - United States and 6 U.S. dependent areas - 2010. HIV Surveillance Supplemental Report. 2012, 17 Google Scholar
  33. 33.
    Berry M, Raymond HF, McFarland W. Same race and older partner selection may explain higher HIV prevalence among black men who have sex with men. AIDS. 2007;21:2349–50.CrossRefPubMedGoogle Scholar
  34. 34.
    Dank M, Lachman P, Zweig JM, Yahner J. Dating violence experiences of lesbian, gay, bisexual, and transgender youth. J Youth Adolesc. 2014;43:846–57.CrossRefPubMedGoogle Scholar
  35. 35.
    Buller AM, Devries KM, Howard LM, Bacchus LJ. Associations between intimate partner violence and health among men who have sex with men: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001609.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Finneran C, Stephenson R. Intimate partner violence among men who have sex with men: a systematic review. Trauma Violence Abuse. 2013;14:168–85.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Finneran C, Stephenson R. Intimate partner violence, minority stress, and sexual risk-taking among U.S. men who have sex with men. J Homosex. 2014;61:288–306.CrossRefPubMedGoogle Scholar
  38. 38.
    Feldman MB, Ream GL, Diaz RM, El-Bassel N. Intimate partner violence and HIV sexual risk behavior among Latino gay and bisexual men: the role of situational factors. J LGBT Health Res. 2007;3:75–87.CrossRefPubMedGoogle Scholar
  39. 39.
    Houston E, McKirnan DJ. Intimate partner abuse among gay and bisexual men: risk correlates and health outcomes. J Urban Health. 2007;84:681–90.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Koblin BA, Torian L, Xu G, et al. Violence and HIV-related risk among young men who have sex with men. AIDS Care. 2006;18:961–7.CrossRefPubMedGoogle Scholar
  41. 41.
    Mustanski B, Garofalo R, Herrick A, Donenberg G. Psychosocial health problems increase risk for HIV among urban young men who have sex with men: preliminary evidence of a syndemic in need of attention. Ann Behav Med. 2007;34:37–45.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men’s use of the Internet: research from the 1990s through 2013. J Sex Res. 2014;51:390–409.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Bauermeister JA, Leslie-Santana M, Johns MM, Pingel E, Eisenberg A. Mr. Right and Mr. Right Now: romantic and casual partner-seeking online among young men who have sex with men. AIDS Behav. 2011;15:261–72.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Downing MJ Jr. Using the internet in pursuit of public sexual encounters: is frequency of use associated with risk behavior among MSM? Am J Mens Health. 2012;6:18–27.CrossRefPubMedGoogle Scholar
  45. 45.
    Garofalo R, Herrick A, Mustanski BS, Donenberg GR. Tip of the Iceberg: young men who have sex with men, the Internet, and HIV risk. Am J Public Health. 2007;97:1113–7.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Horvath KJ, Rosser BR, Remafedi G. Sexual risk taking among young internet-using men who have sex with men. Am J Public Health. 2008;98:1059–67.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Mustanski BS. Are sexual partners met online associated with HIV/STI risk behaviours? Retrospective and daily diary data in conflict. AIDS Care. 2007;19:822–7.CrossRefPubMedGoogle Scholar
  48. 48.
    Ogilvie GS, Taylor DL, Trussler T, et al. Seeking sexual partners on the internet: a marker for risky sexual behaviour in men who have sex with men. Can J Public Health. 2008;99:185–8.PubMedGoogle Scholar
  49. 49.
    Newcomb ME, Mustanski B. Developmental change in the relationship between alcohol and drug use before sex and sexual risk behavior in young men who have sex with men. AIDS Behav. 2014;18:1981–90.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Tonry M, Ohlin LE, Farrington DP. Human development and criminal behavior: New ways of advancing knowledge. New York: Springer-Verlag Publishing; 1991.CrossRefGoogle Scholar
  51. 51.
    Heckathorn DD. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44:174–200.CrossRefGoogle Scholar
  52. 52.
    Mustanski B, Starks T, Newcomb ME. Methods for the design and analysis of relationship and partner effects on sexual health. Arch Sex Behav. 2014;43:21–33.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Pulerwitz J, Gortmaker SL, DeJong W. Measuring sexual relationship power in HIV/STD research. Sex Roles. 2000;42:637–60.CrossRefGoogle Scholar
  54. 54.
    Raudenbush SW, Bryk AS, Cheong YF, Congdon RT, du Toit M. HLM 7: Hierarchical linear and nonlinear modeling. Chicago: Scientific Software International; 2011.Google Scholar
  55. 55.
    Mustanski B, Rendina HJ, Greene GJ, Sullivan PS, Parsons JT. Testing negative means i’m lucky, making good choices, or immune: diverse reactions to HIV test results are associated with risk behaviors. Ann Behav Med. 2014;48:371–83.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Newcomb ME, Heinz AJ, Mustanski B. Examining risk and protective factors for alcohol use in lesbian, gay, bisexual, and transgender youth: a longitudinal multilevel analysis. J Stud Alcohol Drugs. 2012;73:783–93.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

Personalised recommendations