AIDS and Behavior

, Volume 23, Issue 1, pp 283–288 | Cite as

Composite Risk for HIV: A New Approach Towards Integrating Biomedical and Behavioral Strategies in Couples-Based HIV Prevention Research

  • Kristi E. GamarelEmail author
  • Deepalika Chakravarty
  • Torsten B. Neilands
  • Colleen C. Hoff
  • James Lykens
  • Lynae A. Darbes


A substantial number of new HIV infections among gay, bisexual, and other men who have sex with men and transgender women occurs in the context of primary partnerships. Given the diversity of risk reduction needs and various approaches available for reducing risk within couples, condomless sex is no longer the gold standard HIV outcome. We present a novel, comprehensive, and flexible Composite Risk for HIV (CR-HIV) approach for integrating evolving biomedical and behavioral HIV prevention strategies into couples-based HIV prevention intervention and survey research. We provide illustrative examples of the utility of the CR-HIV approach based on couples’ HIV status.


Couples HIV prevention Men who have sex with men Transgender women 



The authors thank both Dr. Gregory Greenwood and Dr. Susannah Allison for their support.


Funding was provided by National Institute of Mental Health (Grant No. R01MH110289; Grant No. R01MH115765). The first author was also supported by research education grant (Grant No. R25MH067127). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

Each of the authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kristi E. Gamarel
    • 1
    • 2
    Email author
  • Deepalika Chakravarty
    • 3
    • 4
  • Torsten B. Neilands
    • 3
  • Colleen C. Hoff
    • 4
  • James Lykens
    • 4
  • Lynae A. Darbes
    • 2
    • 5
  1. 1.Department of Health Behavior & Health EducationUniversity of Michigan School of Public HealthAnn ArborUSA
  2. 2.Center for Sexuality & Health DisparitiesUniversity of Michigan School of NursingAnn ArborUSA
  3. 3.Center for AIDS Prevention Studies, Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.Center for Research and Education on Gender and SexualitySan Francisco State UniversitySan FranciscoUSA
  5. 5.Department of Health Behavior and Biological SciencesUniversity of Michigan School of NursingAnn ArborUSA

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