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Archives of Sexual Behavior

, Volume 48, Issue 1, pp 369–382 | Cite as

The Prevalence and Correlates of Sexual Arrangements in a National Cohort of HIV-Negative Gay and Bisexual Men in the United States

  • Tyrel J. Starks
  • Gabriel Robles
  • Stephen C. Bosco
  • Trey V. Dellucci
  • Christian Grov
  • Jeffrey T. ParsonsEmail author
Original Paper

Abstract

Sexual agreements have received considerable attention as an aspect of dyadic functioning associated with HIV risk. To date, this research has primarily utilized convenience samples which overrepresented men from large urban areas and with higher HIV risk. The current study utilized a national cohort of 1061 HIV-negative gay and bisexual men recruited to be geographically diverse within the U.S. The sample included 531 (50.0%) men who identified as single. Of the 530 partnered men, 240 (45.3%) were monogamous; 238 (44.9%) were in open relationships (where sex with outside partners was permitted); and 52 (9.8%) were in monogamish relationships (where sex with outside partners was limited to instances where both primary partners were present). Regardless of urban (vs. non-urban) residence, men in monogamous relationships engaged in less anal sex generally and condomless anal sex (CAS) specifically with casual partners. Single men reported significantly more frequent anal sex with casual partners compared to open and monogamish men; however, there were no significant differences among these three groups with respect to CAS with casual partners. In multivariable models, monogamish men reported significantly more frequent marijuana use and alcohol consumption compared to all other groups. Urban (vs. non-urban) residence moderated associations between sexual arrangements and depression as well as the use of illicit drugs other than marijuana. These findings point to the need to better examine the potentially unique mechanisms which confer risk and resilience for gay male couples in urban versus non-urban settings. The observed association between sexual arrangements and substance use suggests interventions which facilitate the negotiation of sexual agreements may present an opportunity to engage in dyadic substance use intervention.

Keywords

Gay male relationships MSM Sexual agreements HIV Drug use Mental health Sexual orientation 

Notes

Acknowledgements

The One Thousand Strong study was funded by NIH/NIDA (R01 DA 036466: Jeffrey T. Parsons and Christian Grov, MPIs). We would like to acknowledge members of the One Thousand Strong Study Team (Dr. Ana Ventuneac, Demetria Cain, Mark Pawson, Ruben Jimenez, Chloe Mirzayi, Thomas Whitfield, Raymond Moody, and Brett Millar) and other staff from the Center for HIV/AIDS Educational Studies and Training (Andrew Cortopassi, Chris Hietikko, Doug Keeler, Carlos Ponton, and Brian Salfas). We would also like to thank the staff at Community Marketing and Insights, Inc. (David Paisley, Thomas Roth, and Heather Torch). Finally, special thanks are due to Dr. Jeffrey Schulden and Pamela Goodlow at NIDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Sources of Funding

See above.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

References

  1. Austin, E. W., & Bozick, R. (2011). Sexual orientation, partnership formation, and substance use in the transition to adulthood. Journal of Youth and Adolescence, 41(2), 167–178.  https://doi.org/10.1007/s10964-011-9653-7.CrossRefPubMedGoogle Scholar
  2. Cain, D. N., Mirzayi, C., Rendina, H. J., Ventuneac, A., Grov, C., & Parsons, J. T. (2017). Mediating effects of social support and internalized homonegativity on the association between population density and mental health among gay and bisexual men. LGBT Health, 4(5), 352–359.  https://doi.org/10.1089/lgbt.2017.0002.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Centers for Disease Control and Prevention. (2015). HIV surveillance report, 2015, 27. Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2015-vol-27.pdf.
  4. Crawford, J. M., Rodden, P., Kippax, S., & Van de Ven, P. (2001). Negotiated safety and other agreements between men in relationships: Risk practice redefined. International Journal of STD and AIDS, 12(3), 164–170.  https://doi.org/10.1258/0956462011916965.CrossRefPubMedGoogle Scholar
  5. Davidovich, U., de Wit, J. B. F., & Stroebe, W. (2000). Assessing sexual risk behaviour of young gay men in primary relationships: The incorporation of negotiated safety and negotiated safety compliance. AIDS, 14(6), 701–706.  https://doi.org/10.1097/00002030-200004140-00009.CrossRefPubMedGoogle Scholar
  6. Davidovich, U., de Wit, J. B. F., & Stroebe, W. (2006). Relationship characteristics and risk of HIV infection: Rusbult’s investment model and sexual risk behavior of gay men in steady relationships. Journal of Applied Social Psychology, 36(1), 22–40.  https://doi.org/10.1111/j.0021-9029.2006.00002.x.CrossRefGoogle Scholar
  7. Fals-Stewart, W., O’Farrell, T. J., & Birchler, G. R. (2004). Behavioral couples therapy for substance abuse: Rationale, methods, and findings. Science and Practice Perspectives, 2(2), 30–41.  https://doi.org/10.1151/spp042230.CrossRefPubMedGoogle Scholar
  8. Fals-Stewart, W., O’Farrell, T. J., & Lam, W. K. K. (2009). Behavioral couples therapy for gay and lesbian couples with alcohol use disorders. Journal of Substance Abuse Treatment, 37(4), 379–387.  https://doi.org/10.1016/j.jsat.2009.05.001.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Goldenberg, T., Finneran, C., Andes, K. L., & Stephenson, R. B. (2015). “Sometimes people let love conquer them:” How love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making. Culture, Health and Sexuality, 17(5), 607–622.  https://doi.org/10.1080/13691058.2014.979884.CrossRefPubMedGoogle Scholar
  10. Goodreau, S. M., Carnegie, N. B., Vittinghoff, E., Lama, J. R., Sanchez, J., Grinsztejn, B., … Buchbinder, S. P. (2012). What drives the U.S. and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS ONE, 7(11), e50522.  https://doi.org/10.1371/journal.pone.0050522.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Gottman, J. M., Levenson, R. W., Gross, J., Frederickson, B. L., McCoy, K., Rosenthal, L., … Yoshimoto, D. (2003). Correlates of gay and lesbian couples’ relationship satisfaction and relationship dissolution. Journal of Homosexuality, 45(1), 23–43.  https://doi.org/10.1300/J082v45n01_02.CrossRefPubMedGoogle Scholar
  12. Grov, C., Cain, D., Whitfield, T. H. F., Rendina, H. J., Pawson, M., Ventuneac, A., & Parsons, J. T. (2016). Recruiting a US national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: Challenges and opportunities. Sexuality Research and Social Policy, 13(1), 1–21.CrossRefGoogle Scholar
  13. Grov, C., Starks, T. J., Rendina, H. J., & Parsons, J. T. (2014). Rules about casual sex partners, relationship satisfaction, and HIV risk in partnered gay and bisexual men. Journal of Sex and Marital Therapy, 40(2), 105–122.  https://doi.org/10.1080/0092623X.2012.691948.CrossRefPubMedGoogle Scholar
  14. Hasin, D. S., Saha, T. D., Kerridge, B. T., Goldstein, R. B., Chou, S. P., Zhang, H., … Grant, B. F. (2015). Prevalence of marijuana use disorders in the United States between 2001–2002 and 2012–2013. JAMA Psychiatry, 72(12), 1235–1242.  https://doi.org/10.1001/jamapsychiatry.2015.1858.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Hoff, C. C., & Beougher, S. C. (2010). Sexual agreements among gay male couples. Archives of Sexual Behavior, 39(3), 774–787.  https://doi.org/10.1007/s10508-008-9393-2.CrossRefPubMedGoogle Scholar
  16. Hoff, C. C., Beougher, S. C., Chakravarty, D., Darbes, L. A., & Neilands, T. B. (2010). Relationship characteristics and motivations behind agreements among gay male couples: Differences by agreement type and couple serostatus. AIDS Care, 22(7), 827–835.  https://doi.org/10.1080/09540120903443384.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Hoff, C. C., Campbell, C. K., Chakravarty, D., & Darbes, L. A. (2016). Relationship-based predictors of sexual risk for HIV among msm couples: A systematic review of the literature. AIDS and Behavior, 20(12), 2873–2892.  https://doi.org/10.1007/s10461-016-1350-9.CrossRefPubMedGoogle Scholar
  18. Hoff, C. C., Chakravarty, D., Beougher, S. C., Darbes, L. A., Dadasovich, R., & Neilands, T. B. (2009). Serostatus differences and agreements about sex with outside partners among gay male couples. AIDS Education and Prevention, 21(1), 25–38.  https://doi.org/10.1521/aeap.2009.21.1.25.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Hoff, C. C., Chakravarty, D., Beougher, S. C., Neilands, T. B., & Darbes, L. A. (2012). Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient Care and STDs, 26(12), 738–745.  https://doi.org/10.1089/apc.2012.0198.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Hoff, C. C., Chakravarty, D., Bircher, A. E., Campbell, C. K., Grisham, K., Neilands, T. B., … Dworkin, S. (2015). Attitudes towards PrEP and anticipated condom use among concordant HIV-negative and HIV-discordant male couples. AIDS Patient Care and STDs, 29(7), 408–417.  https://doi.org/10.1089/apc.2014.0315.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Inaba, A., Thoits, P. A., Ueno, K., Gove, W. R., Evenson, R. J., & Sloan, M. (2005). Depression in the United States and Japan: Gender, marital status, and ses patterns. Social Science and Medicine, 61(11), 2280–2292.  https://doi.org/10.1016/j.socscimed.2005.07.014.CrossRefPubMedGoogle Scholar
  22. John, S. A., Starks, T. J., Rendina, H. J., Grov, C., & Parsons, J. T. (2017). Should I convince my partner to go on pre-exposure prophylaxis (PrEP)? The role of personal and relationship factors on PrEP-related social control among gay and bisexual men. AIDS and Behavior, 22(4), 1239–1252.  https://doi.org/10.1007/s10461-017-1835-1.CrossRefGoogle Scholar
  23. Kim, H. K., & McKenry, P. C. (2002). The relationship between marriage and psychological well-being: A longitudinal analysis. Journal of Family Issues, 23(8), 885–911.  https://doi.org/10.1177/019251302237296.CrossRefGoogle Scholar
  24. Kippax, S., Noble, J., Prestage, G., Crawford, J. M., Campbell, D., Baxter, D., & Cooper, D. (1997). Sexual negotiation in the AIDS era: Negotiated safety revisited. AIDS, 11(2), 191–197.  https://doi.org/10.1097/00002030-199702000-00009.CrossRefPubMedGoogle Scholar
  25. Kurdek, L. A. (2004). Are gay and lesbian cohabiting couples really different from heterosexual married couples? Journal of Marriage and Family, 66(4), 880–900.  https://doi.org/10.1111/j.0022-2445.2004.00060.x.CrossRefGoogle Scholar
  26. Lamb, K. A., Lee, G. R., & DeMaris, A. (2003). Union formation and depression: Selection and relationship effects. Journal of Marriage and Family, 65(4), 953–962.  https://doi.org/10.1111/j.1741-3737.2003.00953.x.CrossRefGoogle Scholar
  27. LaSala, M. C. (2004). Extradyadic sex and gay male couples: Comparing monogamous and nonmonogamous relationships. Families in Society: The Journal of Contemporary Social Services, 85(3), 405–412.  https://doi.org/10.1606/1044-3894.1502.CrossRefGoogle Scholar
  28. Lewis, M. A., Gladstone, E., Schmal, S., & Darbes, L. A. (2006). Health-related social control and relationship interdependence among gay couples. Health Education Research, 21(4), 488–500.  https://doi.org/10.1093/her/cyh075.CrossRefPubMedGoogle Scholar
  29. Millar, B. M., Starks, T. J., Grov, C., & Parsons, J. T. (2017). Sexual risk-taking in HIV-negative gay and bisexual men increases with depression: Results from a U.S. national study. AIDS and Behavior, 21(6), 1665–1675.  https://doi.org/10.1007/s10461-016-1507-6.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Mitchell, J. W. (2016). Differences in gay male couples’ use of drugs and alcohol with sex by relationship HIV status. American Journal of Men’s Health, 10(4), 262–269.  https://doi.org/10.1177/1557988314559243.CrossRefPubMedGoogle Scholar
  31. Mitchell, J. W., Boyd, C., McCabe, S., & Stephenson, R. B. (2014). A cause for concern: Male couples’ sexual agreements and their use of substances with sex. AIDS and Behavior, 18(7), 1401–1411.  https://doi.org/10.1007/s10461-014-0736-9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Mitchell, J. W., Harvey, S. M., Champeau, D., Moskowitz, D. A., & Seal, D. W. (2012). Relationship factors associated with gay male couples’ concordance on aspects of their sexual agreements: Establishment, type, and adherence. AIDS and Behavior, 16(6), 1560–1569.  https://doi.org/10.1007/s10461-011-0064-2.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Mitchell, J. W., Lee, J. Y., Woodyatt, C., Bauermeister, J., Sullivan, P. S., & Stephenson, R. B. (2016). Decisions about testing for HIV while in a relationship: Perspectives from an urban, convenience sample of HIV-negative male couples who have a sexual agreement. Archives of Sexual Behavior, 46(4), 1069–1077.  https://doi.org/10.1007/s10508-016-0807-2.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Mitchell, J. W., & Petroll, A. E. (2012). HIV testing rates and factors associated with recent HIV testing among male couples. Sexually Transmitted Diseases, 39(5), 379–381.  https://doi.org/10.1097/OLQ.0b013e3182479108.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Mitchell, J. W., & Petroll, A. E. (2013). Factors associated with men in HIV-negative gay couples who practiced UAI within and outside of their relationship. AIDS and Behavior, 17(4), 1329–1337.  https://doi.org/10.1007/s10461-012-0255-5.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Neilands, T. B., Chakravarty, D., Darbes, L. A., Beougher, S. C., & Hoff, C. C. (2009). Development and validation of the Sexual Agreement Investment scale. Journal of Sex Research, 47(1), 24–37.  https://doi.org/10.1080/00224490902916017.CrossRefGoogle Scholar
  37. Parsons, J. T., Grov, C., & Golub, S. A. (2012a). Sexual compulsivity, co-occurring psychological health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic. American Journal of Public Health, 102(1), 156–162.  https://doi.org/10.2105/AJPH.2011.300284.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Parsons, J. T., Millar, B. M., Moody, R. L., Starks, T. J., Rendina, H. J., & Grov, C. (2017). Syndemic conditions and HIV transmission risk behavior among HIV-negative gay and bisexual men in a U.S. national sample. Health Psychology, 36(7), 695–703.  https://doi.org/10.1037/hea0000509.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Parsons, J. T., & Starks, T. J. (2014). Drug use and sexual arrangements among gay couples: Frequency, interdependence, and associations with sexual risk. Archives of Sexual Behavior, 43(1), 89–98.  https://doi.org/10.1007/s10508-013-0237-3.CrossRefPubMedGoogle Scholar
  40. Parsons, J. T., Starks, T. J., Dubois, S., Grov, C., & Golub, S. A. (2013). Alternatives to monogamy among gay male couples in a community survey: Implications for mental health and sexual risk. Archives of Sexual Behavior, 42(2), 303–312.  https://doi.org/10.1007/s10508-011-9885-3.CrossRefPubMedGoogle Scholar
  41. Parsons, J. T., Starks, T. J., Gamarel, K. E., & Grov, C. (2012b). (Non)monogamy and sexual relationship quality among same-sex male couples. Journal of Family Psychology, 26(5), 669–677.  https://doi.org/10.1037/a0029561.CrossRefPubMedGoogle Scholar
  42. Puckett, J. A., Horne, S. G., Herbitter, C., Maroney, M. R., & Levitt, H. M. (2017). Differences across contexts: Minority stress and interpersonal relationships for lesbian, gay, and bisexual women. Psychology of Women Quarterly, 41(1), 8–19.  https://doi.org/10.1177/0361684316655964.CrossRefGoogle Scholar
  43. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.  https://doi.org/10.1177/014662167700100306.CrossRefGoogle Scholar
  44. Rusbult, C. E., & Van Lange, P. A. (2003). Interdependence, interaction, and relationships. Annual Review of Psychology, 54(1), 351–375.  https://doi.org/10.1146/annurev.psych.54.101601.145059.CrossRefPubMedGoogle Scholar
  45. Simon, R. W. (2002). Revisiting the relationships among gender, marital status, and mental health. American Journal of Sociology, 107(4), 1065–1096.  https://doi.org/10.1086/339225.CrossRefGoogle Scholar
  46. St John, P. D., & Montgomery, P. R. (2009). Marital status, partner satisfaction, and depressive symptoms in older men and women. Canadian Journal of Psychiatry, 54(7), 487–492.  https://doi.org/10.1177/070674370905400710.CrossRefPubMedGoogle Scholar
  47. Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., … Catania, J. A. (2003). Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. American Journal of Public Health, 93(6), 939–942.  https://doi.org/10.2105/AJPH.93.6.939.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Starks, T. J., Doyle, K. M., Millar, B. M., & Parsons, J. T. (2017). Eriksonian intimacy development, relationship satisfaction, and depression in gay male couples. Psychology of Sexual Orientation and Gender Diversity, 4(2), 241–250.  https://doi.org/10.1037/sgd0000225.CrossRefPubMedPubMedCentralGoogle Scholar
  49. Starks, T. J., Gamarel, K. E., & Johnson, M. O. (2014). Relationship characteristics and HIV transmission risk in same-sex male couples in HIV sero-discordant relationships. Archives of Sexual Behavior, 43(1), 139–147.  https://doi.org/10.1007/s10508-013-0216-8.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Starks, T. J., Tuck, A. N., Millar, B. M., & Parsons, J. T. (2016). Linking syndemic stress and behavioral indicators of main partner HIV transmission risk in gay male couples. AIDS and Behavior, 20(2), 439–448.  https://doi.org/10.1007/s10461-015-1248-y.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Stephenson, R. B., Sullivan, P. S., Salazar, L. F., Gratzer, B., Allen, S., & Seelbach, E. (2011). Attitudes towards couples-based HIV testing among msm in three US cities. AIDS and Behavior, 15(Supplement 1), 80–87.  https://doi.org/10.1007/s10461-011-9893-2.CrossRefGoogle Scholar
  52. Stephenson, R. B., White, D., Darbes, L., Hoff, C. C., & Sullivan, P. S. (2015a). HIV testing behaviors and perceptions of risk of HIV infection among msm with main partners. AIDS and Behavior, 19(3), 553–560.  https://doi.org/10.1007/s10461-014-0862-4.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Stephenson, R. B., White, D., & Mitchell, J. W. (2015b). Sexual agreements and perception of HIV prevalence among an online sample of partnered men who have sex with men. Archives of Sexual Behavior, 44(7), 1813–1819.  https://doi.org/10.1007/s10508-015-0532-2.CrossRefPubMedGoogle Scholar
  54. Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23(9), 1153–1162.  https://doi.org/10.1097/QAD.0b013e32832baa34.CrossRefPubMedGoogle Scholar
  55. Sullivan, P. S., White, D., Rosenberg, E. S., Barnes, J., Jones, J. L., Dasgupta, S., … Stephenson, R. B. (2014). Safety and acceptability of couples HIV testing and counseling for US men who have sex with men: A randomized prevention study. Journal of the International Association of Providers of AIDS Care, 13(2), 135–144.  https://doi.org/10.1177/2325957413500534.CrossRefPubMedGoogle Scholar
  56. Swank, E., Frost, D. M., & Fahs, B. (2012). Rural location and exposure to minority stress among sexual minorities in the United States. Psychology and Sexuality, 3(3), 226–243.  https://doi.org/10.1080/19419899.2012.700026.CrossRefGoogle Scholar
  57. Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219–2227.  https://doi.org/10.1056/NEJMra1402309.CrossRefPubMedGoogle Scholar
  58. Whitton, S. W., & Kuryluk, A. D. (2014). Associations between relationship quality and depressive symptoms in same-sex couples. Journal of Family Psychology, 28(4), 571–576.  https://doi.org/10.1037/fam0000011.CrossRefPubMedGoogle Scholar
  59. Yan, X. Y., Huang, S. M., Huang, C.-Q., Wu, W.-H., & Qin, Y. (2011). Marital status and risk for late life depression: A meta-analysis of the published literature. Journal of International Medical Research, 39(4), 1142–1154.  https://doi.org/10.1177/147323001103900402.CrossRefPubMedGoogle Scholar
  60. Yovetich, N. A., & Rusbult, C. E. (1994). Accommodative behavior in close relationships: Exploring transformation of motivation. Journal of Experimental Social Psychology, 30(2), 138–164.  https://doi.org/10.1006/jesp.1994.1007.CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Tyrel J. Starks
    • 1
    • 2
    • 3
  • Gabriel Robles
    • 2
  • Stephen C. Bosco
    • 2
    • 3
  • Trey V. Dellucci
    • 2
    • 3
  • Christian Grov
    • 4
  • Jeffrey T. Parsons
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of PsychologyHunter College of the City University of New YorkNew YorkUSA
  2. 2.Center for HIV/AIDS Educational Studies and TrainingNew YorkUSA
  3. 3.Doctoral Program in Health Psychology and Clinical ScienceThe Graduate Center of CUNYNew YorkUSA
  4. 4.Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health PolicyCUNY Institute for Implementation Science in Population HealthNew YorkUSA

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