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


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.


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



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.


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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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