Prevention Science

, Volume 20, Issue 1, pp 157–167 | Cite as

An Examination of Gay Couples’ Motivations to Use (or Forego) Pre-exposure Prophylaxis Expressed During Couples HIV Testing and Counseling (CHTC) Sessions

  • Tyrel J. StarksEmail author
  • Kendell M. Doyle
  • Ore Shalhav
  • Steven A. John
  • Jeffrey T. Parsons


While many gay couples perceive themselves to have little risk for HIV transmission, research estimates that 35–68% of new HIV infections are transmitted within main partnerships. Pre-exposure prophylaxis (PrEP) is recommended for those partnered gay and bisexual men (GBM) who engage in sex outside their primary relationship or who have an HIV-positive partner. There is reason to believe that couples’ sero-status and sexual agreement will shape perceptions of PrEP’s personal relevance among gay couples. The current study examined motivations for and ambivalence towards PrEP uptake reported in a sample of 67 gay couples during completion of a brief CDC-recommended prevention intervention: Couples HIV Testing and Counseling. Findings suggest that all types of couples identified some circumstances in which they would consider PrEP; however, PrEP messaging should be crafted to avoid undermining current prevention strategies or threatening the trust and legitimacy of the relationship.


Pre-exposure prophylaxis Men who have sex with men Same-sex couples HIV-prevention Sexual agreement Sero-status 



The authors acknowledge the contributions of the We Test Project Team, particularly Patrick Sullivan, Robert Stephenson, Mark Pawson, Andrew Cortopassi, Ruben Jimenez, Chris Hietikko, Chloe Mirzayi and Scott Jones. We also thank Rich Jenkins for his support of the project as well as CHEST staff, recruiters, interns, and our participants who volunteered their time.


The We Test study was funded by a grant from the National Institute on Drug Abuse (R34 DA036419; PI Starks). Data analysis was supported by a grant from the National Institute on Drug Abuse (R34 DA043422; PI Starks).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

All procedures were reviewed and approved by the IRB of Hunter College, CUNY.

Informed Consent

All participants were provided written consent information. The consent form was reviewed, and written documentation of consent was obtained individually, and privately, from each member of the couple.


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Copyright information

© Society for Prevention Research 2018

Authors and Affiliations

  • Tyrel J. Starks
    • 1
    • 2
    • 3
    Email author
  • Kendell M. Doyle
    • 1
  • Ore Shalhav
    • 1
  • Steven A. John
    • 1
  • Jeffrey T. Parsons
    • 1
    • 2
    • 3
  1. 1.Center for HIV/AIDS Educational Studies and Training (CHEST)New YorkUSA
  2. 2.Department of PsychologyHunter College of the City University of New York (CUNY)New YorkUSA
  3. 3.Doctoral Program in Health Psychology and Clinical ScienceThe Graduate Center of CUNYNew YorkUSA

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