There is growing evidence that sexual behaviors among male couples are strongly shaped by emotional and quality characteristics of the relationship, and that the labels that men attach to their relationships may indicate how men perceive and engage in risk taking. There has been a lack of attention to how male couples label their relationships, and how discordant understandings of relationship labels may shape HIV risk behavior. Using data from a sample of 804 partnered men who have sex with men, this analysis examines associations between discordant relationship labeling and participation in HIV testing and sexual behavior. Men who labeled their relationship differently from their partners were less likely to have been recently tested for HIV and more likely to engage in sexual risk. The results underscore the need to develop interventions that provide spaces and skills for men to learn how to effectively navigate HIV risks in their relationships.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Goodreau SM, Carnegie NB, Vittinghoff E, Lama JR, Sanchez J, Grinsztejn B, Koblin BA, Mayer KH, Buchbinder SP. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS ONE. 2012. https://doi.org/10.1371/journal.pone.0050522.
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. https://doi.org/10.1097/QAD.0b013e32832baa34.
Kelly JA, St Lawrence JS, Diaz YE, Stevenson LY, Hauth AC, Brasfield TL, Kalichman SC, Smith JE, Andrew ME. HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. Am J Public Health. 1991;81(2):168–71.
Goldenberg T, Clarke D, Stephenson R. Working together to reach a goal: MSM’s perceptions of dyadic HIV care for same-sex male couples. J Acquir Immune Defic Syndr. 2013. https://doi.org/10.1097/QAI.0b013e3182a9014a.
Pruitt KL, White D, Mitchell JW, Stephenson R. Sexual agreements and intimate-partner violence among male couples. Int J Sex Health. 2015. https://doi.org/10.1080/19317611.2015.1037037.
Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010. https://doi.org/10.1007/s10508-008-9393-2.
Chakravarty D, Hoff CC, Neilands TB, Darbes LA. Rates of testing for HIV in the presence of serodiscordant UAI among HIV-negative gay men in committed relationships. AIDS Behav. 2012. https://doi.org/10.1007/s10461-012-0181-6.
Stephenson R, White D, Darbes L, Hoff C, Sullivan P. HIV testing behaviors and perceptions of risk of HIV infection among MSM with main partners. AIDS Behav. 2015. https://doi.org/10.1007/s10461-014-0862-4.
Mitchell JW. Characteristics and allowed behaviors of gay male couples sexual agreements. J Sex Res. 2014. https://doi.org/10.1080/00224499.2012.727915.
Gass K, Hoff CC, Stephenson R, Sullivan PS. Sexual agreements in the partnerships of internet-using men who have sex with men. AIDS Care. 2012. https://doi.org/10.1080/09540121.2012.656571.
Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: differences by agreement type and couple serostatus. AIDS Care. 2010. https://doi.org/10.1080/09540120903443384.
Mitchell JW, Petroll AE. Patterns of HIV and sexually transmitted infection testing among men who have sex with men couples in the United States. Sex Transm Dis. 2012. https://doi.org/10.1097/OLQ.0b013e3182649135.
Mitchell JW. Aspects of gay male couples’ sexual agreements vary by their relationship length. AIDS Care. 2014. https://doi.org/10.1080/09540121.2014.882491.
Mitchell JW, Harvey SM, Champeau D, Moskowitz DA, Seal DW. Relationship factors associated with gay male couples’ concordance on aspects of their sexual agreements: establishment, type, and adherence. AIDS Behav. 2012. https://doi.org/10.1007/s10461-011-0064-2.
Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. Perceived challenges and rewards of forming a sexual agreement among HIV-negative male couples. Arch Sex Behav. 2016. https://doi.org/10.1007/s10508-016-0701-y.
Bingham TA, Harawa NT, Johnson DF, Secura GM, MacKellar DA, Valleroy LA. The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men’s Survey, Los Angeles, 1999–2000. AIDS Educ Prev. 2003. https://doi.org/10.1521/aeap.188.8.131.52.23613.
Davidovich U, De Wit JBF, Stroebe W. Behavioral and cognitive barriers to safer sex between men in steady relationships: implications for prevention strategies. AIDS Educ Prev. 2004. https://doi.org/10.1521/aeap.16.4.304.40398.
Grov C, Starks TJ, Rendina HJ, Parsons J. Rules about casual sex partners, relationship satisfaction, and HIV risk in partnered gay and bisexual men. J Sex Marital Ther. 2014. https://doi.org/10.1080/0092623X.2012.691948.
Hart G, Dawson J, McKechnie R, Lakhani D. Regular partners and risky behaviour: why do gay men have unprotected intercourse? AIDS Care. 1994. https://doi.org/10.1080/09540129408258645.
Mustanski B, Newcomb ME, Clerkin EM. Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychol. 2011. https://doi.org/10.1037/a0023858.
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. https://doi.org/10.1007/s10508-013-0207-9.
Vroome EMM, Stroebe W, Sandfort TGM, WIT JB, Griensven GJP. Safer sex in social context: individualistic and relational determinants of AIDS-preventive behavior among gay men. J Appl Soc Psychol. 2006. https://doi.org/10.1111/j.1559-1816.2000.tb02439.x.
Blais M. Vulnerability to HIV among regular male partners and the social coding of intimacy in modern societies. Cult Health Sex. 2006. https://doi.org/10.1080/13691050500391232.
Davidovich U, De Wit J, Stroebe W. Relationship characteristics and risk of HIV infection: Rusbult’s investment model and sexual risk behavior of gay men in steady relationships. J Appl Soc Psychol. 2006. https://doi.org/10.1111/j.0021-9029.2006.00002.x.
Berg RC. Barebacking: a review of the literature. Arch Sex Behav. 2009. https://doi.org/10.1007/s10508-008-9462-6.
Carballo-Diéguez A, Ventuneac A, Dowsett GW, Balan I, Bauermeister J, Remien RH, Dolezal C, Giguere R, Mabragaña M. Sexual pleasure and intimacy among men who engage in “Bareback Sex”. AIDS Behav. 2011. https://doi.org/10.1007/s10461-011-9900-7.
Golub SA, Starks TJ, Payton G, Parsons JT. The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS Behav. 2012. https://doi.org/10.1007/s10461-011-9972-4.
Starks TJ, Gamarel KE, Johnson MO. Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships. Arch Sex Behav. 2014. https://doi.org/10.1007/s10508-013-0216-8.
Goldenberg T, Finneran C, Andes KL, Stephenson R. ‘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. Cult Health Sex. 2015. https://doi.org/10.1080/13691058.2014.979884.
Mitchell JW, Harvey SM, Champeau D, Seal DW. Relationship factors associated with HIV risk among a sample of gay male couples. AIDS Behav. 2012. https://doi.org/10.1007/s10461-011-9976-0.
Gomez AM, Beougher SC, Chakravarty D, Neilands TB, Mandic CG, Darbes LA, Hoff CC. Relationship dynamics as predictors of broken agreements about outside sexual partners: implications for HIV prevention among gay couples. AIDS Behav. 2012. https://doi.org/10.1007/s10461-011-0074-0.
Bavinton BR, Duncan D, Grierson J, Zablotska IB, Down IA, Grulich AE, Prestage GP. The meaning of ‘regular partner’ in HIV research among gay and bisexual men: implications of an Australian cross-sectional survey. AIDS Behav. 2016. https://doi.org/10.1007/s10461-016-1354-5.
Bauermeister JA. Sexual partner typologies among single young men who have sex with men. AIDS Behav. 2015. https://doi.org/10.1007/s10461-014-0932-7.
Holt M, Lee E, Prestage GP, Zablotska I, De Wit J, Mao L. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian gay community periodic surveys, 2000–2009. AIDS Care. 2013. https://doi.org/10.1080/09540121.2012.686598.
Sullivan SP, Pingel ES, Stephenson R, Bauermeister JA. “It was supposed to be a onetime thing”: experiences of romantic and sexual relationship typologies among young gay, bisexual, and other men who have sex with men. Arch Sex Behav. 2018. https://doi.org/10.1007/s10508-017-1058-6.
Goldenberg T, Finneran C, Sullivan SP, Andes KL, Stephenson R. “I consider being gay a very high risk factor”: how perceptions of a partner’s sexual identity influence perceptions of HIV risk among gay and bisexual men. Sex Res Soc Policy. 2017. https://doi.org/10.1007/s13178-016-0235-z.
Stephenson R, Freeland R, Sullivan SP, et al. Home-based HIV testing and counseling for male couples (Project Nexus): a protocol for a randomized controlled trial. JMIR Res Protoc. 2017;6(5):e101.
Larzelere RE, Huston TL. The dyadic trust scale: toward understanding interpersonal trust in close relationships. J Marriage Fam. 1980. https://doi.org/10.2307/351903.
Gabbay N, Lafontaine M-F, Bourque L. Factor structure and reliability assessment of the Dyadic Trust Scale with individuals in same-sex romantic relationships. J GLBT Fam Stud. 2012;8(3):258–69.
Salazar LF, Stephenson RB, Sullivan PS, Tarver R. Development and validation of HIV-related dyadic measures for men who have sex with men. J Sex Res. 2013;50(2):164–77.
Futris T, Campbell K, Nielsen RB, Burwell SR. The communication patterns questionnaire-short form: a review and assessment. Fam J. 2010;18:275–87. https://doi.org/10.1177/1066480710370758.
Mitchell JW. HIV-negative and HIV-discordant gay male couples’ use of HIV risk-reduction strategies: differences by partner type and couples’ HIV-status. AIDS Behav. 2013. https://doi.org/10.1007/s10461-012-0388-6.
Darbes L, Chakravarty D, Neilands T, Beougher S, Hoff C. Sexual risk for HIV among gay male couples: a longitudinal study of the impact of relationship dynamics. Arch Sex Behav. 2014;43(1):47–60.
Chomba E, Allen S, Kanweka W, Tichacek A, Cox G, Shutes E, Zulu I, Kancheya N, Sinkala M, Stephenson R, Haworth A, the Rwanda Zambia HIV Research Group. Evolution of couples’ voluntary counseling and testing for HIV in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2007;47(1):108–15.
Sullivan PS, Stephenson R, Grazter B, et al. Adaptation of the African couples HIV testing and counseling model for men who have sex with men in the United States: an application of the ADAPT-ITT framework. Springerplus. 2014. https://doi.org/10.1186/2193-1801-3-249.
Stephenson R, Grabbe KL, Sidibe T, et al. Technical assistance needs for successful implementation of couples HIV testing and counseling (CHTC) intervention for male couples at US HIV testing sites. AIDS Behav. 2016. https://doi.org/10.1007/s10461-015-1150-7.
Wu E, El-Bassel N, McVinney LD, et al. Feasibility and promise of a couple-based HIV/STI preventive intervention for methamphetamine-using, black men who have sex with men. AIDS Behav. 2011. https://doi.org/10.1007/s10461-011-9997-8.
Newcomb ME, Macapagal KR, Feinstein BA, et al. Integrating HIV prevention and relationship education for young same-sex male couples: a pilot trial of the 2GETHER intervention. AIDS Behav. 2017. https://doi.org/10.1007/s10461-017-1674-0.
Gamarel KE, Darbes LA, Hightow-Weidman L, et al. The development and testing of a relationship skills intervention to improve HIV prevention uptake among young gay, bisexual, and other men who have sex with men and their primary partners (we prevent): protocol for a randomized controlled trial. J Med Internet Res. 2019. https://doi.org/10.2196/10370.
Rob Stephenson was supported by National Institutes of Health under Grant No. R01HD078131.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Stephenson, R., Sullivan, S., Sharma, A. et al. Discordant Reporting of Partner Labels, HIV Testing and Sexual Behavior Among a Sample of Partnered Men Who have Sex with Men in the US. AIDS Behav 24, 540–550 (2020). https://doi.org/10.1007/s10461-019-02725-z
- HIV testing