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Dyadic Moderators of the Minority Stress-HIV Risk Association in Male Couples

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Abstract

Minority stressors have been linked to HIV risk behaviors among gay, bisexual, queer, and other men who have sex with men (MSM). Committed partnerships are a key context for new HIV infections and coping with minority stress among MSM, but very little work has tested the minority stress-HIV risk link among male couples, and little is known about how processes within one’s relationship may exacerbate or buffer this association. The present study examined links between minority stress (i.e., internalized stigma, microaggressions) and HIV transmission risk behaviors (i.e., condomless anal sex with outside partners, breaks in relationship agreements) among male couples, as well as relationship-based moderators (i.e., social support, dyadic coping) of these associations. An analytic sample of male couples from a large cohort study (analytic N = 410 individuals, 205 dyads) completed self-report measures of minority stress, relationship-based moderators, and HIV transmission risk behaviors which were submitted to moderated actor-partner interdependence models (APIMs). In many cases, coping with stress with one’s partner buffered the minority stress-HIV transmission link risk. However, findings also suggested situations in which partners may overburden one another with coping, thus exacerbating HIV-related risk behaviors.

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Notes

  1. Because these values were heavily skewed, CAS was winsorized for analysis at the 90th percentile, equivalent to 23 CAS acts.

  2. This is a relatively common practice for coding low base rate events thought to be subject to reporting bias.

  3. Figures can be found in supplemental materials.

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Funding

This work was supported by the National Institute on Drug Abuse under Grant (U01DA036939; PI: Mustanski). Madison Shea Smith’s time was supported by a grant from the National Institute on Drug Abuse (F32DA057128; PI: Smith). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Authors and Affiliations

  1. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA

    Madison Shea Smith, Elissa L. Sarno, Cole Price, Afiya Sajwani, Brian Mustanski & Michael E. Newcomb

  2. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Madison Shea Smith & Elissa L. Sarno

  3. Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Afiya Sajwani

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Contributions

All authors contributed to the study conception and design. Material preparation, project administration, supervision, and data collection were performed by B.M., M.E.N., and M.S.S. Analyses, validation, and data visualizations were completed by M.S.S. The first draft of the manuscript was written by M.S.S., C.P., and A.S., and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Brian Mustanski.

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Approval was obtained from the ethics committee of Northwestern University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. The authors have no relevant financial or non-financial interests to disclose.

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Smith, M.S., Sarno, E.L., Price, C. et al. Dyadic Moderators of the Minority Stress-HIV Risk Association in Male Couples. AIDS Behav (2024). https://doi.org/10.1007/s10461-024-04303-4

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