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Relationship Characteristics and HIV Transmission Risk in Same-Sex Male Couples in HIV Serodiscordant Relationships

  • Special Section: Sexual Health in Gay and Bisexual Male Couples
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Abstract

Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI within serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (n couples = 91; n individuals = 182) simultaneously but independently completed computerized questionnaires and HIV-positive men had blood drawn for viral load. A minority of couples (30 %) engaged in risk taking and/or strategic positioning unprotected anal sex. Results of multinomial logistic regression indicated that HIV-negative partners’ levels of relationship commitment were positively associated with the odds of engaging in strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partners’ reported sexual satisfaction was positively associated with odds of engaging in risk taking behavior. Findings suggested that aspects of relational quality may be differentially associated with sexual decision making for same-sex male couples in serodiscordant relationships. Study findings lend support for the incorporation of discussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care.

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Acknowledgments

This project was funded by Grant R01NR010187 from the National Institute of Nursing Research and K24MH087220 of the National Institute of Mental Health of the National Institutes of Health. We gratefully thank the men who participated in the study and the tireless efforts of research staff Jonelle Taylor, Samantha Dilworth, Gabriel Ortiz, Troy Wood, and Gilda Mendez.

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Authors and Affiliations

  1. Department of Psychology, Pace University, 41 Park Row, New York, NY, 10038, USA

    Tyrel J. Starks

  2. Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA

    Tyrel J. Starks

  3. Department of Basic and Applied Social Psychology, The Graduate Center of the City University of New York, New York, NY, USA

    Kristi E. Gamarel

  4. Department of Medicine, University of California, San Francisco, CA, USA

    Mallory O. Johnson

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  1. Tyrel J. Starks
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  2. Kristi E. Gamarel
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Correspondence to Tyrel J. Starks.

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Starks, T.J., Gamarel, K.E. & Johnson, M.O. Relationship Characteristics and HIV Transmission Risk in Same-Sex Male Couples in HIV Serodiscordant Relationships. Arch Sex Behav 43, 139–147 (2014). https://doi.org/10.1007/s10508-013-0216-8

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