Abstract
Sexual agreements (SAs)—guidelines that outline what type of sexual behaviors are permissible with sexual partners outside of their primary relationship—are often negotiated within same-sex male relationships to reduce their risk for HIV infection. However, HIV risk is not only a function of sexual behavior, but is also affected by factors such as antiretroviral therapy (ART) adherence. We examined whether HIV-positive partners in serodiscordant male couples who have better communication about SAs and report concordant SAs with their partners have greater odds of being adherent to ART to not only improve their health, but to also reduce the risk of transmitting HIV to partners. We analyzed longitudinal data from 135 HIV-positive partners in serodiscordant male couples recruited from Atlanta, GA, Boston, MA, and Chicago, IL to examine the relationship between optimal ART adherence and two independent variables: communication about SAs and if the couples have discrepant SAs. HIV-positive male partners who reported high levels of communication regarding SAs had nearly three times the odds of optimal adherence to ART compared to those who reported lower levels. The HIV-positive partners with discrepant SAs with their male partner had approximately half the odds of optimal adherence to ART compared to those with concordant SAs. Our findings suggest that integrating communication skills training into dyad-level HIV interventions to improve communication regarding HIV may provide more opportunities for couples to discuss ways of reducing the risk of HIV transmission. Couples may benefit from interventions that assist them in composing SAs.
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Funding
H. Jin was supported by the U.S. NIH, NIAID, T32 Training Program in HIV Epidemiology and Prevention Science at the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (5T32AI102623-08). Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD075655 (MPIs: Drs. Garofalo, Mimiaga, and Stephenson). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Jin, H., Biello, K., Garofalo, R. et al. Better Communication Regarding Sexual Agreements Within Serodiscordant Male Couples Leads to Improved Antiretroviral Therapy Adherence Among the HIV-Positive Partner. Arch Sex Behav 50, 1771–1779 (2021). https://doi.org/10.1007/s10508-021-01954-5
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DOI: https://doi.org/10.1007/s10508-021-01954-5