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Urban African-American Men Speak Out on Sexual Partner Concurrency: Findings from a Qualitative Study

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Abstract

Sexual partner concurrency, which fuels the spread of HIV, has been hypothesized as a cause of higher rates of HIV among low-income, urban African-Americans. Despite this hypothesis, little is known about the phenomenology of partner concurrency. To address this gap in the literature, we recruited 20 urban African-American men from a public STD clinic to elicit their ideas about partner concurrency. Five themes emerged during focus group discussions. First, there was a general consensus that it is normative to have more than one sexual partner. Second, men agreed it is acceptable for men to have concurrent partners, but disagreed about whether it is acceptable for women. Third, although men provided many reasons for concurrent partnerships, the most common reasons were that (a) multiple partners fulfill different needs, and (b) it is in a man’s nature to have multiple partners. Fourth, men described some (but not all) of the negative consequences of having concurrent partners. Finally, men articulated spoken and unspoken rules that govern concurrent partnerships. These findings increase knowledge about urban, African-American men’s attitudes toward concurrent partnerships, and can help to improve the efficacy of sexual risk-reduction interventions for this group of underserved men and their partners.

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References

  • Adimora, A. A., & Schoenbach, V. J. (2002). Contextual factors and the Black-White disparity in heterosexual HIV transmission. Epidemiology, 13, 707–712. doi:10.1097/00001648-200211000-00016.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., & Schoenbach, V. J. (2005). Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. Journal of Infectious Diseases, 191, S115–S122. doi:10.1086/425280.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., Bonas, D. M., Martinson, F. E. A., Donaldson, K. H., & Stancil, T. R. (2002). Concurrent sexual partnerships among women in the United States. Epidemiology, 13, 320–327. doi:10.1097/00001648-200205000-00013.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., & Doherty, I. A. (2007). Concurrent sexual partnerships among men in the United States. American Journal of Public Health, 97, 2230–2237. doi:10.2105/AJPH.2006.099069.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., Martinson, F. E. A., Coyne-Beasley, T., Doherty, I., Stancil, T. R., et al. (2006). Heterosexually transmitted HIV infection among African Americans in North Carolina. Journal of Acquired Immune Deficiency Syndromes, 41, 616–623. doi:10.1097/01.qai.0000191382.62070.a5.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., Martinson, F. E. A., Donaldson, K. H., Stancil, T. R., & Fullilove, R. E. (2003). Concurrent partnerships among rural African Americans with recently reported heterosexually transmitted HIV infection. Journal of Acquired Immune Deficiency Syndromes, 34, 423–429. doi:10.1097/00126334-200312010-00010.

    Article  PubMed  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., Martinson, F., Donaldson, K. H., Stancil, T. R., & Fullilove, R. E. (2004). Concurrent sexual partnerships among African Americans in the rural South. Annals of Epidemiology, 14, 155–160. doi:10.1016/S1047-2797(03)00129-7.

    Article  PubMed  Google Scholar 

  • Buss, D. M., & Schmitt, D. P. (1993). Sexual strategies theory: An evolutionary perspective on human mating. Psychological Review, 100, 204–232. doi:10.1037/0033-295X.100.2.204.

    Article  CAS  PubMed  Google Scholar 

  • Carey, M. P., Vanable, P. A., Senn, T. E., Coury-Doniger, P., & Urban, M. (in press). Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: Rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R). Contemporary Clinical Trials.

  • Crawford, M., & Popp, D. (2003). Sexual double standards: A review and methodological critique of two decades of research. Journal of Sex Research, 40, 13–26.

    Article  PubMed  Google Scholar 

  • Davidovich, U., de Wit, J. B. F., & Stroebe, W. (2000). Assessing sexual risk behaviour of young gay men in primary relationships: The incorporation of negotiated safety and negotiated safety compliance. AIDS, 14, 701–706. doi:10.1097/00002030-200004140-00009.

    Article  CAS  PubMed  Google Scholar 

  • Doherty, I. A., Shiboski, S., Ellen, J. M., Adimora, A. A., & Padian, N. S. (2006). Sexual bridging socially and over time: A simulation model exploring the relative effects of mixing and concurrency on viral sexually transmitted infection transmission. Sexually Transmitted Diseases, 33, 368–373. doi:10.1097/01.olq.0000194586.66409.7a.

    Article  PubMed  Google Scholar 

  • Drumright, L. N., Gorbach, P. M., & Holmes, K. K. (2004). Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sexually Transmitted Diseases, 31, 437–442. doi:10.1097/01.OLQ.0000129949.30114.37.

    Article  PubMed  Google Scholar 

  • Ellen, J. M., Aral, S. O., & Madger, L. S. (1998). Do differences in sexual behaviors account for the racial/ethnic differences in adolescents’ self-reported history of a sexually transmitted disease? Sexually Transmitted Diseases, 25, 125–129. doi:10.1097/00007435-199803000-00002.

    Article  CAS  PubMed  Google Scholar 

  • Epstein, H. (2007). The invisible cure: Africa, the West, and the fight against AIDS. New York: Farrar, Straus, & Giroux.

    Google Scholar 

  • Fenton, K. A., Korovessis, C., Johnson, A. M., McCadden, A., McManus, S., Wellings, K., et al. (2001). Sexual behaviour in Britain: Reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet, 358, 1851–1854. doi:10.1016/S0140-6736(01)06886-6.

    Article  CAS  PubMed  Google Scholar 

  • Floyd, F. J., & Wasner, G. H. (1994). Social exchange, equity, and commitment: Structural equation modeling of dating relationships. Journal of Family Psychology, 8, 55–73. doi:10.1037/0893-3200.8.1.55.

    Article  Google Scholar 

  • Ford, K., Sohn, W., & Lepkowski, J. (2002). American adolescents: Sexual mixing patterns, bridge partners, and concurrency. Sexually Transmitted Diseases, 29, 13–19. doi:10.1097/00007435-200201000-00003.

    Article  PubMed  Google Scholar 

  • Ghani, A., Swinton, J., & Garnett, G. P. (1997). The role of sexual partnership networks in the epidemiology of gonorrhea. Sexually Transmitted Diseases, 24, 45–56. doi:10.1097/00007435-199701000-00009.

    Article  CAS  PubMed  Google Scholar 

  • Gilbart, V. L., Williams, D. I., Macdonald, N. D., Rogers, P. A., Evans, B. G., Hart, G., et al. (2000). Social and behavioural factors associated with HIV seroconversion in homosexual men attending a central London STD clinic: A feasibility study. AIDS Care, 12, 49–58. doi:10.1080/09540120047468.

    Article  CAS  PubMed  Google Scholar 

  • Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.

    Google Scholar 

  • Gorbach, P. M., Drumright, L. N., & Holmes, K. K. (2005). Discord, discordance, and concurrency: Comparing individual and partnership-level analyses of new partnerships of young adults at risk of sexually transmitted infections. Sexually Transmitted Diseases, 32, 7–12. doi:10.1097/01.olq.0000148302.81575.fc.

    Article  PubMed  Google Scholar 

  • Gorbach, P. M., Stoner, B. P., Aral, S. O., Whittington, W. L. H., & Holmes, K. K. (2002). “It takes a village”: Understanding concurrent sexual partnerships in Seattle, Washington. Sexually Transmitted Diseases, 29, 453–462. doi:10.1097/00007435-200208000-00004.

    Article  PubMed  Google Scholar 

  • Guzman, R., Colfax, G. N., Wheeler, S., Mansergh, G., Marks, G., Rader, M., et al. (2004). Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men. Journal of Acquired Immune Deficiency Syndromes, 38, 82–86. doi:10.1097/00126334-200501010-00015.

    Google Scholar 

  • Hallfors, D. D., Iritani, B. J., Miller, W. C., & Bauer, D. J. (2007). Sexual and drug behavior patterns and HIV and STD racial disparities: The need for new directions. American Journal of Public Health, 97, 125–132. doi:10.2105/AJPH.2005.075747.

    Article  PubMed  Google Scholar 

  • Harawa, N. T., Greenland, S., Bingham, T. A., Johnson, D. F., Cochran, S. D., Cunningham, W. E., et al. (2004). Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States. Journal of Acquired Immune Deficiency Syndromes, 35, 526–536. doi:10.1097/00126334-200404150-00011.

    Article  PubMed  Google Scholar 

  • Harawa, N. T., Greenland, S., Cochran, S. D., Cunningham, W. E., & Visscher, B. (2003). Do differences in relationship and partner attributes explain disparities in sexually transmitted disease among young White and Black women? Journal of Adolescent Health, 32, 187–191. doi:10.1016/S1054-139X(02)00458-5.

    Article  PubMed  Google Scholar 

  • Homans, G. C. (1958). Social behavior as exchange. American Journal of Sociology, 63, 597–606. doi:10.1086/222355.

    Article  Google Scholar 

  • Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (1992). Reductions in HIV risk-associated sexual behaviors among Black adolescents: Effects of an AIDS prevention. American Journal of Public Health, 82, 372–377.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C. (1996). Preventing AIDS: A sourcebook for behavioral interventions. Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Kalichman, S. C., Cain, D., Weinhardt, L., Benotsch, E., Presser, K., Zweben, A., et al. (2005). Experimental components analysis of brief theory-based HIV/AIDS risk-reduction counseling for sexually transmitted infection patients. Health Psychology, 24, 198–208. doi:10.1037/0278-6133.24.2.198.

    Article  PubMed  Google Scholar 

  • Kelly, J. A. (1995). Changing HIV risk behavior: Practical strategies. New York: Guilford Press.

    Google Scholar 

  • Kelly, J. A. (2004). Popular opinion leaders and HIV peer education: Resolving discrepant findings, and implications for the implementation of effective community programmes. AIDS Care, 16, 139–150. doi:10.1080/09540120410001640986.

    Article  CAS  PubMed  Google Scholar 

  • Kerrigan, D., Andrinopoulos, K., Johnson, R., Parham, P., Thomas, T., & Ellen, J. M. (2007). Staying strong: Gender ideologies among African-American adolescents and implications for HIV/STI prevention. Journal of Sex Research, 44, 172–180.

    PubMed  Google Scholar 

  • Koumans, E. H., Farley, T. A., Gibson, J. J., Langley, C., Ross, M. W., McFarlane, M., et al. (2001). Characteristics of persons with syphilis in areas of persisting syphilis in the United States: Sustained transmission associated with concurrent partnerships. Sexually Transmitted Diseases, 28, 497–503. doi:10.1097/00007435-200109000-00004.

    Article  CAS  PubMed  Google Scholar 

  • Kraut-Becher, J. R., & Aral, S. O. (2003). Gap length: An important factor in sexually transmitted disease transmission. Sexually Transmitted Diseases, 30, 221–225. doi:10.1097/00007435-200303000-00009.

    Article  PubMed  Google Scholar 

  • Lambert, T. A., Kahn, A. S., & Apple, K. J. (2003). Pluralistic ignorance and hooking up. Journal of Sex Research, 40, 129–133.

    Article  PubMed  Google Scholar 

  • Lane, S. D., Rubinstein, R. A., Keefe, R. H., Webster, N., Cibula, D. A., Rosenthal, A., et al. (2004). Structural violence and racial disparity in HIV transmission. Journal of Health Care for the Poor and Underserved, 15, 319–335. doi:10.1353/hpu.2004.0043.

    Article  PubMed  Google Scholar 

  • Lenoir, C. D., Adler, N. E., Borzekowski, D. L. G., Tschann, J. M., & Ellen, J. M. (2006). What you don’t know can hurt you: Perceptions of sex-partner concurrency and partner-reported behavior. Journal of Adolescent Health, 38, 179–185. doi:10.1016/j.jadohealth.2005.01.012.

    Article  PubMed  Google Scholar 

  • Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.

    Google Scholar 

  • Manhart, L. E., Aral, S. O., Holmes, K. K., & Foxman, B. (2002). Sex partner concurrency: Measurement, prevalence, and correlates among urban 18–39-year-olds. Sexually Transmitted Diseases, 29, 133–143. doi:10.1097/00007435-200203000-00003.

    Article  PubMed  Google Scholar 

  • Marx, J. (2003). Season of life: A football star, a boy, a journey to manhood. New York: Simon & Schuster.

    Google Scholar 

  • McNair, L. D., & Prather, C. M. (2004). African American women and AIDS: Factors influencing risk and reaction to HIV disease. Journal of Black Psychology, 30, 106–123. doi:10.1177/0095798403261414.

    Article  Google Scholar 

  • Miller, H. G., Cain, V. S., Rogers, S. M., Gribble, J. N., & Turner, C. F. (1999). Correlates of sexually transmitted bacterial infections among US women in 1995. Family Planning Perspectives, 31, 4–9 & 23.

    Article  CAS  PubMed  Google Scholar 

  • Morris, M. (2001). Concurrent partnerships and syphilis persistence: New thoughts on an old puzzle. Sexually Transmitted Diseases, 28, 504–507. doi:10.1097/00007435-200109000-00005.

    Article  CAS  PubMed  Google Scholar 

  • Morris, M., & Kretzschmar, M. (1995). Concurrent partnerships and transmission dynamics in networks. Social Networks, 17, 299–318. doi:10.1016/0378-8733(95)00268-S.

    Article  Google Scholar 

  • Nelson, S. J., Manhart, L. E., Gorbach, P. M., Martin, D. H., Stoner, B. P., Aral, S. O., et al. (2007). Measuring sex partner concurrency: It’s what’s missing that counts. Sexually Transmitted Diseases, 34, 801–807.

    PubMed  Google Scholar 

  • Pilcher, C. D., Tien, H. C., Eron, J. J., Vernazza, P. L., Szu-Yun, L., Stewart, P. W., et al. (2004). Brief but efficient: Acute HIV infection and the sexual transmission of HIV. Journal of Infectious Diseases, 189, 1785–1792. doi:10.1086/386333.

    Article  PubMed  Google Scholar 

  • Potterat, J. J., Zimmerman-Rogers, H., Muth, S. Q., Rothenberg, R. B., Green, D. L., Taylor, J. E., et al. (1999). Chlamydia transmission: Concurrency, reproduction number, and the epidemic trajectory. American Journal of Epidemiology, 150, 1331–1339.

    CAS  PubMed  Google Scholar 

  • Rosenberg, M. D., Gurvey, J. E., Adler, N. E., Dunlop, M. B. V., & Ellen, J. M. (1999). Concurrent sex partners and risk for sexually transmitted diseases among adolescents. Sexually Transmitted Diseases, 26, 208–212. doi:10.1097/00007435-199904000-00004.

    Article  CAS  PubMed  Google Scholar 

  • Rusbult, C. E. (1983). A longitudinal test of the investment model: The development (and deterioration) of satisfaction and commitment in heterosexual involvements. Journal of Personality and Social Psychology, 45, 101–117. doi:10.1037/0022-3514.45.1.101.

    Article  Google Scholar 

  • Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Tanfer, K., Cubbins, L. A., & Billy, J. O. G. (1995). Gender, race, class and self-reported sexually transmitted disease incidence. Family Planning Perspectives, 27, 196–202. doi:10.2307/2136275.

    Article  CAS  PubMed  Google Scholar 

  • Treadwell, H. M., & Ro, M. (2003). Poverty, race, and the invisible men. American Journal of Public Health, 93, 705–707.

    Article  PubMed  Google Scholar 

  • Warner, L., Newman, D. R., Kamb, M. L., Fishbein, M., Douglas, J. M., Zenilman, J., et al. (2008). Problems with condom use among patients attending sexually transmitted disease clinics: Prevalence, predictors, and relation to incident gonorrhea and chlamydia. American Journal of Epidemiology, 167, 341–349. doi:10.1093/aje/kwm300.

    Article  PubMed  Google Scholar 

  • Watts, C. H., & May, R. M. (1992). The influence of concurrent partnerships on the dynamics of HIV/AIDS. Mathematical Biosciences, 108, 89–104. doi:10.1016/0025-5564(92)90006-I.

    Article  CAS  PubMed  Google Scholar 

  • Whitehead, T. L. (1997). Urban, low-income African American men, HIV/AIDS, and gender identity. Medical Anthropology Quarterly, 11, 411–447. doi:10.1525/maq.1997.11.4.411.

    Article  CAS  PubMed  Google Scholar 

  • Yach, D., McKee, M., Lopez, A. D., & Novotny, T. (2005). Improving diet and physical activity: 12 lessons from controlling tobacco smoking. British Medical Journal, 330, 898–900. doi:10.1136/bmj.330.7496.898.

    Article  PubMed  Google Scholar 

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Acknowledgements

This research was supported by NIH grant # R01-MH068171 to Michael P. Carey. We thank all those who participated in the research, and the Health Improvement Project team members.

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  1. Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244-2340, USA

    Michael P. Carey, Theresa E. Senn & Peter A. Vanable

  2. Counseling and Human Development, University of Rochester, Rochester, NY, USA

    Derek X. Seward

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  1. Michael P. Carey
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  2. Theresa E. Senn
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  3. Derek X. Seward
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  4. Peter A. Vanable
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Correspondence to Michael P. Carey.

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Carey, M.P., Senn, T.E., Seward, D.X. et al. Urban African-American Men Speak Out on Sexual Partner Concurrency: Findings from a Qualitative Study. AIDS Behav 14, 38–47 (2010). https://doi.org/10.1007/s10461-008-9406-0

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