September 9, 2011
Considering oneself to be in a serious relationship was associated with an eight-fold increase in the rate of unprotected sex in this study of young US MSM.
Epidemiological research, the authors wrote, "suggests that the majority of [HIV] transmissions among MSM are occurring in the context of primary partnerships, but little research has been done on the processes within these dyads that increase HIV risk behaviors." The researchers used longitudinal partnership-level data to explore the effects of partner and relationship characteristics on the frequency of unprotected sex within young MSM relationships.
The participants, 122 MSM ages 16-20 at baseline, were assessed at three points, six months apart, with 91 percent retention at the 12-month follow-up wave. More than 80 percent of the MSM were racial/ethnic minorities. At each wave, the participants reported characteristics of their relationships and partners for up to three sex partners. Hierarchical linear modeling was used for analyses.
The largest effect was noted for considering ones relationship to be serious, "which was associated with nearly an eight-fold increase in the rate of unprotected sex," the authors found. Older partners, drug use before sex, physical violence, forced sex, and being in a relationship for more than six months also increased risk behaviors. Meeting partners online was not associated with significantly more sexual risk.
"These data provide insight into the relationship processes that should be addressed in prevention programs targeted at young MSM," the authors concluded. "Relationships may serve as a promising unit for HIV prevention interventions, although more formative research will be required to address potential logistical obstacles to implementing such interventions. The partner-by-partner analytic approach (i.e., evaluating situational variables associated with several partners for a given participant) holds promise for future HIV behavioral research."