Gay Couples Need HIV Prevention, Says Study

Couples should be included in HIV prevention campaigns that have traditionally targeted only single gay and bisexual men, according to new research.

The study examined sexual agreements among 566 gay male couples from the San Francisco Bay Area. These agreements consisted of decisions the couples made about whether they allowed sex with outside partners and the kinds of sexual behaviors they engaged in together.

Roughly equal proportions were in monogamous (45 percent) or open (47 percent) relationships. However, 8 percent had "discrepant agreements," in which the partners reported different understandings of whether their relationship was monogamous or open.

The major motivations for agreements among most couples included strengthening or improving the relationship by building trust, promoting honesty, and fostering the primacy of the coupled partners. Except among concordant HIV-negative partners, HIV/STD prevention was not usually listed among the top motivators.

"We found that gay couples are interested in building healthy, satisfying, and loving relationships," said lead author Colleen Hoff, a San Francisco State University professor and director of its Center for Research on Gender and Sexuality. "These desires, when nurtured, can lead to strong relationships. Yet the reality is that a broken sexual agreement, or one that isn?t clear to either partner, can make both partners vulnerable to HIV."

Given efforts by many researchers to tie disease prevention to sexual agreements, it is critical to understand the primary motivations couples have in establishing them, noted Hoff and colleagues. In the study, most couples cited relationship dynamics rather than risk reduction for their mutual understandings. Prevention messages should urge couples to discuss their agreements on an ongoing basis, the authors suggested.

The full study, "Relationship Characteristics and Motivations Behind Agreements Among Gay Male Couples: Differences by Agreement Type and Couple Serostatus," was published in AIDS Care (2010;22(7):827-835).

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