Abstract:
Recent estimates indicate that over 50% of gay men acquire HIV from their
main sexual partners while in their relationship (Sullivan et al., 2009). Despite this
statistic, the majority of research has focused on individual factors as predictors of
unprotected anal intercourse (UAI) and not on relationship factors. The few studies
that have examined relationship factors indicate these dynamics are important for
better understanding HIV risk among gay male couples. The present study examined
how relationship factors of trust, relationship commitment, investment in sexual
agreements and other characteristics were associated with risky sexual behaviors
among gay male couples in Portland, Oregon and Seattle, Washington.
A cross-sectional study design paired with a standard, reciprocal dyadic
collection method was used. Data were collected and analyzed from a convenience
sample of 142 gay male couples. Descriptive statistics, dyad-level logistic regression,
and multilevel modeling to estimate actor-partner effects were used to examine the
research hypotheses. Findings indicate that less than half of the couples had a sexual
agreement and far fewer chose their agreement to be monogamous. In addition,
couples who had a less positive attitude about using condoms with non-main partners
and perceived more alternatives to their current sexual relationship were significantly
more likely to be at higher risk for HIV. In contrast, couples who were employed were
significantly less likely to be at higher risk for HIV. Only actor effects were detected
to significantly predict HIV risk among the couples; no partner effects were
significant.
Using themes that emerged from the study findings, important implications for
public health are discussed. More specifically, data indicate a need for future HIV
prevention strategies to focus on strengthening communication skills and improving
relationship characteristics among gay male couples. Both strategies are needed in
order to reduce HIV incidence among gay men and their main sexual partners. Areas
of future research must emphasize the importance of collecting dyadic data and
incorporating theories and measures that focus on relationship dynamics in order to
further our understanding of HIV risk among gay male couples.
