Relatnship Characteristics and Motivatns behd Agreements among Gay Male Coupl: Differenc by Agreement Type and Couple Serostat - PMC

Contents:

• ABOUT THE CENTERSCE 1983 THE CENTER HAS BEEN SUPPORTG, FOSTERG AND CELEBRATG THE LGBT MUNY OF NEW YORK CY. FD MORE RMATN ON AND OUR WORK ABOUT THE CENTER. VIS ABOUT THE CENTEROUR MISSNCYBER CENTERCENTER HISTORYRACE EQUYMEDIA CENTERLEARSHIP & STAFFEMPLOYMENT OPPORTUNICORPORATE PARTNERSHIPSANNUAL REPORTS & FANCIAL INFORMATNCONTACT USHOURS & LOTNSEMAPSUPPORT THE CENTER
• PHYSIL, BEHAVRAL, AND PSYCHOLOGIL TRAS OF GAY MEN INTIFYG AS BEARS
• 15 STEREOTYP THAT LIM OUR PERCEPTNS OF GAY MEN
• CHARACTERISTICS AND ALLOWED BEHAVRS OF GAY MALE UPL’ SEXUAL AGREEMENTS
• ASPECTS OF GAY MALE COUPL’ SEXUAL AGREEMENTS VARY BY THEIR RELATNSHIP LENGTH
• RELATNSHIP CHARACTERISTICS AND MOTIVATNS BEHD AGREEMENTS AMONG GAY MALE COUPL: DIFFERENC BY AGREEMENT TYPE AND COUPLE SEROSTAT

ABOUT THE CENTERSCE 1983 THE CENTER HAS BEEN SUPPORTG, FOSTERG AND CELEBRATG THE LGBT MUNY OF NEW YORK CY. FD MORE RMATN ON AND OUR WORK ABOUT THE CENTER. VIS ABOUT THE CENTEROUR MISSNCYBER CENTERCENTER HISTORYRACE EQUYMEDIA CENTERLEARSHIP & STAFFEMPLOYMENT OPPORTUNICORPORATE PARTNERSHIPSANNUAL REPORTS & FANCIAL INFORMATNCONTACT USHOURS & LOTNSEMAPSUPPORT THE CENTER

Bee there is a arth of general rearch regardg this muny, and no studi to date that e quantative methods, we cid to explore this muny quantatively—g an Inter-nvenience sample, followed by a purposive suggted, the Bear culture exhibs and valu a greater sense of domant (but not necsarily domeerg) “thentic masculy” parison to other subcultur wh the gay muny (e. Whereas mastream gay men often do not engage sired or preferred sexual behavrs bee of fears of rejectn or judgment (Kamski, Chapman, Hayn, & Own, 2004), those the more acceptg Bear muny reject the fears due to their beg ultimately “feme” nature (Hennen, 2005).

G., uratn, fistg, voyrism, exhibnism) (Grov, Parsons, & Bimbi, 2010) to the active existence of the Bear muny and regnn of this subculture by the larger gay/bisexual male culture, more rearch is need to explore the gree to which the prevly mentned physil, behavral, and psychologil differenc actually exist. Consirg the likely prevalence of a Bear inty may be held (wh varyg tenaci) by about 14–22% of gay men, the rults provi addnal evince for the manift and latent heterogeney of gay and bisexual rults regardg body tras and partner selectn nfirm, for the first time a systematic manner, fdgs documented prev terview and ethnographic studi.

A study that answers the rearch qutns would provi further evince to support the heterogeney hypothis: Not only is the mastream gay muny culturally heterogeneo, but so are the sexual health behavrs and problems wh last suggtn for future rearch would be to tt some of the theori generated by the current data. For stance, prr rearch has intified that gay men have UAI wh their ma partners as a way to foster and strengthen their mment to and satisfactn wh the relatnship (Davidovich, W, & Stroebe, 2006; Vroome, Stroebe, Sandfort, W, & Van Griensven, 2000; McLean et al., 1994; McNeal, 1997; Worth, Reid, & McMillan, 2002), as well as, to monstrate love, timacy, and tst for one another (Appleby, Miller, & Rothspan, 1999; Blais, 2006; Davidovich, W, & Stroebe, 2004; Vroome et al., 2000; McLean et al., 1994; McNeal, 1997; Worth et al., 2002) addn to practicg UAI wh their ma partners, some studi have intified a subgroup of gay men who also have UAI wh sual MSM partners (Chakravarty, Hoff, Neilands, & Darb, 2012; Gass, Hoff, Stephenson, & Sullivan, 2012; Mchell, Harvey, Champe, & Seal, 2012; Mchell & Petroll, 2012). For example, among gay upl who practice UAI, men who received HIV-specific social support om their ma partners and those who had higher levels of mment and value to their sexual agreements were ls likely to have had UAI wh a sual MSM partner (Darb, Chakravarty, Beougher, Neilands, & Hoff, 2011; Mchell et al., 2012; Mchell & Petroll, 2012).

PHYSIL, BEHAVRAL, AND PSYCHOLOGIL TRAS OF GAY MEN INTIFYG AS BEARS

To better asss HIV risk among gay male upl, rearch has begun to exame the role that sexual agreements may have on gay men’s practice of UAI wh their ma and their sual MSM partners (Crawford, Rodn, Kippax, & Van Ven, 2001; Davidovich, W, & Stroebe, 2000; Gass et al., 2012; Gomez et al., 2012; Hoff & Beougher, 2010; Hoff, Beougher, Chakravarty, Darb, & Neilands, 2010; Hoff et al., 2009; Kippax, Crawford, Davis, Rodn, & Dowsett, 1993; Kippax et al., 1997; Mchell et al., 2012; Mchell, Harvey, Champe, Moskowz, & Seal, 2011; Mchell & Petroll, 2012; Prtage et al., 2006; Prtage et al., 2008; Wheldon & Pathak, 2009) the U. S., Europe and Atralia, sexual agreements appear to be mon among gay male upl (Crawford et al., 2001; Davidovich et al., 2000; Elford, Boldg, Maguire, & Sherr, 1999; Gass et al., 2012; Hoff & Beougher, 2010; Mchell et al., 2012; More-Get, Jeann, Dubois-Arber, & Spencer, 2000; Prtage et al., 2006; Prtage et al., 2008). One particular type of an open sexual agreement is lled “negotiated safety”, which allows HIV-negative seronrdant gay male upl to practice UAI wh their relatnship as long as both partner’s serostat rema HIV negative and both men practice safer sex wh sendary partners (Kippax et al., 1997).

Fdgs om the studi dite that between 48% and 98% of gay male upl formed a sexual agreement (Gass et al., 2012; Mchell et al., 2001; Prtage et al., 2006; Prtage et al., 2008), which clud upl wh closed monogamo sexual agreements or a variety of different open nonmonogamo sexual agreements (Adam, 2006; Bryant & Demian, 1994; Crawford et al., 2001; Hoff et al., 2009; LaSala, 2004a; 2004b; Parsons, Starks, DuBois, Grov, & Golub, 2011; Ramirez & Brown, 2010; Wagner, Remien, & Carballo-Dieguez, 2000; Wheldon & Pathak, 2009; Worth et al., 2002). However, all of the studi llected data om nvenience sampl, which lims our abily to fively state how mon sexual agreements are among gay male agreements appear to be mon, not all gay male upl tablish a sexual agreement or ncur about aspects of their sexual agreements. For example, Wheldon & Pathak (2009) found that partnered gay men wh a high endorsement of normative masculy predicted that men would be more likely to have an open sexual agreement that permted UAI to occur outsi of their reasons that men break their sexual agreements and their attus toward disclosg those breaks to their ma partners have also been examed.

Specifilly, we employed a novel recment and dyadic data llectn method to asss: 1) the prevalence, and characteristics of, sexual agreements among a natnal nvenience sample of gay male upl; 2) the sequence which upl discs their HIV stat, engage UAI, and tablish a sexual agreement; 3) the primary reasons for tablishg and breakg sexual agreements; 4) the primary reasons that men do and do not disclose breaks the sexual agreement to their ma partners; 5) the extent to which upl ncur about aspects of their sexual agreements; 6) which behavrs are allowed the upl’ sexual agreements; and 7) whether upl who ncurred about aspects of their sexual agreements (e. Table 1 scrib addnal tails about the socmographic and relatnship characteristics of the study sample of gay male upl, cludg how equent they engaged UAI wh and outsi of their 1Socmographic and Relatnship Characteristics of 361 Gay Male Coupl, 722 MSMIndividual-level characteristicN%Sexual orientatn Gay70998 Bisexual132Race/ethnicy Whe55977 Hispanic or Lato679 Ain Amerin284 Mixed race365 Othera325Hight tn level Some graduate school or pletn of adv.

15 STEREOTYP THAT LIM OUR PERCEPTNS OF GAY MEN

Addnal rmatn about the sampl’ sexual agreement characteristics is provid Table 3Characteristics of Sexual Agreements Reported by 506 Partnered Gay MenCharacteristicN%MSM who reported havg a sexual agreement wh ma partner50670Origal type of sexual agreementa Only have sex wh ma partner31963 Sex wh each other and allowed to have sex wh sual partners unr certa guil17134 Sex wh each other and allowed to have sex wh sual partners whout any guil163Current type of sexual agreementa Only have sex wh ma partner28456 Sex wh each other and allowed to have sex wh sual partners unr certa guil20641 Sex wh each other and allowed to have sex wh sual partners whout any guil163Discsed sexual agreement explicly when first tablished34869Sexual agreement ever broken the relatnship Y – by one or both men the uple15931 No – both men the uple kept their agreement34769Sexual agreement broken wh the prev three months Perceived that ma partner broke265 Self-reported break469Disclosed break to ma partner wh prev three monthsb No3270 Y1430Primary reason for disclosg recent break to ma partnerc We believe and practice open l of munitn wh each other857 I told him bee was jt the right thg to do17 Tst429 Part of our agreement clus full disclosure of any breaks17Primary reason for not disclosg recent break to ma partnerd I didn’t want to give him a reason to not tst me1753 I feared that the relatnship would end if I told him1031 I didn’t know how to tell him516MSDNumber of tim men reported talkg about their sexual agreemente4. Addnal dyad-level data of gay male upl’ sexual agreements are scribed Table 5Coupl’ Conrdance About Their Sexual Agreement Establishment, Type, Discsns, and AdherenceCharacteristicN%Establishment of a sexual agreement *** Coupl wh one male who reported havg a sexual agreement9225 Coupl wh both men who reported not havg a sexual agreement6217 Coupl wh both men who reported havg a sexual agreement20757Coupl who ncurred about their origal type of sexual agreement ***16680 Only have sex wh ma partnera10362 Sex wh each other and allowed to have sex wh sual partners unr certa guila6137 Sex wh each other and allowed to have sex wh sual partners whout any guila21Coupl who ncurred about their current type of sexual agreement ***17484 Only have sex wh ma partnerb9253 Sex wh each other and allowed to have sex wh sual partners unr certa guilb8147 Sex wh each other and allowed to have sex wh sual partners whout any guilb1< 1Type of discsn when sexual agreement was first tablished ** Coupl who ncurred their discsn was explicc12158 Coupl who ncurred their discsn was more implied and assumedc2211 Coupl who reported disrdance about their type of discsnc6431Sexual agreement ever broken relatnship *** Y – by both men the uple136 Y – by one male the uple7340 No – both men uple kept their agreement11254Sexual agreement broken relatnship wh prev three months *** Y – by both men the uple105 Y – by one male the uple3115 No – both men uple kept their agreement16680Allowed Behavrs of the Sexual AgreementAcrdg to the current type of sexual agreement, participants endorsed which behavrs they were allowed to engage wh their ma partner, other partners, and anyone/everyone.

The men among our Inter-based sample of gay upl dited that their risk of acquirg HIV and STIs was one of their most important reasons for why they formed a sexual agreement wh their study intified important fdgs regardg the stabily of sexual agreements over time. As prevly mentned, we did not asss whether upl allowed UAI to occur outsi of their relatnship based on g seroadaptive risk rctn strategi and did not asss how other relatnship characteristics, such as tst and mment, affect aspects of the upl’ sexual further our unrstandg of how gay male upl’ sexual agreements affect an dividual’s and a uple’s risk for acquisn of HIV, future rearch mt explore the tersectn of allowed behavrs of sexual agreements wh certa seroadaptive risk rctn strategi among gay male upl.

CHARACTERISTICS AND ALLOWED BEHAVRS OF GAY MALE UPL’ SEXUAL AGREEMENTS

Though one recent study has examed what relatnship characteristics predict gay men to break the sexual agreement wh their ma partner (Gomez et al., 2012), ls is known about the characteristics of the upl wh both men adherg to their agreement, and the factors that prevent both of the men om breakg . Our suggtns for future rearch on gay male upl’ sexual agreements require further quiry that may be bt acplished by g a mixed methods, longudal study sign that llects data om both men the prent study is the first to provi data about sexual agreements om a natnal sample of Inter-g gay male upl the U. Dpe the persistence of stereotyp that portray lbian, gay, and bisexual people as disturbed, several s of rearch and clil experience have led all mastream medil and mental health anizatns this untry to nclu that the orientatns reprent normal forms of human experience.

Helpful rpons of a therapist treatg an dividual who is troubled about her or his same sex attractns clu helpg that person actively pe wh social prejudic agast homosexualy, succsfully rolve issu associated wh and rultg om ternal nflicts, and actively lead a happy and satisfyg life. The phrase “g out” is ed to refer to several aspects of lbian, gay, and bisexual persons’ experienc: self-awarens of same-sex attractns; the tellg of one or a few people about the attractns; wispread disclosure of same-sex attractns; and intifitn wh the lbian, gay, and bisexual muny. If they are a heterosexual relatnship, their experienc may be que siar to those of people who intify as heterosexual unls they choose to e out as bisexual; that se, they will likely face some of the same prejudice and discrimatn that lbian and gay dividuals enunter.

ASPECTS OF GAY MALE COUPL’ SEXUAL AGREEMENTS VARY BY THEIR RELATNSHIP LENGTH

Keywords: gay male upl, tablishment of a sexual agreement, type of sexual agreement, adherence to a sexual agreement, relatnship length, dyadic dataEstimat om two recent studi dite that between one-third and two-thirds of gay men and other men who have sex wh men (MSM) the U. Rat of new HIV fectns among gay male upl may be part due to their low levels of ndom e, greater likelihood of havg anal sex, and greater equency of unprotected anal terurse (UAI), thereby creasg their cumulative risk for HIV fectn over time (Sullivan et al., 2009).

One study wh HIV-negative Lato gay male upl found that matag knowledgeable about HIV, beg exposed to social support groups for Lato gay men, and fdg support their relatnship om their ma partner had helped lower the upl’ risk for HIV (Beougher, Gomez, & Hoff, 2011) rponse to the fdgs, rearchers have reported that gay male upl’ relatnship characteristics mt be asssed for velopment of HIV preventn terventns (Burton, Darb, & Operar, 2010; El-Bassel et al., 2010; Herbst et al., 2007; Grossman et al., 2011). However, studi have found that gay male upl form different typ of sexual agreements, and tablishg an agreement wh the relatnship appears to be a fairly mon practice (Gass, Hoff, Stephenson, & Sullivan, 2012; Gomez et al., 2012; Hoff & Beougher, 2008; Hoff, Beougher, Chakravarty, Darb, & Neilands, 2010; Hoff, Chakravarty, Beougher, Neilands, & Darb, 2012; Hoff et al., 2009; LaSala, 2004a; LaSala, 2004b; Mchell, 2013; Mchell, Harvey, Champe, Moskowz, & Seal, 2012; Mchell, Harvey, Champe, & Seal, 2012; Mchell & Petroll, 2013; Parsons, Starks, DuBois, Grov, & Golub, 2013; Parsons, Starks, Gamarel, & Grov, 2012; Prtage et al., 2008; Wheldon & Pathak, 2010). Addnally, one recent study noted that some HIV-disrdant gay male upl form agreements that allow an acceptable level of HIV risk (as termed by the uple), which may or may not volve g ndoms wh the relatnship (Beougher, Chakravarty, Garcia, Darb, Neilands, & Hoff, 2012) men break their agreement (e.

Studi have also found that certa characteristics are associated wh gay male upl who have broken their sexual agreement, cludg partners who have had UAI outsi of the relatnship, and/or reportg lower levels of tst, relatnship mment, and vtment the agreement (Gomez et al., 2012; Mchell et al., 2012). Characteristics of the sample are prented Table 1Socmographic and Behavral Characteristics of 361 Male CouplCouple-level characteristicN%Sexual orientatn Both men uple intified as gay34997 One or both partners uple intified as bisexual123Race Mixed12434 Whe23766Edutn: Had a Bachelor’s gree or higher Both partners13437 Only one partner11031 Neher partner11732Employment stat Both partners employed23565 Only one partner employed10429 Neher partner employed226Had health surance at time of asssment Both partners reported y22763 Only one partner reported y9125 Both partners reported no4312HIV serostat Conrdant negative27576 Conrdant posive288 Disrdant5816Practiced unprotected anal terurse (UAI) wh relatnship30484One or both men uple had sex outsi their relatnship11331One or both men uple had UAI wh a sual MSM partner a7566Establishment of a sexual agreement Couple ncurred about havg an agreement20757 Couple disagreed about havg an agreement9225 Couple did not have an agreement6217Current type of sexual agreement b Closed agreement9244 Open agreement8240Kept sexual agreement wh prr three months to asssment Both partners uple kept agreement16680 Only one partner uple kept agreement3115 Both partners broke their agreement105Ever broken sexual agreement Both partners reported y Only one partner reported y Both partners reported noMeanSDIndividual age [range: 18–68 years]33. Table 2 provis addnal rmatn about the 2Differenc Aspects of Gay Male Coupl’ Sexual Agreements, by Relatnship lengthAspects of sexual agreementRelatnship length< 6 m6 m–2 yr2–5 yr5–10 yr> 10 yr% (N)% (N)% (N)% (N)% (N)pFormatn/tablishment, N=361 dyadsN=35N=118N=96N=57N=55<.

RELATNSHIP CHARACTERISTICS AND MOTIVATNS BEHD AGREEMENTS AMONG GAY MALE COUPL: DIFFERENC BY AGREEMENT TYPE AND COUPLE SEROSTAT

The ma strengths of our study clu the large geographilly diverse sample size of Inter-g gay male upl, the e of paid targeted social media advertisements to pture a large sample size a short perd of time, the e of dyadic data, and ascertag how aspects of agreements vary by relatnship length.

Keywords: gay male upl, sexual agreements, relatnship characteristics, HIVIntroductnEpimlogil studi pot to unprotected anal terurse (UAI) wh primary partners as a signifint source of many HIV fectns (Davidovich et al., 2001; More-Get, Jeann, Dubois-Arber, & Spencer, 2001; Sullivan, Salazar, Buchbr, & Sanchez, 2009). Behavral studi report that gay men mted relatnships engage higher rat of UAI wh their primary partners than sgle gay men wh their sual partners, which for some uld crease risk (Ekstrand, Stall, Pl, Osmond, & Coat, 1999; Elford, Boldg, Maguire, & Sherr, 1999; Hoff et al., 1997) and for others not change their level of risk at all (J et al. Therefore, we sought to vtigate aspects of gay male relatnships – sexual agreements, uple serostat and relatnship characteristics – which may ntribute to unrstandg the dyadic ntext where HIV risk tak aspect of gay upl that may play an important role termg HIV risk is sexual agreements (hereafter referred to as ‘agreements’).

In light of the nclive fdgs regardg the effectivens of negotiated safety and recent rearch suggtg that HIV preventn is not a primary motivatg factor for havg agreements, is imperative to lve further to agreements and their associatn wh other characteristics of gay male relatnships. Although protectg onelf or one’s partner om HIV was endorsed by 74% of the upl wh monogamo agreements, 53% of the upl wh open agreements, and 53% of upl wh discrepant agreements, was not among the top reasons chosen by upl wh any of the three agreement 3Endorsement of specific reasons for makg the agreement, tegorized by agreement typeAgreement TypeMonogamoOpenDiscrepantReasons for Makg the Agreementn = 510n = 524n = 88To build tst the relatnship wh primary partner867375*To be hont the relatnship wh primary partner848376To protect the relatnship836669*To strengthen the relatnship wh primary partner826674*To protect partner/self om STDs815668*To please primary partner756160*To protect partner/self om HIV745353*To have satisfyg sex646353To promote gay inty of self352424*To be more sexually adventuro316541*To keep self om gettg bored relatnship wh primary partner286135*Motivatns for makg agreements were also siar across all three uple serostat groups, however, only nrdant negative upl endorsed HIV or STD preventn among their top three motivators (see Table 4).