Negotiating sexual safety in the era of biomedical HIV prevention: relationship dynamics among male couples using pre-exposure prophylaxis. Issue 6 (3rd June 2018)

• Record Type: Journal Article
• Authors: Malone, Jowanna; Syvertsen, Jennifer L.; Johnson, Blake E.; Mimiaga, Matthew J.; Mayer, Kenneth H.; Bazzi, Angela R.
• Is Part Of: Culture, health & sexuality. Volume 20:Issue 6(2018)
• Page Start: 658
• Page End: 672
• Publication Date: 2018-06-03
• Subjects: HIV prevention -- pre-exposure prophylaxis -- men who have sex with men -- relationships -- sexual health -- USA; Sex -- Periodicals; Sex -- Cross-cultural studies -- Periodicals; Sex -- Health aspects -- Periodicals; 306.705
• DOI: 10.1080/13691058.2017.1368711
• Languages: English
• ISSNs: 1369-1058

Abstract

Abstract: Up to two-thirds of new cases of HIV transmission between gay, bisexual and other men who have sex with men in the USA are attributed to primary relationships. Understanding the relationship dynamics and sexual agreements of male-male couples can provide insight into HIV transmission patterns and prevention needs in this population. The daily use of antiretroviral pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV, but its negotiation and use within social and intimate relationship contexts remain understudied. We conducted semi-structured qualitative interviews with 20 male couples ( n = 40 men) in which at least one partner was either using or in the process of initiating PrEP. Congruent with a theoretical focus on social theories of relationships and negotiated risk, couples were interviewed about relationship dynamics, trust, communication and sexual health practices, including their perception and use of PrEP. Overall, we found that couples showed heightened trust and communication when establishing open, sexual agreements and demonstrated high awareness of sexual risks and health practices in the context of PrEP use. This study demonstrates how understanding relationship dynamics can better inform HIV prevention and sexual health promotion efforts for male couples at risk of HIV.