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Arch Sex Behav. 2018 Nov 21. doi: 10.1007/s10508-018-1282-8. [Epub ahead of print]

The Prevalence and Correlates of Sexual Arrangements in a National Cohort of HIV-Negative Gay and Bisexual Men in the United States.

Author information

1
Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA.
2
Center for HIV/AIDS Educational Studies and Training, New York, NY, USA.
3
Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA.
4
Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, USA.
5
Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA. Jeffrey.Parsons@hunter.cuny.edu.
6
Center for HIV/AIDS Educational Studies and Training, New York, NY, USA. Jeffrey.Parsons@hunter.cuny.edu.
7
Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA. Jeffrey.Parsons@hunter.cuny.edu.

Abstract

Sexual agreements have received considerable attention as an aspect of dyadic functioning associated with HIV risk. To date, this research has primarily utilized convenience samples which overrepresented men from large urban areas and with higher HIV risk. The current study utilized a national cohort of 1061 HIV-negative gay and bisexual men recruited to be geographically diverse within the U.S. The sample included 531 (50.0%) men who identified as single. Of the 530 partnered men, 240 (45.3%) were monogamous; 238 (44.9%) were in open relationships (where sex with outside partners was permitted); and 52 (9.8%) were in monogamish relationships (where sex with outside partners was limited to instances where both primary partners were present). Regardless of urban (vs. non-urban) residence, men in monogamous relationships engaged in less anal sex generally and condomless anal sex (CAS) specifically with casual partners. Single men reported significantly more frequent anal sex with casual partners compared to open and monogamish men; however, there were no significant differences among these three groups with respect to CAS with casual partners. In multivariable models, monogamish men reported significantly more frequent marijuana use and alcohol consumption compared to all other groups. Urban (vs. non-urban) residence moderated associations between sexual arrangements and depression as well as the use of illicit drugs other than marijuana. These findings point to the need to better examine the potentially unique mechanisms which confer risk and resilience for gay male couples in urban versus non-urban settings. The observed association between sexual arrangements and substance use suggests interventions which facilitate the negotiation of sexual agreements may present an opportunity to engage in dyadic substance use intervention.

KEYWORDS:

Drug use; Gay male relationships; HIV; MSM; Mental health; Sexual agreements; Sexual orientation

PMID:
30465312
DOI:
10.1007/s10508-018-1282-8

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