Online Program

Examining personal and relational motivations in the context of sexual risk behavior among HIV serodiscordant same-sex male couples

Tuesday, November 5, 2013 : 3:15 p.m. - 3:30 p.m.

Kristi Gamarel, PhD, Department of Medicine, Brown University, Providence, RI
Tyrel Starks, PhD, Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY
Samantha Dilworth, MA, Department of Medicine, University of California, San Francisco, San Francisco, CA
Torsten B. Neilands, PhD, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
Jonelle Taylor, BA, Department of Medicine, University of California, San Francisco, San Francisco, CA
Mallory Johnson, PhD, Department of Medicine, University of California, San Francisco, San Francisco, CA
Background: Couples' ability to adopt a relational orientation – as opposed to a focus on personal motivations – has been associated with optimal health outcomes. This study examined how personal and relational motivations are associated with unprotected anal intercourse (UAI), protected anal intercourse (PAI), and the absence of sexual activity within serodiscordant same-sex male couples.

Methods: HIV-positive men and their HIV-negative partners (N = 116 couples, 232 men) were surveyed. Participants' mean age was 46.70; 38.4% were racial/ethnic minority; 40% earned less than $20,000 annually; and 63% of HIV-positive men had an undetectable viral load confirmed by plasma HIV RNA viral load tests. A multinomial logistic regression model examined the associations between each partners' reported sexual satisfaction, viral suppression and relational orientation with sexual behavior, adjusting for relationship duration, age, and time since HIV diagnosis.

Results: Overall, 27.6% of couples reported engaging in PAI, 29.3% engaging in UAI, and 43.1% reported no anal sex in the past 3 months. Sexual satisfaction was positively associated with PAI among HIV-negative partners (p<0.05) and negatively associated with PAI among HIV-positive partners(p<0.05),compared with UAI. Viral suppression was not associated with sexual behavior. Endorsing a relational orientation was positively associated with PAI among HIV-positive partners,compared with UAI(p<0.05).

Discussion: Findings suggest that HIV-positive partners who espouse relational orientations may be willing to forgo their personal interests to protect their HIV-negative partners from HIV transmission. Examining personal and relational motivations for sexual risk behavior represents an important area for future research with same-sex male couples.

Learning Areas:

Chronic disease management and prevention
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Evaluate how sexual satisfaction and viral suppression are differentially associated with intradyadic (within couple) sexual risk behavior among same-sex male couples in serodiscordant relationships. Describe the associations between personal and relational motivations and sexual behavior within serodiscordant same-sex male couples, and to consider their unique roles in reducing HIV transmission.

Keyword(s): HIV/AIDS, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Kristi Gamarel is a doctoral candidate at the Graduate Center of the City University of New York (CUNY) in the Department of Basic and Applied Social Psychology. Kristi has over 10 years of work experience in the fields of health psychology and public health research within the areas of mental health and HIV prevention. She has presented her research at scientific conferences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4318.0: HIV and sexual identity