Perceived Challenges and Rewards of Forming a Sexual Agreement Among HIV-Negative Male Couples

Abstract

Sexual agreements, explicit mutual understandings made between two partners about which sexual and related behaviors they agree to engage in within and/or outside of their relationship, are common among male couples. However, little is known about the perceived rewards and challenges partnered men face in the process of forming a sexual agreement. Such knowledge may be useful for development of future HIV preventive and sexual health programs that encourage male couples to establish a sexual agreement in their relationship. By using qualitative dyadic data from a sample of 29 self-reported concordant HIV-negative male couples who had a sexual agreement, the present qualitative study sought to: assess partnered men’s perceived rewards and challenges of forming a sexual agreement in their relationship; and examine whether both men in the couple concurred about their perceived rewards and challenges of forming a sexual agreement. Themes for perceived rewards were: 1) being honest, 2) improving communication, 3) increasing understanding about expectations and permitted behaviors, 4) enhancing intimacy and relational bond, and 5) building trust. Themes for perceived challenges were: 1) stigma about having an open agreement; 2) awkwardness about the topic and talking about it; 3) jealousy; 4) no perceived challenges. Few couples had both partners concur about their perceived rewards or challenges toward establishing a sexual agreement. The variety of perceived rewards and challenges highlight the need for tailoring given that a variety of factors may influence partnered men’s establishment of a sexual agreement in their relationship.

How Best to Obtain Valid, Verifiable Data Online From Male Couples? Lessons Learned From an eHealth HIV Prevention Intervention for HIV-Negative Male Couples

“…Both individual- and couple-level criteria were used to deem couples’ eligibility to participate in the study. Based on our prior work with male couples [ 34 , 35 ], we developed a system of decision rules to assess the verification of a couples’ relationship based on both partners’ responses to screener items (ie, to verify that a couple is in a relationship). Verification of couples’ relationships was based on data collected from both members of the couple and whether they concurred (ie, agreed) on certain predetermined eligibility screener items (see Figure 1 ), including (1) matching their relationship length within a margin of 1 month, (2) exact matching of each other’s birthday months, (3) matching each other’s ages within a margin of one year, and (4) exact matching of at least one of their two contact information options (eg, phone number, email address).…”

A cluster randomized trial to reduce HIV risk from outside partnerships in Zambian HIV-Negative couples using a novel behavioral intervention, “Strengthening Our Vows”: Study protocol and baseline data

“…Mitchell et al found that MSM cited rewards of sexual agreements included honesty, communication, clear expectations, intimacy and trust. Challenges included stigma about having an open agreement; awkwardness and jealousy [ 79 ]. Hoff et al found positive relationship dynamics are associated with less risk with partners outside the relationship, but were associated with greater odds of condomless anal sex (CAS) with primary partners [ 80 ].…”

Illuminating the Context and Circumstances of Male Couples Establishing a Sexual Agreement in Their Relationship

“…While there is a fairly thorough understanding about what motivates male couples to establish a sexual agreement (Gass et al, 2012; Hoff & Beougher, 2010; Mitchell, Lee, Woodyatt, Bauermeister, Sullivan, & Stephenson, 2016), the actual process and context of how this formation occurs is lacking in the literature. By using qualitative dyadic data from 29 concordant HIV-negative male couples residing in either the Atlanta, GA or Detroit, MI metro areas, the present study sought to: 1) report when the sexual agreement in the relationship was formed at the individual- and couple-levels; 2) investigate the context and circumstances that led to couples to establish a sexual agreement (i.e., the process) at the individual- and couple-levels; and 3) describe whether the timing, contexts and circumstances that led couples to form a sexual agreement differed by their agreement type.…”