Seroconversion in context

Kippax, Susan; Slavin, Sean; Ellard, Jeanne; Hendry, Olympia; Richters, Juliet; Grulich, Andrew E.; Kaldor, John

doi:10.1080/09540120310001618685

Cited by 59 publications

(62 citation statements)

References 34 publications

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“…While an association between positive relationship dynamics and sexual risk behavior may seem paradoxical, evidence suggests that factors such as closeness, investment in and dependence on the relationship, the desire for a stable and lasting relationship, and relationship satisfaction are associated with UAI (4,5). For example, as couples grow closer, 3 taking risks such as engaging in UAI may be seen as part of building trusting, commitment and love (5).…”

Section: Introductionmentioning

confidence: 99%

Relationship Dynamics as Predictors of Broken Agreements About Outside Sexual Partners: Implications for HIV Prevention Among Gay Couples

et al. 2011

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Agreements about allowing sex with outside partners are common among gay couples, and breaks in these agreements can be indicative of HIV risk. Using longitudinal survey data from both partners in 263 gay couples, we investigate whether relationship dynamics are associated with broken agreements. 23% of respondents report breaking their agreement.Partners who report higher levels of trust, communication, commitment, and social support are significantly less likely to report breaking their agreement. Promoting positive relationship dynamics as part of HIV prevention interventions for gay couples provides the opportunity to minimize the occurrence of broken agreements and, ultimately, reduce HIV risk.2

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Section: Introductionmentioning

confidence: 99%

Relationship Dynamics as Predictors of Broken Agreements About Outside Sexual Partners: Implications for HIV Prevention Among Gay Couples

et al. 2011

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“…2,3,10,11 Epidemiological investigations provide additional support for these findings by attributing the source of many new HIV infections to primary partners. 6,7,9,12 Various relationship dynamics are associated with decreased condom use among MSM in relationships, each one reducing it in its own way. For instance, couples may forgo condoms to establish trust, build intimacy, increase sexual pleasure, and demonstrate their commitment to the relationship.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Behavioral studies consistently find that men are more likely to engage in unprotected anal intercourse (UAI) with primary partners than with outside partners, especially in concordant relationships. 2,3,10,11 Epidemiological investigations provide additional support for these findings by attributing the source of many new HIV infections to primary partners.…”

Section: Introductionmentioning

confidence: 99%

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

Hoff

Chakravarty

Beougher

et al. 2012

AIDS Patient Care and STDs

115

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Understanding situations that increase HIV risk among men who have sex with men (MSM) requires consideration of the context in which risky behaviors occur. Relationships are one such context. This study examines the presence and predictors of unprotected anal intercourse (UAI) in the past 3 months among 566 MSM couples. A majority of couples allowed sex with outside partners. Overall, 65% of the sample engaged in UAI with primary partner, including nearly half of discordant couples. Positive relationship factors, such as attachment and intimacy, were associated with an increased likelihood of UAI with primary partner. Meanwhile, 22% of the sample engaged in at least one episode of UAI with an outside partner, half of whom were discordant or unknown HIV status outside partners. Higher levels of HIV-specific social support, equality, and sexual agreement investment were significantly associated with a decreased likelihood of engaging in UAI with a discordant or unknown HIV status outside partner. HIV-positive men in discordant relationships had two and one half times the odds of having UAI with a discordant or unknown HIV status outside partner as their HIVnegative partners. Many MSM in relationships, including some in serodiscordant ones, engage in UAI with primary partners. Potential explanations include relationship closeness, relationship length, and agreement type. In addition, relationship context appears to have a differential impact upon UAI with primary and outside partners, implying that prevention messages may need to be tailored for different types of couples. Prevention efforts involving MSM couples must take into account relationship characteristics as couples balance safer sex and HIV risk with intimacy and pleasure.

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“…41 Respondents in PSPs were also less likely to engage in practices essential to the ongoing maintenance of negotiated safety agreements, such as regularly discussing with that partner their agreement and testing for HIV over time. 4 Within partnerships of unknown seroconcordance, agreements about both monogamy and reducing risk from outside partners were less common, as was general discussion of HIV risk. Attempts were made at some form of negotiated safety in approximately one-quarter of unknown seroconcordance PSPs and nearly two-thirds of RCRs.…”

Section: Discussionmentioning

confidence: 99%

“…3 Approximately one-third of infections among newly diagnosed men in Australia are estimated to be from regular partners, [4][5][6] whereas modelling from the US estimates that 68% of infections in GBM are from 'main' partners. 7 Intimacy and familiarity with partners have been associated with increased CLAI among GBM, [8][9][10][11] and HIV prevention and research have described ongoing sexual relationships as potentially high risk for HIV transmission.…”

Section: Introductionmentioning

confidence: 99%

How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men

et al. 2017

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Abstract. Background: Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission. Methods: An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. Results: Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. Conclusion: CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be addressed by HIV education.Additional keywords: HIV prevention, men who have sex with men, relationships.

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Seroconversion in context

Cited by 59 publications

References 34 publications

Relationship Dynamics as Predictors of Broken Agreements About Outside Sexual Partners: Implications for HIV Prevention Among Gay Couples

Relationship Dynamics as Predictors of Broken Agreements About Outside Sexual Partners: Implications for HIV Prevention Among Gay Couples

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men

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