The Challenges to Intimacy and Sexual Relationships for Gay Men in Hiv Serodiscordant Relationships: A Pilot Study

Abstract

Human Immunodeficiency Virus (HIV) infection and disease progression create imbalance in long-term, HIV-serodiscordant, gay male relationships, particularly in sexual relations and issues of physical and emotional intimacy. Stage of disease progression and worldview of the couple both affect the relationship and its survival. To redress imbalance, partners employ a range of coping strategies and techniques. This article explores these issues in the context of HIV serodiscordant gay couples and how they preserve their relationships in the face of these unique challenges. For workers who provide psychotherapeutic and community support for people with HIV and for their partners, the results of this study may be helpful in recognizing stress factors for couples, and tailoring support services to the needs of both partners. Overall, this study provides a basis for further work examining the dynamics of serodiscordant relationships.

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

“…The fact that many of the discordant couples in this study engaged in UAI may support earlier findings of condom fatigue, perception of low risk due to undetectable viral load, and the sense that condoms represent a barrier to establishing trust, intimacy, and pleasure. 4,7,13,16,18,24 Relationship dynamics associated with sexual behavior revealed differences as well as similarities by partner type (i.e., primary vs. outside partners of discordant or unknown HIV status) and couple serostatus. Attachment (for concordant positive and discordant couples) and intimacy (for concordant negative couples), two variables that convey relationship closeness, were positively associated with UAI with one's primary partner, findings that fit nicely with existing research on why many couples typically avoid condoms.…”

“…For instance, couples may forgo condoms to establish trust, build intimacy, increase sexual pleasure, and demonstrate their commitment to the relationship. [6][7][8]10,[13][14][15][16][17][18] They may also do so as a result of their agreements about sex, preferences for sexual positions, or in light of each partner's HIV status. 1,3,5,6,10,13,19 While knowledge and disclosure of HIV status is critical in condom decision-making, testing rates among HIV-negative MSM in committed relationships, are lower than those in the general MSM population, even in the presence of risky sexual behavior.…”

A Relationship-Oriented Model of HIV-Related Stigma Derived from a Review of the HIV-Affected Couples Literature

“…Next, emotional shifting is a term used by Beckerman (2002) to describe the possibility that HIV-affected couples oscillate between periods of emotional intimacy and periods of emotional distancing. Accordingly, more than half of the reviewed qualitative studies (Beckerman et al 2000;Beckerman 2002;Bogart et al 2000;D'cruz 2003;Palmer and Bor 2001;Powell-Cope 1995;Remien et al 1995;van der Straten et al 1998) reveal themes consistent with this phenomenon. A serodiscordant couple member may be describing shifting toward emotional intimacy by stating, ''We are more dear to each other because we understand the fragility of our life together'' (Beckerman 2002 p. 57).…”

Dating and Sexual Challenges Faced by Hiv-Positive People in Kwazulu-Natal, South Africa

“…Non-disclosure was also cited as protecting family members from the pain of "knowing", and is mentioned by Palmer and Bor (2001). In the present study it produced negative consequences, as mentioned below:…”