Understanding why gay men seek HIV‐seroconcordant partners: Intimacy and risk reduction motivations

Abstract

Our goal was to situate the interest of some gay men in having HIV-seroconcordant partners within the psychosocial context of concurrent motivations for intimacy and sexual risk reduction. Data were obtained from semi-structured qualitative interviews with a racially/ethnically diverse sample of 32 gay men (16 HIV-positive and 16 HIV-negative) living in New York City who sought HIV-seroconcordant partners. Thematic analysis indicated that seroconcordant partner selection was strongly motivated by a desire to reduce sexual risk as well as the pursuit of multiple forms of intimacy. Affirmative experiences in seroconcordant relationships and goals for future long-term relationships also informed men's current partner selection practices. When seeking seroconcordant partners, men reported key junctures and disjunctures between motivations for intimacy and interests in risk reduction. Our findings suggest that HIV prevention efforts will have greater relevance if they address broader motivational concerns for partner selection and serosorting, including the pursuit of intimacy.

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

“…[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. 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.…”

“…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. 7,10,13 Loneliness, (for concordant positive couples) and HIV-specific social support (for concordant positive couples and discordant couples) were associated with lower odds of UAIPP. Feeling lonely could diminish one's desire for sex and having a partner who provides more HIV-specific social support may reduce the odds of UAI with one's primary partner, which could decrease the chances of HIV transmission to the HIV-negative partner in discordant relationships or reduce the transmission of STIs among concordant HIVpositive couples.…”

“…[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. 20 Finally, MSM in relationships may experience condom fatigue or mistakenly perceive themselves to be low risk due to their relationship status or access to new biomedical interventions.…”

Risk Behaviors Among HIV-Positive Gay and Bisexual Men at Party-Oriented Vacations

“…However, it is crucial not to place undue emphasis on this population at the cost of increasing stigma toward or discrimination against HIV-positive individuals. Some studies show that HIV-positive individuals engage in more safe sex behaviors than those who are HIV negative (e.g., Robinson et al, 2011) and that many HIV-positive individuals are motivated by a desire to reduce sexual risk (Frost et al, 2008;Rutledge, 2009;Serovich and Mosack, 2003;Wolitski et al, 2003). Moreover, given the complex and unclear relationship between drug use and unprotected sex at high-risk events, interventions should target factors in addition to, or other than, drug use alone.…”

“…Although many HIV-positive MSM are motivated by a desire to reduce sexual risk (Frost et al, 2008;Serovich and Mosack, 2003;Wolitski et al, 2003), research also suggests that for some, sex without condoms may be "a default circumstance to be interrupted only when a partner asserts a need to protect himself " (Adam et al, 2008, p. 759). In other words, telling a sex partner about one's HIV status could aid in prevention in situations where seroconcordance is assumed and desired by one or more partner(s).…”