Hoff Colleen C, Beougher Sean C, Chakravarty Deepalika, Darbes Lynae A, Neilands Torsten B
Center for Research on Gender and Sexuality, San Francisco State University, San Francisco, CA, USA.
AIDS Care. 2010 Jul;22(7):827-35. doi: 10.1080/09540120903443384.
Gay men in relationships are often overlooked in HIV prevention efforts, yet many engage in sexual behaviors that increase their HIV risk and some seroconvert as a result. While different aspects of gay male relationships have been studied, such as sexual agreements, relationship characteristics, and couple serostatus, little research combines these elements to examine HIV risk for this population. The present study recruited 566 gay male couples from the San Francisco Bay Area to study their sexual agreements, motivations behind making agreements, and other relationship characteristics, such as agreement investment, relationship satisfaction, intimacy, and communication. Participants rated their level of concurrence with a set of reasons for making their agreements. They were also measured on relationship characteristics using standard instruments. Analyses were conducted by agreement type (monogamous, open, and discrepant) and couple serostatus (concordant negative, concordant positive, and discordant). A majority reported explicitly discussing their agreements and nearly equal numbers reported being in monogamous and open relationships. A small number (8%) reported discrepant agreements. Across all agreement type and serostatus groups, HIV prevention as a motivator for agreements fell behind every motivator oriented toward relationship-based factors. Only concordant negative couples endorsed HIV and STD prevention among their top motivators for making an agreement. Mean scores on several relationship characteristics varied significantly. Couples with monogamous agreements had higher scores on most relationship characteristics, although there was no difference in relationship satisfaction between couples with monogamous and open agreements. Scores for concordant positive couples were distinctly lower compared to concordant negative and discordant couples. Agreements, the motivations behind them, and the relationship characteristics associated with them are an important part of gay male relationships. When examined by agreement type and couple serostatus, important differences emerge that must be taken into account to improve the effectiveness of future HIV prevention efforts with gay couples.
处于恋爱关系中的男同性恋者在艾滋病预防工作中常常被忽视，然而他们中的许多人会进行增加感染艾滋病风险的性行为，并且有些人因此血清转化。虽然男同性恋关系的不同方面已被研究，如性协议、关系特征和伴侣血清状态，但很少有研究将这些因素结合起来考察这一人群的艾滋病风险。本研究从旧金山湾区招募了566对男同性恋伴侣，以研究他们的性协议、达成协议背后的动机以及其他关系特征，如协议投入、关系满意度、亲密感和沟通情况。参与者对他们对达成协议的一系列原因的认同程度进行了评分。他们还使用标准工具对关系特征进行了测量。分析按协议类型（一夫一妻制、开放式和不一致型）和伴侣血清状态（血清阴性一致、血清阳性一致和不一致）进行。大多数人报告明确讨论过他们的协议，报告处于一夫一妻制和开放式关系的人数几乎相等。少数人（8%）报告了不一致的协议。在所有协议类型和血清状态组中，将预防艾滋病作为达成协议的动机落后于每一个基于关系因素的动机。只有血清阴性一致的伴侣将预防艾滋病和性传播感染列为达成协议的首要动机之一。几个关系特征的平均得分有显著差异。一夫一妻制协议的伴侣在大多数关系特征上得分较高，尽管一夫一妻制和开放式协议的伴侣在关系满意度上没有差异。血清阳性一致的伴侣的得分明显低于血清阴性一致和不一致的伴侣。协议、其背后的动机以及与之相关的关系特征是男同性恋关系的重要组成部分。当按协议类型和伴侣血清状态进行考察时，会出现一些重要差异，必须加以考虑，以提高未来针对男同性恋伴侣的艾滋病预防工作的有效性。
