Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.
Am J Drug Alcohol Abuse. 2011 Sep;37(5):294-300. doi: 10.3109/00952990.2011.596874.
HIV prevention interventions often promote monogamy to reduce sexual risk. However, there is little consensus about how to define monogamy.
To determine the extent to which recent monogamy and/or being in a committed relationship serve as markers for low sexual risk among men in substance abuse treatment.
Participants were 360 men enrolled in the National Institute on Drug Abuse Clinical Trials Network "Real Men Are Safe" protocol who completed all assessments (baseline, 3 months, and 6 months). Self-reported behaviors included number of sexual partners, type of relationships, frequency of vaginal/anal intercourse, and percentage of condom use.
The rate of self-reported monogamy in the prior 90 days was stable across assessments (54.2%, 53.1%, 58.3%). However, at each assessment 7.5-10% of monogamous men identified their partner as a casual partner, and only 123 (34.2%) reported being monogamous at every assessment. Of these, 20 (5.6%) reported being monogamous with different partners across assessments. Men with both committed relationship and casual partners reported more condom use with their committed relationship partners than men with only a committed relationship partner.
Clinicians and researchers should consider individual relationship context and behavior and avoid assuming that recent monogamy or being in a committed relationship denotes low risk.
This study provides evidence that, in male drug users, monogamy does not necessarily reflect low sexual risk. Rather, "monogamous" men actually encompass various combinations of partner types and levels of risk behavior that are unstable, even over brief time periods. Clinicians and researchers must take these variations into account.
艾滋病毒预防干预措施通常提倡一夫一妻制以降低性风险。然而，对于一夫一妻制的定义，尚未达成共识。
确定在物质滥用治疗中，最近的一夫一妻制和/或处于承诺关系在多大程度上可作为男性低性风险的标志。
360 名参加国家药物滥用研究所临床研究网络“真正的男人是安全的”方案的男性参与者完成了所有评估（基线、3 个月和 6 个月）。自我报告的行为包括性伴侣数量、关系类型、阴道/肛门性交频率以及避孕套使用率。
在过去 90 天内，自我报告的一夫一妻制率在各评估中保持稳定（54.2%、53.1%、58.3%）。然而，在每个评估中，有 7.5-10%的一夫一妻制男性将其伴侣认定为偶然伴侣，只有 123 名（34.2%）报告在每次评估中都是一夫一妻制。在这些男性中，有 20 名（5.6%）报告在不同评估中与不同的伴侣保持一夫一妻制。既有承诺关系伴侣又有偶然伴侣的男性与只有承诺关系伴侣的男性相比，与承诺关系伴侣的性行为中使用避孕套的频率更高。
临床医生和研究人员应考虑个体关系背景和行为，避免假定最近的一夫一妻制或处于承诺关系表示低风险。
本研究提供了证据表明，在男性吸毒者中，一夫一妻制不一定反映低性风险。相反，“一夫一妻制”的男性实际上包括各种伴侣类型和风险行为水平的组合，这些组合甚至在短时间内也是不稳定的。临床医生和研究人员必须考虑到这些变化。
