Mitchell Jason W
a Health Promotion and Risk Reduction Programs , University of Michigan School of Nursing , Ann Arbor , MI , USA.
AIDS Care. 2014;26(9):1164-70. doi: 10.1080/09540121.2014.882491. Epub 2014 Feb 10.
Few HIV-preventing interventions exist for gay male couples in the USA, yet estimates indicate that between one- and two-thirds of US men who have sex with men acquire HIV while in a primary relationship (e.g., gay male couples). In response to these statistics, research has been conducted to better understand gay male couples' relationships, including their sexual agreements. Many gay male couples in the USA establish a sexual agreement, which is an explicit mutual understanding between two main partners about what sexual and other behaviors they agree to engage in and with whom while in the relationship. Although some research about sexual agreements has been conducted, little is known on whether aspects of gay male couples' sexual agreements (e.g., establishment, type, and adherence) vary as a function of their relationship length. The present study aimed to fulfill this gap of knowledge, which may lead to a better understanding of how agreements can be used for developing HIV/sexually transmitted infection (STI) prevention interventions. A national, cross-sectional, Internet-based study was used to collect dyadic data from 361 US gay male couples. Men in each couple completed the questionnaire independently. All analyses were employed at the couple level. Our findings showed that the longer the couples had been in their relationship, the more likely they would concur about having a sexual agreement. As relationship length increased, the proportion of couples who disagreed about their current agreement type increased. No direct trend was found for recent adherence to an agreement; however, the likelihood of ever breaking an agreement increased as relationship length increased. Findings from this study indicate there is a need to help gay male couples' establish and maintain their agreements, particularly for those who are in their early formative stages, as well as, for those who are experiencing challenges and/or changes in their relationships.
在美国，针对男同性恋伴侣的预防艾滋病干预措施很少，然而据估计，在美国与男性发生性关系的男性中，有三分之一到三分之二在建立主要关系（例如男同性恋伴侣关系）时感染了艾滋病病毒。针对这些统计数据，开展了相关研究，以更好地了解男同性恋伴侣关系，包括他们的性约定。美国许多男同性恋伴侣会达成性约定，这是两个主要伴侣之间就他们在关系存续期间同意进行的性行为和其他行为以及与谁进行这些行为达成的明确共识。虽然已经开展了一些关于性约定的研究，但对于男同性恋伴侣性约定的各个方面（例如约定的建立、类型和遵守情况）是否会随着他们关系持续时间的变化而有所不同，人们知之甚少。本研究旨在填补这一知识空白，这可能有助于更好地理解如何利用约定来制定预防艾滋病病毒/性传播感染（STI）的干预措施。一项基于互联网的全国性横断面研究收集了361对美国男同性恋伴侣的二元数据。每对伴侣中的男性独立完成问卷。所有分析均在伴侣层面进行。我们的研究结果表明，伴侣关系持续的时间越长，他们就越有可能就达成性约定达成一致。随着关系持续时间的增加，对当前约定类型存在分歧的伴侣比例也在增加。在近期遵守约定方面未发现直接趋势；然而，随着关系持续时间的增加，曾经违背约定的可能性也在增加。这项研究的结果表明，有必要帮助男同性恋伴侣建立并维持他们的约定，特别是对于那些处于关系形成早期阶段的伴侣，以及那些在关系中面临挑战和/或变化的伴侣。
