Center for Sexuality and Health Disparities, University of Michigan, 400 N Ingalls St., Ann Arbor, MI, 48109, USA.
School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Arch Sex Behav. 2019 May;48(4):1203-1216. doi: 10.1007/s10508-019-1391-z. Epub 2019 Mar 20.
Male couples often formulate sexual agreements, but little is known about the extent to which partners concur about their exact terms. Disagreements, particularly with respect to sex outside the relationship, may induce stress and potentially increase the risk of HIV and other sexually transmitted infections. Our study sought to describe concordance between male partners on several aspects of their sexual agreements, overall, as well as stratified by dyadic HIV serostatus and relationship duration. Between July 2014 and May 2016, we collected bidirectional data from 160 male couples residing in Atlanta, Boston, and Chicago. Overall, we observed weak concordance for whether or not couples had a mutual agreement about sex with outside partners. Even among 110 couples in which both partners reported having an agreement, there was weak-to-moderate concordance for general rules that might apply to having sex outside the relationship (e.g., forming emotional relationships is not allowed, outside sexual activities must be disclosed), and for specific sexual behaviors allowed or disallowed (e.g., topping without a condom, bottoming without a condom). Concordance for the type of sexual agreement was higher within HIV seroconcordant negative partnerships compared to HIV serodiscordant partnerships, and lower within relationships ≥ 5 years and 1 to < 5 years compared to those < 1 year. Dyadic interventions for male couples (e.g., couples HIV testing and counseling, relationship education programs) can offer unique opportunities for skills building around negotiating sexual agreements and might especially benefit HIV serodiscordant partnerships, and those in the formative stages of their relationships.
男性伴侣通常会制定性行为协议，但对于伴侣之间在具体条款上的一致性程度知之甚少。不一致，尤其是在性关系之外的性行为方面，可能会导致压力，并可能增加感染艾滋病毒和其他性传播感染的风险。我们的研究旨在描述男性伴侣在几个方面对其性行为协议的一致性，包括总体情况以及根据对偶 HIV 血清学状况和关系持续时间进行分层的情况。2014 年 7 月至 2016 年 5 月期间，我们从居住在亚特兰大、波士顿和芝加哥的 160 对男性伴侣那里收集了双向数据。总体而言，我们观察到伴侣之间是否对与外部伴侣发生性行为达成一致意见的一致性较弱。即使在 110 对报告双方都达成一致意见的伴侣中，对于可能适用于性关系之外性行为的一般规则（例如，不允许形成情感关系，必须披露外部性活动）以及允许或不允许的特定性行为（例如，不戴安全套的顶入，不戴安全套的插入）也存在弱到中度的一致性。在 HIV 血清学一致的阴性伴侣关系中，性行为协议的类型一致性高于 HIV 血清学不一致的伴侣关系，而在关系持续时间≥5 年和 1 至<5 年的伴侣关系中，低于<1 年的伴侣关系。男性伴侣的对偶干预措施（例如，伴侣 HIV 检测和咨询、关系教育计划）可以为协商性行为协议提供独特的机会，这可能对 HIV 血清学不一致的伴侣关系以及关系处于形成阶段的伴侣关系特别有益。
