Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges

Purcell, David W.; Mizuno, Yuko; Smith, Dawn K.; Grabbe, Kristina L.; Courtenay‐Quirk, Cari; Tomlinson, Hank; Mermin, Jonathan

doi:10.1007/s10508-013-0205-y

Cited by 35 publications

(29 citation statements)

References 82 publications

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“…New research shows that sexual negotiations begin early in the relationship, before couples discuss their agreements about whether to allow sex with outside partners and that having an agreement is associated with testing (Mitchell, in press; Mitchell & Petroll, 2012a). Messages, announcements, and campaigns that emphasize testing could encourage men to do so when forming their sexual agreements (i.e., whether to allow sex with outside partners) early in their relationships as this may be a time when HIV risk is elevated and they are motivated (Davidovich, et al, 2004; Purcell, et al, 2014; Rendina, et al, 2014). These efforts need not end where relationships begin, as there are opportunities to emphasize HIV testing for partners in couples throughout the course of the relationship.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that men in relationships endorse CHTC and that CHTC supports the relationship (Stephenson, et al, 2011; Wagenaar, et al, 2012). Gay men’s testing during relationship formation to establish trust and commitment could dovetail with efforts that promote HIV testing for gay men in relationships (Purcell, et al, 2014). Home testing for HIV has been shown to be popular among and empowering to gay men and to increase HIV testing (Carballo-Diéguez, Frasca, Balan, Ibitoye, & Dolezal, 2012; Carballo-Diéguez, Frasca, Dolezal, & Balan, 2012; MacKellar, et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Motivations to Test for HIV Among Partners in Concordant HIV-Negative and HIV-Discordant Gay Male Couples

et al. 2014

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Previous studies of HIV testing among gay men describe the motivations, facilitators and barriers, behaviors, and demographic characteristics of individuals who test. What little research focuses on HIV testing among gay men in relationships shows that they do not test regularly or, in some cases, at all – their motivations to test have not been investigated. With so little data on HIV testing for this population, and the continued privileging of individually-focused approaches, gay men in relationships fall into a blind spot of research and prevention efforts. This study examined motivations to test for HIV using qualitative data from both partners in 20 gay male couples. Analysis revealed that the partners’ motivations were either event-related (e.g., participants testing the beginning of their relationship or HIV-negative participants in an HIV-discordant relationship testing after risky episode with their discordant primary partner) or partner-related (e.g., participants testing in response to a request or suggestion to test from their primary partner or participants testing out of concern for their primary partner’s health and wellbeing). These data provide insight into relationship-oriented motivations to test for HIV for gay men in relationships and, in doing so, demonstrates their commitment to their primary partner and relationship. These motivations can be leveraged to increase HIV testing among gay men in relationships, a population that tests less often than single gay men, yet, until recently, has been underserved by prevention efforts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Motivations to Test for HIV Among Partners in Concordant HIV-Negative and HIV-Discordant Gay Male Couples

et al. 2014

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“…It is estimated that 33-67% of HIV infections in MSM are acquired from primary sexual partners (204) and in the UK approximately 40% of MSM are in a regular relationship at the time of diagnosis (7). A high proportion of young MSM interviewed in Scotland aspired to sex within relationships (205) and proofreading changes included in published version which is available on the BASHH website.…”

Section: Motivation For and Barriers To Hiv Testingmentioning

confidence: 99%

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

et al. 2018

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This guideline is intended for use in UK Genitourinary medicine clinics and sexual health services but is likely to be of relevance in all sexual health settings, including general practice and Contraception and Sexual Health (CASH) services, where men who have sex with men (MSM) seek sexual health care or where addressing the sexual health needs of MSM may have public health benefits. For the purposes of this document, MSM includes all gay, bisexual and all other males who have sex with other males and both cis and trans men. This document does not provide guidance on the treatment of particular conditions where this is covered in other British Association for Sexual Health and HIV (BASHH) Guidelines but outlines best practice in multiple aspects of the sexual health care of MSM. Where prevention of sexually transmitted infections including HIV can be addressed as an integral part of clinical care, this is consistent with the concept of combination prevention and is included. The document is designed primarily to provide guidance on the direct clinical care of MSM but also makes reference to the design and delivery of services with the aim of supporting clinicians and commissioners in providing effective services. Methodology This document was produced in accordance with the guidance set out in the BASHH CEG’s document ‘Framework for guideline development and assessment’ published in 2010 at http://www.bashh.org/guidelines and with reference to the Agree II instrument. Following the production of the updated framework in April 2015, the GRADE system for assessing evidence was adopted and the draft recommendations were regraded. Search strategy (see also Appendix 1) Ovid Medline 1946 to December 2014, Medline daily update, Embase 1974 to December 2014, Pubmed NeLH Guidelines Database, Cochrane library from 2000 to December 2014. Search language English only. The search for Section 3 was conducted on PubMed to December 2014. Priority was given to peer-reviewed papers published in scientific journals, although for many issues evidence includes conference abstracts listed on the Embase database. In addition, for ‘Identification of problematic recreational drug and alcohol use’ section and ‘Sexual problems and dysfunctions in MSM’ section, searches included PsycINFO. Methods Article titles and abstracts were reviewed and if relevant the full text article was obtained. Priority was given to randomised controlled trial and systematic review evidence, and recommendations made and graded on the basis of best available evidence. Piloting and feedback The first draft of the guideline was circulated to the writing group and to a small group of relevant experts, third sector partners and patient representatives who were invited to comment on the whole document and specifically on particular sections. The revised draft was reviewed by the CEG and then reviewed by the BASHH patient/public panel and posted on the BASHH website for public consultation. The final draft was piloted before publication. Guideline update The guidelines will be reviewed and revised in five years’ time, 2022.

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“…HIV research among GBM has identified the importance of focusing on same-sex male dyads, recognizing that it is important to understand not only individual-level decision-making, but decisions about relationships and sex that occur between partners (Mustanski & Parsons, 2014;Purcell et al, 2014). The influence of one'spartner's identity on perceptions and the inferences made about risk based on perceptions of a population's risk level add an additional layer to the understanding of how an individual's gay identity, or their perception of other's identities, influences their willingness to participate in sexual risk-taking.…”

Section: Discussionmentioning

confidence: 99%

“I consider being gay a very high risk factor”: How Perceptions of a Partner’s Sexual Identity Influence Perceptions of HIV Risk Among Gay and Bisexual Men

et al. 2016

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Gay and bisexual men (GBM) in the USA experience a disproportionate burden of new HIV infections. Previous studies demonstrate that gay self-identification and outness are associated with GBM's sexual risk-taking behaviors. However, little is known about the extent to which GBM make sexual decisions based on the level of HIV risk they associate with a male partner's sexual identity. Using qualitative interviews with 13 GBM, we examine how a partner's gay identification, outness, and sex with women influence perceptions of HIV risk and decisions about condoms. Participants discussed a reduced HIV risk perception for partners who were not gay-identified, not out, or having sex with women, based on the belief that they were not having sex with other men. Some participants stated that this could lead to condomless sex. Participants perceived lower risk despite stating that these partners had reduced exposure to HIV prevention interventions and increased substance use during intercourse. These findings indicate a potential discrepancy between how GBM perceive HIV risk and the behavioral factors associated with risk. HIV prevention messages and policies should focus on tackling the myth that a non-gay identity is protective of HIVand decentralize messages and policies from being only about gay men.

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Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges

Cited by 35 publications

References 82 publications

Motivations to Test for HIV Among Partners in Concordant HIV-Negative and HIV-Discordant Gay Male Couples

Motivations to Test for HIV Among Partners in Concordant HIV-Negative and HIV-Discordant Gay Male Couples

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

“I consider being gay a very high risk factor”: How Perceptions of a Partner’s Sexual Identity Influence Perceptions of HIV Risk Among Gay and Bisexual Men

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