The Gay Couples Study seeks to identify and examine relationship dynamics in gay and bisexual male couples and explore how those dynamics may affect sexual risk behaviors with primary and outside partners. Relationship dynamics include issues such as communication, power, and agreements about whether or not to allow sex with outside partners. Other objectives include exploring factors associated with how, why, and when couples make sexual agreements, examining the various types and styles of those agreements, and describing how they differ relative to couple serostatus.
The Gay Couples Study is a single-site study conducted in four phases. In the first phase, the Qualitative Phase, 39 couples participated in face-to-face, in-depth, semi-structured interviews. Once analyzed, those interviews revealed common themes, many of which were integrated into a unique and original survey instrument, the Sexual Agreement Investment Scale. This scale, coupled with other psychological and behavioral measurements, was combined into one survey and pilot-tested for validity and reliability with 200 couples during the second phase, the Pilot Phase. In the next phase, the Cross-Sectional Phase, 450 couples were recruited to take the survey. Using a larger pool of participants, various themes and research questions within the survey were explored in greater detail.
For the final and current phase, the Longitudinal Phase, 116 additional couples were recruited and all 566 will be followed over a three year period to monitor how and when their relationships and sexual agreements change over time. The Longitudinal Phase includes two sets of additional qualitative interviews, one that examines themes similar to the survey and another that explores the impact of language, culture, and ethnicity for monolingual Spanish speakers.
All couples participating in the study will be surveyed six
times over three years. The first follow-up survey (T2) occurs
one year after Baseline. The four remaining follow-up surveys
(T3 – T6) occur every six months thereafter for the
last two years. Baseline surveys were completed in February
2007, T2 in February 2008, and T3 in August/September 2008.
Previous research shows that gay and bisexual men in relationships engage in substantially higher rates of unprotected anal intercourse (UAI) with their primary partners than do single men with their casual partners. Additionally, studies differentiating relationships by partner serostatus have found that men with seroconcordant partners report significantly higher rates of UAI than men with serodiscordant partners. Although a desire for more intimacy in the relationship may contribute to couples engaging in UAI with each other, serostatus differences, in addition to the couple’s sexual agreements, present new questions and challenges for HIV prevention research. For example, whether these behaviors are ‘risky’ depends on many factors and needs to be further explored.
With high rates of seroconversion among gay male couples,
and primary partners an often unrecognized and under-studied
source of new HIV infections, studying gay and bisexual male
couples is an important next step in HIV research and prevention.
What have we discovered so far?
Initial findings revealed during the Qualitative Phase include some of the motivations for developing and maintaining sexual agreements, such as to support stronger, healthier, and more satisfying relationships and non-heteronormative identities; to emphasize trust, safety, love, and commitment; and, to a lesser extent, to avoid HIV and STD infection.
Agreements about whether or not to allow sex with outside partners covered a wide range of types, including “traditional” monogamous arrangements as well as those that permitted sex with outside partners. For those couples who allowed sex with outside partners, most placed rules or conditions limiting when, where, how often, and with whom outside sex was permitted. How couples handled breaks in their agreements varied, depending on what condition was broken, whether it was disclosed, and the partner’s reaction. In general, disclosure benefited the relationship by giving couples the opportunity to discuss their needs and expectations and by allowing an opportunity for increased communication about and renegotiation of the agreement, if necessary.
Analysis of data from the Pilot and Cross-Sectional Phases is ongoing and several manuscripts are currently in production. Please contact the Principal Investigator or Project Director for more information.
This study is made possible by grants from the National Institutes
of Mental Health, R01MH 75598 & MH 65141.