Abstract
Main partnerships represent one context in which HIV transmission may occur that has been insufficiently addressed to date for gay and bisexual men, but few studies have focused on the acceptability of couples-based voluntary HIV counseling and testing (CVCT) for male couples in the U.S. Our aim in this study was to explore the acceptability of CVCT among a national U.S. sample of 1,532 gay and bisexual men surveyed online using a sexual networking site. We examined the role of demographic (i.e., geographic region, age, relationship status, sexual orientation, race/ethnicity) and HIV risk (i.e., substance use, number of sexual partners, unprotected anal intercourse, sexual role identity, and sexual compulsivity) factors that may be associated with CVCT among the full sample and among partnered men separately. We found that single men expressed higher interest in CVCT than partnered men and that greater age was more strongly associated with lower interest in CVCT for partnered men than for single men. The intersection of sexual orientation and race/ethnicity was also significantly associated with CVCT interest, with a higher proportion of Black bisexual men being interested than White bisexual men. These findings suggest that the uptake of CVCT may be less impacted by HIV risk factors than by demographic factors and that young gay and bisexual men of color—for whom rates of HIV continue to rise—may be the group with the highest levels of interest in CVCT.
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References
Ackers, M. L., Greenberg, A. E., Lin, C. Y., Bartholow, B. N., Goodman, A. H., Longhi, M., et al. (2012). High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities. PLoS ONE, 7, e34972. doi:10.1371/journal.pone.0034972.
Allen, S., Meinzen-Derr, J., Kautzman, M., Zulu, I., Trask, S., Fideli, U., et al. (2003). Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS, 17, 733–740. doi:10.1097/01.aids.0000050867.71999.ed.
Allen, S., Serufilira, A., Bogaerts, J., Ven de Perre, P., Nsengumuremyi, F., Lindan, C., et al. (1992). Confidential HIV testing and condom promotion in Africa: Impact on HIV and gonorrhea rates. Journal of the American Medical Association, 268, 3338–3343. doi:10.1001/jama.1992.03490230068030.
Benotsch, E. G., Kalichman, S. C., & Pinkerton, S. D. (2001). Sexual compulsivity in HIV-positive men and women: Prevalence, predictors, and consequences of high-risk behaviors. Sexual Addiction and Compulsivity, 8, 83–99. doi:10.1080/10720160127561.
Burton, J., Darbes, L. A., & Operario, D. (2010). Couples-focused behavioral interventions for prevention of HIV: Systematic review of the state of evidence. AIDS and Behavior, 14, 1–10. doi:10.1007/s10461-008-9471-4.
Centers for Disease Control and Prevention. (2010). CDC analysis provides new look at disproportionate impact of HIV and syphilis among U.S. gay and bisexual men. Atlanta: U.S. Department of Health and Human Services. Retrieved from http://www.cdc.gov/nchhstp/Newsroom/msmpressrelease.html.
Centers for Disease Control and Prevention. (2011). HIV surveillance report, 2009. Atlanta: U.S. Department of Health and Human Services. Retrieved from http://www.cdc.gov/hiv/pdf/statistics_2009_HIV_Surveillance_Report_vol_21.pdf.
Chomba, C., Allen, S., Kaweka, W., Tichacek, A., Cox, G., Shutes, E., et al. (2008). Evolution of couples’ voluntary counseling and testing for HIV in Lusaka, Zambia. Journal of Acquired Immune Deficiency Syndrome, 47, 108–115. doi:10.1097/QAI.0b013e31815b2d67.
Coates, T. J. (2000). Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: A randomised trial. Lancet, 356, 103–112. doi:10.1016/S0140-6736(00)02446-6.
Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity, 7, 5–29. doi:10.1080/10720160008400205.
Davidovich, U., Wit, J., & Strobbe, W. (2006). Relationship characteristics and risk of HIV infection: Rusbult’s investment model and sexual risk behavior of gay men in steady relationships. Journal of Applied Social Psychology, 36, 22–40. doi:10.1111/j.0021-9029.2006.00002.x.
El-Bassel, N., Gilbert, L., Witte, S., Wu, E., Hunt, T., & Remien, R. H. (2010). Couple-based HIV prevention in the United States: Advantages, gaps, and future directions. Journal of Acquired Immune Deficiency Syndromes, 55, S98–S101. doi:10.1097/QAI.0b013e3181fbf407.
Farquhar, C., Kiarie, J. N., Richardson, B. A., Kabura, M., Francis, J., Nduati, R., et al. (2004). Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. Journal of Acquired Immune Deficiency Syndrome, 37, 1620–1626. doi:10.1097/00126334-200412150-00016.
Gere, J., Schimmack, U., Pinkus, R. T., & Lockwood, P. (2011). The effects of romantic partners’ goal congruence on affective well-being. Journal of Research in Personality, 45, 549–559. doi:10.1016/j.jrp.2011.06.010.
Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39, 940–949. doi:10.1007/s10508-009-9483-9.
Grov, C., Starks, T. J., Rendina, H. J., & Parsons, J. (2012). Rules about casual sex partners, relationship satisfaction, and HIV risk in partnered gay and bisexual men. Journal of Sex and Marital Therapy,. doi:10.1080/0092623X.2012.691948.
Guthrie, B. L., de Bruyn, G., & Farquhar, C. (2007). HIV-1 discordant couples in sub-Saharan Africa: Explanations and implications for high rates of discordancy. Current HIV Research, 5, 416–429. doi:10.2174/157016207781023992.
Hook, J. N., Hook, J. P., Davis, D. E., Worthington, E. L., & Penberthy, J. K. (2010). Measuring sexual addiction and compulsivity: A critical review of instruments. Journal of Sex and Marital Therapy, 36, 227–260. doi:10.1080/00926231003719673.
Houts, C. R., & Horne, S. G. (2008). The role of relationship attributions in relationship satisfaction among cohabiting gay men. The Family Journal, 16, 240–248. doi:10.1177/1066480708318887.
Kalichman, S. C., Johnson, J. R., Adair, V., Rompa, D., Multhauf, K., & Kelly, J. A. (1994). Sexual sensation seeking: Scale development and predicting AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62, 385–397. doi:10.1207/s15327752jpa6203_1.
Kalichman, S. C., & Rompa, D. (2001). The Sexual Compulsivity Scale: Further development and use with HIV-positive persons. Journal of Personality Assessment, 76, 379–395. doi:10.1207/S15327752JPA7603_02.
Kelley, H. H., & Thibaut, J. W. (1978). Interpersonal relations: A theory of interdependence. New York: Wiley.
Kurdek, L. A. (2007). Avoidance motivation and relationship commitment in heterosexual, gay male, and lesbian partners. Personal Relationships, 14, 291–306. doi:10.1111/j.1475-6811.2007.00155.x.
Lewis, M. A., Gladstone, E., Schmal, S., & Darbes, L. A. (2006). Health-related social control and relationship interdependence among gay couples. Health Education Research, 21, 488–500. doi:10.1093/her/cyh075.
Margolis, A. D., Joseph, H., Belcher, L., Hirshfield, S., & Chiasson, M. A. (2012). ‘Never testing for HIV’ among men who have sex with men recruited from a sexual networking website, United States. AIDS and Behavior, 16, 23–29. doi:10.1007/s10461-011-9883-4.
Mitchell, J. W., & Petroll, A. E. (2012a). Factors associated with men in HIV-negative gay couples who practiced UAI within and outside of their relationship. AIDS and Behavior, 17, 1329–1337. doi:10.1007/s10461-012-0255-5.
Mitchell, J. W., & Petroll, A. E. (2012b). HIV testing rates and factors associated with recent HIV testing among male couples. Sexually Transmitted Diseases, 39(379–381), 3. doi:10.1097/OLQ.1090b1013e3182479108.
Painter, T. M. (2001). Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Social Science and Medicine, 53, 1397–1411. doi:10.1016/S0277-9536(00)00427-5.
Parsons, J. T., Bimbi, D. S., & Halkitis, P. N. (2001). Sexual compulsivity among gay/bisexual male escorts who advertise on the Internet. Sexual Addiction & Compulsivity, 8, 101–112. doi:10.1080/10720160127562.
Parsons, J. T., Starks, T. J., Gamarel, K. E., & Grov, C. (2012). Non-monogamy and sexual relationship quality among same-sex male couples. Journal of Family Psychology, 26, 669–677. doi:10.1037/a0029561.
Prejean, J., Song, R., Hernandez, A., Ziebell, R., Green, T., Walker, F., et al. (2011). Estimated HIV incidence in the United States, 2006–2009. PLoS ONE, 6, e17502. doi:10.1371/journal.pone.0017502.
Rendina, H. J., Golub, S. A., Grov, C., & Parsons, J. T. (2012). Stigma and sexual compulsivity in a community-based sample of HIV-positive gay and bisexual men. AIDS and Behavior, 16, 741–750. doi:10.1007/s10461-011-0048-2.
Rosenberger, J. G., Reece, M., Schick, V., Herbenick, D., Novak, D. S., Van Der Pol, B., et al. (2011). Sexual behaviors and situational characteristics of most recent male-partnered sexual event among gay and bisexually identified men in the United States. Journal of Sexual Medicine, 8, 3040–3050. doi:10.1111/j.1743-6109.2011.02438.x.
Rusbult, C. E., & Van Lange, P. A. M. (2003). Interdependence, interaction, and relationships. Annual Review of Psychology, 54, 351–375. doi:10.1146/annurev.psych.54.101601.145059.
Stall, R., Duran, L., Wisniewski, S. R., Friedman, M. S., Marshal, M. P., McFarland, W., et al. (2009). Running in place: Implications of HIV incidence estimates among urban men who have sex with men in the United States and other industrialized countries. AIDS and Behavior, 13, 615–629. doi:10.1007/s10461-008-9509-7.
Stephenson, R., Rentsch, C., & Sullivan, P. S. (2012a). High levels of acceptability of couples-based HIV testing among MSM in South Africa. AIDS Care, 24, 529–535. doi:10.1080/09540121.2011.617413.
Stephenson, R., Rentsch, C., Sullivan, P. S., McAdams-Mahmoud, A., Jobson, G., Struthers, H., et al. (2012b). Attitudes toward couples-based HIV counseling and testing among MSM in Cape Town, South Africa. AIDS and Behavior, 17, 43–50. doi:10.1007/s10461-012-0293-z.
Stephenson, R., Sullivan, P. S., Salazar, L. F., Gratzer, B., Allen, S., & Seelbach, E. (2011). Attitudes towards couples-based HIV testing among MSM in three US cities. AIDS and Behavior, 15, 80–87. doi:10.1007/s10461-011-9893-2.
Sullivan, P. S., Salazar, L. F., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162. doi:10.1097/QAD.0b013e32832baa34.
Wagenaar, B. H., Christiansen-Lindquist, L., Khosropour, C., Salazar, L. F., Benbow, N., Prachand, N., et al. (2012). Willingness of US men who have sex with men (MSM) to participate in couples HIV voluntary counseling and testing (CVCT). PLoS ONE, 7, e42953. doi:10.1371/journal.pone.0042953.
World Health Organization. (2012). Guidance on couples HIV testing and counseling including antiretroviral therapy for treatment and prevention in serodiscordant couples. Geneva: World Health Organization HIV/AIDS Programme. Retrieved from http://www.who.int/hiv/pub/guidelines/9789241501972/en/.
Acknowledgments
Data for this study were gathered in concert with online recruitment efforts to identify and screen potential participants to enroll in one of the following studies: Pillow Talk (R01-MH087714; PI: Parsons), MiChat (R03-DA031607; PI: Weinberger), Brotha (U01-PS000707 PI: Nanin), and W.I.S.E. (R01-DA029567; PI: Parsons). H. Jonathon Rendina was supported in part by a National Institute of Mental Health Individual Predoctoral Fellowship (F31-MH095622). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to give special thanks for the contributions of Andrea Vial, Anna Johnson, Chris Hietikko, Joshua Guthals, and Ruben Jimenez.
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Rendina, H.J., Breslow, A.S., Grov, C. et al. Interest in Couples-Based Voluntary HIV Counseling and Testing in a National U.S. Sample of Gay and Bisexual Men: The Role of Demographic and HIV Risk Factors. Arch Sex Behav 43, 149–159 (2014). https://doi.org/10.1007/s10508-013-0226-6
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DOI: https://doi.org/10.1007/s10508-013-0226-6