Amsterdam 2015
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| Abstract #2350 - Generation 2.0 - using the internet in the fight against HIV | ||||
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Session: 37.2: Generation 2.0 - using the internet in the fight against HIV (Symposium) on Thursday @ 14.30-16.00 in C002 Chaired by Tawanda Makusha, Alastair van Heerden Authors: Presenting Author: Dr. Jason Mitchell - University of Miami Miller School of Medicine, United States |
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| Aim: Although between one- and two-thirds of men who have sex with men in the United States acquire HIV from their primary relationship partners, few evidence-based HIV prevention interventions exist for male couples. Studies show that male couples’ relationship dynamics, including sexual agreements, affect their risk for HIV acquisition and/or transmission, and that many male couples in the U.S. establish a sexual agreement. A sexual agreement is an explicit mutual understanding between two primary relationship partners about which sexual and other relational behaviors are allowed to occur within their relationship, and if applicable, outside the relationship. While establishment and adherence to a sexual agreement helps to reduce male couples’ risk for HIV, their perceived challenges and rewards of establishing a sexual agreement remain poorly understood. Understanding male couples’ perspectives on the challenges and rewards of establishing a sexual agreement is relevant for development of future dyadic HIV prevention interventions, including our tailored online toolkit which aims to assist at-risk HIV-negative male couples form and adhere to a sexual agreement. | ||||
| Method / Issue: The present study is part of a larger HIV prevention intervention project aimed to help male couples form and adhere to a sexual agreement via an online interactive toolkit. During Phase 1, active and passive recruitment strategies were used to enroll 29 consented HIV-negative male couples from Detroit, MI and Atlanta, GA to participate in semi-structured individual- and couple-level interviews about aspects of their sexual agreement. All couples had a sexual agreement, and the sample was stratified by agreement type (N=15 closed, N=14 open) and location. Interviews were digitally recorded, transcribed verbatim, checked for accuracy, and anonymized. Thematic analysis was then used to identify, analyze, and report on the themes that captured, represented, and explicated the meanings and complexities of male couples’ challenges and rewards of establishing a sexual agreement in their relationship. | ||||
| Results / Comments: The following themes emerged about men’s challenges of establishing a sexual agreement with their primary partner: 1) stigma regarding being open, 2) awkwardness about the topic, 3) jealousy issues, and 4) not perceiving it to be a challenge. Themes that emerged about men’s perceived rewards of forming a sexual agreement with their primary partner, included: 1) being honest, 2) increasing understanding about expectations and permitted behaviors, 3) enhancing intimacy and relational bond, 4) improving communication, and 5) building trust. When comparing both partner’s responses and relevant themes, some couples concurred about these reasons while many did not differences in themes were also noted based on couples’ type of agreement and study location. These themes will be discussed and supported with participant quotes. | ||||
| Discussion: Themes elicited during the interviews differed more by agreement type than by location, and emphasized some of the perceived challenges and rewards of establishing a sexual agreement. These findings highlight important messaging and content considerations toward development of an online prevention toolkit aimed to assist HIV-negative male couples to establish and adhere to a sexual agreement. | ||||
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