Skip to main content

Advertisement

Log in

HIV Testing Behaviors and Perceptions of Risk of HIV Infection Among MSM with Main Partners

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Male couples represent a high priority group for HIV prevention interventions because primary partners have been identified as the source of one-third to two-thirds of HIV infections among men who have sex with men (MSM). HIV testing is an important component of the U.S. National AIDS Strategy. In previous research rates of HIV testing among partnered MSM have been found to be lower compared to other MSM. In this paper, we use a sample of 906 MSM recruited through internet advertisements to contrast HIV testing behavior, perceived risk of HIV infection and confidence in remaining HIV sero-negative between single MSM and MSM who report having a main partner. We also examine associations between sexual agreements and HIV testing and perceived risk among partnered MSM. Although results were marginally significant, men with a main partner had significantly higher odds of perceiving zero risk of HIV infection, higher odds of being very confident they will remain HIV-negative, and lower odds of testing for HIV in the past 6 months. Partnered men who reported they were in an open relationship had higher odds of recent HIV testing, lower odds of perceiving zero risk, and lower odds of being very confident in remaining HIV-negative, relative to those who reported monogamy. The results point to the need for dyadic interventions to tackle the underestimation of potential risk associated low HIV testing among partnered MSM. Couples HIV Testing and Counseling—CHTC—affords male couples the opportunity to learn their sero-status together and discuss the realities of their agreement and relationship and should be considered a priority intervention for male couples in the U.S.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2011. Atlanta: Centers for Disease Control and Prevention; 2013.

    Google Scholar 

  2. Goodreau SM, Carnegie NB, Vittinghoff E, Lama JR, Sanchex J, Grinsztejn B, et al. What drives the US and Peruvian epidemics in men who have sex with men (MSM)? PLoS One. 2012;7(11).

  3. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62. doi:10.1097/QAD.0b013e32832baa34.

    Article  PubMed  Google Scholar 

  4. Mitchell JW, Horvath KJ. Factors associated with regular HIV testing among a sample of US MSM with HIV-negative main partners. J Acquir Immune Defic Syndr. 2013;64.4:417–23. doi:10.1097/QAI.0b013e3182a6c8d9.

    Article  Google Scholar 

  5. Hoff CC, Chakravarty D, Beougher SC, Neilands TB, Darbes LA. Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient Care STDs. 2012;26(12):738–45. doi:10.1089/apc.2012.0198.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Gomez AM, Beougher SC, Chakravarty D, Neilands TB, Mandic CG, Darbes LA, et al. Relationship dynamics as predictors of broken agreements about outside sexual partners: implications for HIV prevention among gay couples. AIDS Beha. 2012;16(6):1584–8. doi:10.1007/s10461-011-0074-0.

    Article  Google Scholar 

  7. Mitchell JW. Characteristics and allowed behaviors of gay male couples’ sexual agreements. J Sex Res. 2013;. doi:10.1080/00224499.2012.727915.

    PubMed Central  Google Scholar 

  8. Wall KM, Stephenson R, Sullivan PS. Frequency of sexual activity with most recent male partner among young, internet using men who have sex with men in the United States. J Homosex. 2013;60(10):1520–38.

    Article  PubMed  Google Scholar 

  9. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446–53.

    Article  PubMed  Google Scholar 

  10. Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20(10):1447–50.

    Article  PubMed  Google Scholar 

  11. The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. In: U.S. Department of Health & Human Services, editor. Washington, DC; 2010.

  12. Chakravarty D, Hoff CC, Neilands TB, Darbes LA. Rates of testing for HIV in the presence of serodiscordant UAI among HIV-negative gay men in committed relationships. AIDS Behav. 2012;16(7):1944–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Gass K, Hoff CC, Stephenson R, Sullivan PS. Sexual agreements in the partnerships of Internet-using men who have sex with men. AIDS Care. 2012;24(10):1255–63.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2008. doi:10.1007/s10508-008-9393-2.

  15. Mitchell JW, Petroll AE. HIV testing rates and factors associated with recent HIV testing among male couples. Sex Transm Dis. 2012;39(5):379–81.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Hoff CC, Chakravarty D, Beougher SC, Darbes L, Dadasovich R, Neilands T. Serostatus differences and agreements about sex with outside partners among gay male couples. AIDS Educ Prev. 2009;25(1):25–38.

    Article  Google Scholar 

  17. Mitchell JW, Petroll AE. Patterns of HIV and sexually transmitted infection testing among men who have sex with men couples in the United States. Sex Transm Dis. 2012;39(11):871–6.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Oster AM, Miles IW, Le BC, DiNenno EA, Wiegand RE, Heffelfinger JD, et al. HIV testing among men who have sex with men—21 cities, United States, 2008. Morb Mortal Wkly Report (MMWR). 2011;60(21):694–9.

    Google Scholar 

  19. Mitchell JW, Harvey SM, Champeau D, Moskowitz DA, Seal DW. Relationship factors associated with gay male couples’ concordance on aspects of their sexual agreements: establishment, type, and adherence. AIDS Behav. 2012;16(6):1560–9. doi:10.1007/s10461-011-0064-2.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Smith A, Miles I, Le B, Finlayson T, Oster A, DiNenno E. Prevalence and awareness of HIV infection among men who have sex with men—21 cities, United States, 2008. Morb Mortal Wkly Report (MMWR). 2010;59(37):1201–7.

    Google Scholar 

  21. Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL, Wilson PA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380:341–8.

    Article  PubMed  Google Scholar 

  22. Klitzman R, Exner T, Correale J, Kirshenbaum SB, Remien R, Ehrhardt AA, et al. It’s not just what you say: relationships of HIV dislosure and risk reduction among MSM in the post-HAART era. AIDS Care. 2007;19(6):749−56. doi: 10.1080/09540120600983971.

  23. Winter AK, Sullivan PS, Khosropour CM, Rosenberg ES. Discussion of HIV status by serostatus and partnership sexual risk among internet-using MSM in the United States. J Acquir Immune Defic Syndr. 2012;60(5):525–9. doi:10.1097/QAI.0b013e318257d0ac.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Mitchell JW. HIV-negative and HIV-discordant gay male couples’ use of HIV risk-reduction strategies: differences by partner type and couples’ HIV-status. AIDS Behav. 2013;17(4):1557–69. doi:10.1007/s10461-012-0388-6.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Mitchell JW, Petroll AE. Factors associated with men in HIV-negative gay couples who practiced UAI within and outside of their relationship. AIDS Behav. 2012;17(4):1–9.

    Google Scholar 

  26. Mitchell JW, Garcia L, Champeau D, Harvey SM, Petroll AE. HIV-negative seroconcordant gay male couples’ attitudes, intentions, and perceived behavioral control for planned condom use within and outside of their relationships. Int J Sex Health. 2012;24(4):239–53.

    Article  Google Scholar 

  27. Mitchell JW, Champeau D, Harvey SM. Actor–partner effects of demographic and relationship factors associated with HIV risk within gay male couples. Arch Sex Behav. 2012;42(7):1–9.

    Google Scholar 

  28. Braitstein P, Asselin JJ, Schilder A, Miller ML, Laliberte N, Schechter MT, et al. Sexual violence among two populations of men at high risk of HIV infection. AIDS Care. 2006;18(7):681–9. doi:10.1080/13548500500294385.

    Article  PubMed  Google Scholar 

  29. Feldman MB, Ream GL, Diaz RM, El-Bassel N. Intimate partner violence and HIV sexual risk behavior among Latino gay and bisexual men: the role of situational factors. J LGBT Health Res. 2007;3(4):75–87 Epub 2008/12/02.

    Article  PubMed  Google Scholar 

  30. Houston E, McKirnan DJ. Intimate partner abuse among gay and bisexual men: risk correlates and health outcomes. J Urban Health. 2007;84(5):681–90. doi:10.1007/s11524-007-9188-0.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Nieves-Rosa LE, Carballo-Dieguez A, Dolezal C. Domestic abuse and HIV-risk behavior in Latin American men who have sex with men in New York city. J Gay Lesbian Soc Serv. 2000;11(1):77–90. doi:10.1300/J041v11n01_04.

    Article  Google Scholar 

  32. Relf MV, Huang B, Campbell J, Catania J. Gay identity, interpersonal violence, and HIV risk behaviors: an empirical test of theoretical relationships among a probability-based sample of urban men who have sex with men. J Assoc Nurses AIDS Care. 2004;15(2):14–26. doi:10.1177/1055329003261965.

    Article  PubMed  Google Scholar 

  33. Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J of Public Health. 2003;93(6):939–42.

    Article  Google Scholar 

  34. Sullivan PS, White D, Rosenberg ES, Barnes J, Jones J, Dasgupta S, et al. Safety and acceptability of couples HIV testing and counseling for US men who have sex with men: a randomized prevention study. J Int Assoc Provid AIDS Care. 2013. doi:10.1177/2325957413500534. PubMed PMID: 23995295

  35. Stephenson R, Chard A, Finneran C, Sullivan P. Willingness to use couples voluntary counseling and testing services among men who have sex with men in seven countries. AIDS Care. 2013. doi:10.1080/09540121.2013.808731. PubMed PMID: 23786340

  36. Wagenaar BH, Grabbe KL, Stephenson R, Khosropour CM, Sullivan PS. Do men who have sex with men (MSM) in the United States understand that HIV Serodiscordance is possible? Open AIDS J. 2013;7:14–6.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Wagenaar BH, Christiansen-Lindquist L, Khosropour C, Salazar LF, Benbow N, Prachand N, et al. Willingness of US men who have sex with men (MSM) to participate in couples HIV voluntary counseling and testing (CVCT). PLoS One. 2012;7(8):e42953. doi:10.1371/journal.pone.0042953.

  38. Stephenson R, Sullivan PS, Salazar LF, Gratzer B, Allen S, Seelbach E. Attitudes towards couples-based HIV testing among MSM in three US cities. AIDS Behav. 2011;15(Suppl 1):80–7. doi:10.1007/s10461-011-9893-2.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rob Stephenson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stephenson, R., White, D., Darbes, L. et al. HIV Testing Behaviors and Perceptions of Risk of HIV Infection Among MSM with Main Partners. AIDS Behav 19, 553–560 (2015). https://doi.org/10.1007/s10461-014-0862-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0862-4

Keywords

Navigation