Is monogamy or committed relationship status a marker for low sexual risk among men in substance abuse treatment? Clinical and methodological considerations

Culturally adapted safer sex skills building: development and initial testing of an HIV prevention intervention for Black women using substances in the United States

Black women who use substances in the United States face unique human immunodeficiency virus (HIV) risk factors. However, interventions addressing cultural factors relevant for preventing HIV risk behaviors among Black women are limited. This project aimed to develop and initially test the effectiveness of a culturally adapted version of safer sex skills building (SSSB), an evidence-based HIV prevention intervention for reducing HIV risk among Black women who use substances. The cultural adaptation procedures involved (i) review of existing literature, (ii) use of Delphi process and theater testing to generate an adapted version, (iii) theater testing of the culturally adapted version and (iv) initial testing. Forty-eight Black women recruited from a substance use treatment clinic in the United States participated in three 2.5-h sessions of a culturally adapted or a generic version of the intervention. More (48%) women in the culturally adapted version self-reported condom use with casual partners compared to women in the generic (29%) version at a 6-week follow-up. The two groups did not differ on self-reported condom use with main partners. The culturally adapted SSSB offers a promising intervention for sexual risk reduction among Black women who use substances. Moreover, the findings advance the field by illustrating a concrete methodology for cultural adaptation.

A dyadic approach to understanding safer sex behavior in intimate heterosexual relationships

This study applied a dyadic approach to condom-use research. Partners from 124 heterosexual couples independently completed a questionnaire assessing condom-related attitudes, subjective norms, perceived behavioral control, and intentions to use condoms. Results demonstrate the superiority of a dyadic approach to understanding couples’ condom-use intentions and behavior over traditional, individual-level approaches. The addition of partner effects to the model, via the actor–partner interdependence model, resulted in an increase in the variance accounted for in condom-use intentions and this dyadic model showed better fit compared to the individual-level model. The results suggest that consideration of relationship partners plays an important role in the prediction of safer sex intentions.

Attachment orientation and sexual risk behaviour among young Black gay and bisexual men

This mixed methods study used an explanatory sequential design to examine the relationship between attachment and sexual behavior among young Black gay and bisexual men (YBGBM). Cross sectional online surveys and sex diaries were completed by a sample of YBGBM in New York City (n = 153) to assess the association between adult attachment insecurity and sexual risk behavior. The Experiences in Close Relationships Scale-Revised (ECR-R) was used to assess three types of adult attachment (i.e., secure, anxious, and avoidant). Participants reported condomless sex encounters, as well as serodiscordant condomless anal sex encounters, as measures of sexual risk. Quantitative findings suggested that there were few associations between attachment type and sexual risk behavior; only men with attachment avoidance were likely to engage in condomless sex. However, qualitative findings illuminated some of the social complexities of the association between attachment in childhood, attachment in young adulthood and intimate partnerships, which could be linked to young adult sexual risk behavior. The study findings highlight the need for researchers to further examine the process by which individual differences in attachment orientation are related to YBGBM's sexual behavior.

Differential risk factors for HIV drug and sex risk-taking among non-treatment-seeking hospitalized injection drug users

Injection drug users (IDUs) are at increased risk of contracting HIV. From a clinical trial assessing an intervention to enhance the linkage of hospitalized patients to opioid treatment after discharge, we conducted multivariate analysis of baseline data from hospitalized IDUs with a history of opioid dependence (n = 104) to identify differences in factors predicting HIV drug and sex risk behaviors. Factors significantly associated with HIV drug risk were being non-Hispanic Caucasian and recent cocaine use. Being female, binge drinking, and poorer mental health were significantly associated with higher sex risk. Because factors predicting HIV sex risk behaviors differ from those predicting HIV drug risk, interventions aimed at specific HIV risks should have different behavioral and substance use targets.

Examining the correspondence between relationship identity and actual sexual risk behavior among HIV-positive men who have sex with men

Sexual behavior of men who have sex with men (MSM), within and outside of one's primary relationship, may contribute to increased risk of HIV transmission among those living with HIV. The current study sought to understand how HIV-infected MSM report their relationship status and the degree to which this corresponds with their sexual behavior. Further, we examined rates and psychosocial associations with sexual HIV transmission risk behavior (TRB) across relationship categories. In a sample of 503 HIV-infected MSM in HIV care, 200 (39.8 %) reported having a primary partner. Of these, 115 reported that their relationship was open and 85 reported that it was monogamous. Of the 85 who reported a monogamous relationship, 23 (27 %) reported more than one sexual partner in the prior 3 months, 53 (62 %) reported only one partner, and nine did not report on the number of partners in the past 3 months. Hence, there were three categories of relationships: (1) "monogamous with one sexual partner," (2) "monogamous with more than one sexual partner," and (3) "open relationship." The "monogamous with more than one sexual partner" group reported higher TRB and crystal methamphetamine use compared to the "monogamous with one sexual partner" group and different patterns of relationships with TRB emerged across the three groups. Couples-based HIV prevention interventions for MSM may be enhanced by considering that there may be different definitions of monogamy among MSM, and that the context of relationship status may require tailoring interventions to meet the needs of specific subgroups of MSM couples.

A critical examination of popular assumptions about the benefits and outcomes of monogamous relationships

In this article, we critically examine the social institution of monogamy. First, we discuss the lack of an adequate and consistent definition of the construct of monogamy and consider how common monogamy is. Next, we address perceived benefits of monogamy and whether those ostensible benefits are supported by empirical evidence. We conclude that evidence for the benefits of monogamy relative to other relationship styles is currently lacking, suggesting that, for those who choose it, consensual non-monogamy may be a viable alternative to monogamy. Implications for theories of close relationships are discussed.