Development and Validation of the Sexual Agreement Investment Scale
Neilands, Torsten B., Chakravarty, Deepalika, Darbes, Lynae A., Beougher, Sean C., Hoff, Colleen C., The Journal of Sex Research
Over the past two decades, the AIDS epidemic has greatly impacted the lives and sexual behavior of gay men in the United States. Although HIV incidence among gay men significantly decreased throughout the 1980s and 1990s, more recently this trend appears to be reversing (Osmond, Pollack, Paul, & Catania, 2007), suggesting that HIV prevention efforts have fallen short of the current pace of the epidemic. Epidemiological studies report that a significant number of gay men who had recently acquired HIV attributed their infection to unprotected anal intercourse (UAI) with their primary partners (Davidovich et al., 2001; Rosser, Gobby, & Carr, 1999; Xiridou, Geskus, de Wit, Coutinho, & Kretzschmar, 2003). For instance, the Amsterdam Young Men's study conducted between 1995 and 1997 found that 50% of new infections were attributed to UAI with a primary partner (Davidovich, de Wit, & Stroebe, 2000). To reduce the toll of HIV on gay men, innovative approaches for identifying the salient influences on gay men's risk behaviors are needed and these approaches need to incorporate relationship-oriented constructs.
Throughout the epidemic HIV prevention efforts targeting gay men have primarily focused on the individual, thereby ignoring other important contextual factors such as relationship status and relationship quality, although previous research has documented differences in sexual behavior between gay men in primary partnerships and single gay men. Specifically, compared with sexually active single gay men, gay men in relationships reported substantially higher rates of UAI with their primary partners, particularly when their partner was of the same serostatus (Bosga et al., 1995; Caceres & Rosasco 1997; Connell et al., 1989; Crawford et al., 2006; Davidovich et al., 2001; Ekstrand, Stall, Paul, Osmond, & Coates, 1999; Elford, Bolding, Maguire, & Sherr, 1999; Fitzpatrick, McLean, Dawson, Boulton, & Hart, 1990; Hays, Kegeles, & Coates, 1990, 1997; Hoff, Coates, Barrett, Collette, & Ekstrand, 1996; Hoff et al., 1997; Hope & MacArthur, 1998; Kippax, Crawford, Davis, Rodden, & Dowsett, 1993; Martin, Dean, Garcia, & Hall, 1989; McKusick, Coates, Morin, Pollack, & Hoff, 1990; Schmidt, Fouchard, Krasnik, & Zoffman, 1992; Stall, Ekstrand, Pollack, McKusick, & Coates, 1990; Stolte, Dukers, Geskus, Coutinho, & de Wit, 2004; Valdiserri et al., 1988; Xiridou et al., 2003).
The increased likelihood of engaging in UAI with primary partners could be partially accounted for by relationship factors such as closeness, investment in and dependence on the relationship, desire for a stable and lasting relationship, and relationship satisfaction (Appleby, Miller, & Rothspan, 1999; Gold, Skinner, & Ross, 1994; Hays et al., 1997; McNeal, 1997). These findings highlight that to improve the effectiveness of HIV prevention efforts, it is necessary to examine not only the dynamics that shape the relationship but also the relationship itself because the relationship is the context within which UAI most often occurs. Yet, there are few HIV prevention efforts that target gay men in relationships.
Relationship theories such as interdependence theory (Kelley & Thibaut, 1978; Rusbult, Olsen, Davis, & Hannon, 2001), cognitive-behavioral approaches (Gottman, 1995), attachment theory (Hazan & Shaver, 1987), and evolutionary theory (Buss, 1989) have been utilized to provide a framework for understanding behaviors and emotional responses in the context of relationships, including intimate relationships, familial relationships, and friendships. These theoretical approaches have been used in studies of both heterosexual and homosexual couples to explore how relationship processes, such as commitment and satisfaction, influence relationship outcomes such as longevity, divorce, and infidelity (Allen et al., 2008; Kurdek, 1998). Prior literature specifically focusing on gay male couples has described how factors such as relationship satisfaction (Boesch, Cerqueira, Safer, & Wright, 2007), commitment (Kurdek, 1989, 2000), and social support (Darbes & Lewis, 2005) influence sexual behavior. …