One Love: Explicit Monogamy Agreements among Heterosexual Young Adult Couples at Increased Risk of Sexually Transmitted Infections
Warren, Jocelyn T., Harvey, S. Marie, Agnew, Christopher R., The Journal of Sex Research
The impact of HIV on women of color in the United States is especially severe. The rate of HIV infection among African American women was nine times that of White women in 2008 (73.7 vs. 8.2 per 100,000). Among Hispanic women, the rate (25.0 per 100,000) was three times that of White women (Centers for Disease Control and Prevention [CDC], 2010). HIV incidence trends among Hispanics over time have mirrored those among African Americans (CDC, 2008). High-risk heterosexual contact was the primary route of transmission among women and the second largest route of HIV transmission in the United States in 2008, accounting for 32% of new infections; and the number of infections acquired through heterosexual contact continues to increase (CDC, 2010).
Behavioral strategies recommended for the prevention of HIV and other sexually transmitted infections (STIs) among heterosexual couples include condom use, mutual monogamy between uninfected partners, and HIV testing (CDC, 2006; Donovan, 2000; Gavey & McPhillips, 1997; Shelton, Halperin, Nantulya, Potts, & Gayle, 2004). Research has largely focused on condom use. Among the more robust findings is that condom use is more likely with new or casual sexual partners and tends to decline as relationships become more intimate and steady over time (Comer & Nemeroff, 2000; Macaluso, Demanda, Artza, & Hook, 2000).
A significant percentage of individuals in sexual relationships, however, appear to misjudge their partners' risk behaviors and, as a consequence, their own vulnerability to infection. For example, heterosexual patients with gonorrhea or chlamydia infection, recruited from clinics in Seattle, frequently underestimated their partners' total number of sex partners in the previous three months (Stoner et al., 2003). In another clinic-based study, 16% of male adolescent patients and 37% of female patients misperceived their partner's sexual exclusivity (Lenoir, Adler, Borzekowski, Tschann, & Ellen, 2006). Furthermore, mistaken assumptions about overlapping or concurrent partnerships have been associated with the transmission of HIV and other STIs (Drumright, Gorbach, & Holmes, 2004).
Although studies such as those cited earlier have assessed assumptions about partner behavior, few studies have examined the extent to which young adults in heterosexual relationships make and keep explicit agreements to be sexually exclusive or monogamous. Studies of sexual agreements within gay male couples are more common, including studies of monogamy agreements (Hoff & Beougher, 2010) and negotiated safety in which partners agree either to be monogamous or to practice safe sex outside the primary relationship (Kippax & Race, 2003). Neilands, Chakravarty, Darbes, Beougher, and Hoff (2010) noted that sexual agreements between gay male partners appear to be widespread and that such agreements may play a critical role in HIV prevention. Whether heterosexual couples at risk of HIV make such agreements, however, is less clear. One exploratory study of 25 high-risk heterosexual couples found that many of the couples used strategies other than condom use to mitigate their STI risk, including monogamy agreements and HIV and STI testing (Corbett, Dickson-G6mez, Hilario, & Weeks, 2009). The strategies employed were not consistently used and individuals often put emotional needs ahead of health concerns. Whether explicit sexual agreements and other strategies, such as HIV testing, are common among young adult heterosexual couples at increased risk of HIV and STIs or whether agreements are maintained over time, however, is unknown.
Relationship factors, including communication, and other couple characteristics may be particularly salient in understanding whether couples make and keep sexual agreements. Health protective communication and negotiation of safer sex with one's partner play a major role in theories of HIV preventive behavior, …
Questia, a part of Gale, Cengage Learning. www.questia.com
Publication information: Article title: One Love: Explicit Monogamy Agreements among Heterosexual Young Adult Couples at Increased Risk of Sexually Transmitted Infections. Contributors: Warren, Jocelyn T. - Author, Harvey, S. Marie - Author, Agnew, Christopher R. - Author. Journal title: The Journal of Sex Research. Volume: 49. Issue: 2-3 Publication date: March-June 2012. Page number: 282+. © 2007 Taylor & Francis Group, LLC. COPYRIGHT 2012 Gale Group.
This material is protected by copyright and, with the exception of fair use, may not be further copied, distributed or transmitted in any form or by any means.