Mutual monogamy agreements and HIV testing among young adult couples at increased risk of STIs

High-risk heterosexual contact accounted for over a third of all new HIV infections in the United States in 2006 and 80% of new infections among women. Among the strategies promoted for HIV prevention among couples are condom use and mutual monogamy. Research suggests that condom use is more likely with new or casual partners and tends to decline as relationships become more intimate and steady over time. Little is known, however, about mutual monogamy agreements within heterosexual couples. This study uses data collected from 435 heterosexual couples at increased risk of HIV/STIs recruited from Los Angeles and Oklahoma for the PARTNERS project, a couples-based HIV intervention. Women were eligible if they were aged 18-25, had a male sex partner over age 18 willing to participate, and met at least one HIV risk criteria. Women in Los Angeles had to self-identify as Latina. Data are from the individual baseline interviews. In this study we examine the frequency of agreements about monogamy and condom use in the event that monogamy fails. We also assess interpartner concordance in monogamy perceptions. Finally, we examine whether individual and relationship factors predict couple fidelity to a monogamy agreement. Preliminary analyses indicated that 70% of individuals reported they had a clear agreement with their partner to be monogamous. Interpartner concordance, however, was only moderate, with over a third of couples having discordant perceptions of a monogamy agreement. Additional findings will be presented and implications for prevention programs designed for heterosexual couples will be discussed.