Similarities and differences in strategies used to reduce HIV risk within and outside of the relationship among a large sample of gay male couples in the U.S

A growing body of research has emerged to better understand how relationship dynamics affect HIV risk among gay male couples. Recent research also indicates that gay men and other MSM use a variety of strategies to reduce their HIV risk. However, few studies with gay male couples have compared how these strategies differ within and outside of the couple's relationship, and by the couples' HIV serostatus. Examining how couples manage their sexual risk within and outside the context of their relationship is important for future development of HIV/STD prevention interventions. Accordingly, the present study assessed whether the risk reduction strategies used by gay male couples differed within and outside of their relationship, and by the couples' HIV serostatus. In this cross sectional study, dyadic data from a convenience sample of 361 dyads were collected electronically throughout the U.S. Men in each dyad completed the questionnaire independently. Descriptive statistics and multilevel modeling were used to compare differences and assess similarities of risk reduction strategies employed among the sample. Results from this study found that besides using condoms, men used a variety of different risk reduction strategies, including: oral sex only, strategic positioning, serosorting, withdrawal, undetectable viral load, and others. Some men also did not use a risk reduction strategy. Of importance, some strategies statistically differed within and outside of the couple's relationship, and by the couples' HIV serostatus. Other results will be presented and implications for development of programs to prevent HIV transmission among gay male couples will be discussed.