title: Management of the risk of HIV infection in male homosexual couples.
abstract: OBJECTIVE
  To study the ways of managing HIV risk within male homosexual steady relationships (gay couples), including factors associated with consistent condom use during anal sex with the steady partner.
  
  
  METHODS
  An anonymous and standardized questionnaire completed by a convenience sample of homosexuals in Switzerland in 1997 (n = 1097). Information on the couple was provided by the 74% (n = 786) of male respondents who reported having a steady partner in the past 12 months. Data were analysed by contingency tables and logistic regression.
  
  
  RESULTS
  Different ways of managing HIV risk were reported: negotiated safety (both HIV negative, condoms abandoned) was chosen by one quarter of the couples, but the most frequent solution was reliance on condoms for anal sex, chosen by more than four in 10. Altogether 84% of couples exhibited safe management of HIV risk within their partnership. The 16% of couples showing inadequate management of HIV risk within the couple mostly relied on questionable assumptions about past or present risks. A total of 74% of couples had spoken about managing HIV risk with possible casual partners. Reported behaviour with the steady partner and with casual partners was highly consistent with claimed strategies chosen to manage HIV risk. Consistent condom use with the steady partner was mostly associated with variables characterizing the relationship: initial 2 years of the relationship, discordant or unknown serological HIV status, non-exclusivity.
  
  
  CONCLUSIONS
  Gay couples manage HIV risk in a variety of ways. Most strategies provide adequate protection with casual partners, but leave gaps in protection between the steady partners themselves.
authors.affiliation: University Institute of Social and Preventive Medicine, Lausanne, Switzerland. florence.moreau@inst.hospvd.ch
authors.forename: F
authors.initials: F
authors.lastname: Moreau-Gruet
authors.forename: A
authors.initials: A
authors.lastname: Jeannin
authors.forename: F
authors.initials: F
authors.lastname: Dubois-Arber
authors.forename: B
authors.initials: B
authors.lastname: Spencer
mesh_terms: D000328:Adult; D017280:Condoms; D005191:Family Characteristics; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D021841:Safe Sex; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology