title: Perceived Challenges and Rewards of Forming a Sexual Agreement Among HIV-Negative Male Couples.
abstract: Sexual agreements, explicit mutual understandings made between two partners about which sexual and related behaviors they agree to engage in within and/or outside of their relationship, are common among male couples. However, little is known about the perceived rewards and challenges partnered men face in the process of forming a sexual agreement. Such knowledge may be useful for the development of future HIV preventive and sexual health programs that encourage male couples to establish a sexual agreement in their relationship. By using qualitative dyadic data from a sample of 29 self-reported concordant HIV-negative male couples who had a sexual agreement, the present qualitative study sought to assess partnered men's perceived rewards and challenges of forming a sexual agreement in their relationship and examine whether both men in the couple concurred about their perceived rewards and challenges of forming a sexual agreement. Themes for perceived rewards were (1) being honest, (2) improving communication, (3) increasing understanding about expectations and permitted behaviors, (4) enhancing intimacy and relational bond, and (5) building trust. Themes for perceived challenges were: (1) stigma about having an open agreement; (2) awkwardness about the topic and talking about it; (3) jealousy; and (4) no perceived challenges. Few couples had both partners concur about their perceived rewards or challenges toward establishing a sexual agreement. The variety of perceived rewards and challenges highlight the need for tailoring given that a variety of factors may influence partnered men's establishment of a sexual agreement in their relationship.
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA. jwm35@med.miami.edu.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Mitchell
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Cory
authors.initials: C
authors.lastname: Woodyatt
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
authors.forename: José
authors.initials: J
authors.lastname: Bauermeister
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
authors.affiliation: Department of Health Behavior and Biological Sciences, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Rob
authors.initials: R
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005191:Family Characteristics; D015658:HIV Infections; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D035502:Trust / Q000523:psychology*; D055815:Young Adult
keywords: HIV prevention; Male couples; Sexual agreements; Sexual orientation