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Linking Syndemic Stress and Behavioral Indicators of Main Partner HIV Transmission Risk in Gay Male Couples

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Abstract

The purpose of the current study was to examine whether syndemic stress in partnered gay men might undermine communication processes essential to the utilization of negotiated safety and other harm reduction strategies that rely on partners’ HIV status disclosure. Participants included 100 gay male couples (N = 200 individuals) living in the U.S., who responded to an online survey. Participants completed measures of five syndemic factors (depression, poly-drug use, childhood sexual abuse, intimate partner violence, and sexual compulsivity). They also reported on whether condoms were used during first intercourse together and the timing of first condomless anal intercourse (CAI) relative to HIV disclosure in their relationship. Results of binary logistic regression analyses supported the hypothesis that the sum of partners’ syndemic stress was negatively associated with condom use at first intercourse and with HIV disclosure prior to first CAI. Syndemic stress may contribute to HIV transmission risk between main partners in part because it accelerates the progression to CAI and interferes with communication processes central to harm reduction strategies utilized by gay men in relationships. Implications for prevention strategies and couples interventions, such as couples HIV counseling and testing, that facilitate communication skill-building, are discussed.

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Acknowledgments

The Couples Project was conducted by the Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), under the direction of Jeffrey T. Parsons. The authors acknowledge the contributions of other members of the Couples Project Research Team: Drew Mullane, Kailip Boonrai, Catherine Jones, Joel Rowe, Anna Johnson, Ruben Jimenez, and Chris Hietikko – and thank the participants involved. Tyrel Starks was supported in part by a National Institute on Drug Abuse Grant (R34 DA036419). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA

    Tyrel J. Starks & Jeffrey T. Parsons

  2. Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York (CUNY), 365 5th Ave, New York, NY, 10016, USA

    Tyrel J. Starks, Brett M. Millar & Jeffrey T. Parsons

  3. Center for HIV/AIDS Educational Studies and Training (CHEST), 142 W 36th St. 9th Floor, New York, NY, 10018, USA

    Tyrel J. Starks, Andrew N. Tuck, Brett M. Millar & Jeffrey T. Parsons

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  1. Tyrel J. Starks
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  2. Andrew N. Tuck
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  4. Jeffrey T. Parsons
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Correspondence to Jeffrey T. Parsons.

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Starks, T.J., Tuck, A.N., Millar, B.M. et al. Linking Syndemic Stress and Behavioral Indicators of Main Partner HIV Transmission Risk in Gay Male Couples. AIDS Behav 20, 439–448 (2016). https://doi.org/10.1007/s10461-015-1248-y

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