Abstract
Researchers have documented the psychological and physical health benefits of being in a relationship among heterosexuals, although there has been limited research to examine such benefits among gay and bisexual men. Gay and bisexual men demonstrate considerable variety in the nature of their relationships, particularly in terms of the degree to which they are monogamous. In order to better understand the psychological and behavioral impact of same-sex relationships on the health of gay and bisexual men, demographic characteristics, psychological factors, sexual behavior, and substance use data were examined in a sample of 819 gay and bisexual men who self-identified as single (n = 503) or were classified as being in monogamous (n = 182), open (n = 71) or monogamish (n = 63) relationships. Monogamish relationships were those in which both men have agreed that any sexual activity with casual partners must happen when both members of the couple are present and involved (e.g., “threeways” or group sex). Findings indicated that being in a same-sex relationship had health benefits compared to being single among gay and bisexual men. Men in monogamous relationships reported the least amount of substance use compared to all other groups, and less substance use during sex than single men or men in open relationships. Men in monogamish relationships demonstrated psychological and sexual health benefits relative to single men and men in open relationships. Gay and bisexual men in monogamish relationships more closely resembled those in monogamous relationships, in terms of psychological and sexual health benefits, rather than men in open relationships, suggesting that varying forms of non-monogamy should be explored for their relevance to health behaviors.
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Benotsch, E. G., Kalichman, S. C., & Cage, M. (2002). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183.
Benotsch, E. G., Martin, A. M., Espil, F. M., Nettles, C. D., Seal, D. W., & Pinkerton, S. D. (2011). Internet use, recreational travel, and HIV risk behaviors in men who have sex with men. Journal of Community Health, 36, 398–405.
Bybee, J. A. (2009). Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out. Journal of Adult Development, 16, 144–154.
Carey, M. P., Braaten, L. S., Jaworski, B. C., Durant, L. E., & Forsyth, A. D. (1999). HIV and AIDS relative to other health, social, and relationship concerns among low-income women: A brief report. Journal of Women’s Health and Gender Based Medicine, 8, 657–661.
CDC. (2008). Trends in HIV/AIDS diagnoses among men who have sex with men—33 States, 2001–2006. Morbidity and Mortality Weekly Report, 57, 681–686.
CDC. (2009). HIV/AIDS and young men who have sex with men. Atlanta: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hiv_factsheet_ymsm.pdf.
Chen, J. L., Kodagoda, D., Lawrence, A. M., & Kerndt, P. R. (2002). Rapid public health interventions in response to an outbreak of syphilis in Los Angeles. Sexually Transmitted Diseases, 29, 285–287.
Ciesla, J. A., & Roberts, J. E. (2001). Meta-analysis of the relationship between HIV infection and risk for depressive disorders. American Journal of Psychiatry, 158, 725.
Cochran, S. D. (2009). Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. Journal of Abnormal Psychology, 118, 647–658.
Coyne, J. C., Rohrbaugh, M. J., Shoham, V., Sonnega, J. W., Nicklas, J. M., & Cranford, J. A. (2001). Prognostic importance of marital quality for survival of congestive heart failure. American Journal of Cardiology, 88, 526–529.
Crepaz, N., Marks, G., Mansergh, G., Murphy, S., Miller, L., & Appleby, P. (2000). Age-related risk for HIV infection in men who have sex with men: Examination of behavioral, relationship, and serostatus variables. AIDS Education and Prevention, 12, 405–415.
Dermen, K. H., & Cooper, M. L. (2000). Inhibition conflict and alcohol expectancy as moderators of alcohol’s relationship to condom use. Experimental and Clinical Psychopharmacology, 8, 198–206.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75.
Diener, E., Gohm, C. L., Suh, E., & Oishi, S. (2000). Similarity of the relations between marital status and subjective well-being across cultures. Journal of Cross-Cultural Psychology, 31, 419–436.
Duncan, T. E., Duncan, S. C., & Strycker, L. A. (2006). An introduction to latent variable growth curve modeling: Concepts, issues, and applications (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.
Fendrich, M., & Vaughn, C. M. (1994). Diminished lifetime substance use over time: An inquiry into differential underreporting. Public Opinion Quarterly, 58, 96–123.
Friedman, H. S., Tucker, J. S., Schwartz, J. E., Tomlinson-Keasey, C., Martin, L. R., Wingard, D. L., et al. (1995). Psychosocial and behavioral predictors of longevity: The aging and death of the” termites”. American Psychologist, 50, 69–78.
Greenwood, G., White, E., Page-Shafer, K., Bein, E., Osmond, D., Paul, J., et al. (2001). Correlates of heavy substance use among young gay and bisexual men: The San Francisco Young Men’s Health Study. Drug and Alcohol Dependence, 61, 105–112.
Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). The association between penis size and sexual health among men who have sex with men. Archives of Sexual Behavior, 39, 788–797.
Halkitis, P. N., & Parsons, J. T. (2002). Recreational drug use and HIV-risk sexual behavior among men frequenting gay social venues. Journal of Gay & Lesbian Social Services, 14, 19–38.
Halpin, S. (2004). Changes in psychosocial well-being during stages of gay identity development. Journal of Homosexuality, 47, 109–126.
Holt-Lunstad, J., Birmingham, W., & Jones, B. (2008). Is there something unique about marriage? The relative impact of marital status, relationship quality, and network social support on ambulatory blood pressure and mental health. Annals of Behavioral Medicine, 35, 239–244.
Horwitz, A. V., White, H. R., & Howell-White, S. (1996). Becoming married and mental health: A longitudinal study of a cohort of young adults. Journal of Marriage and the Family, 58, 895–907.
Hyoun, K., & McKenry, P. (2002). The relationship between marriage and psychological well-being. Journal of Family Issues, 23, 885–911.
Johnson, N. J., Backlund, E., Sorlie, P. D., & Loveless, C. A. (2000). Marital status and mortality: The National Longitudinal Mortality Study. Annals of Epidemiology, 10, 224–238.
Kalichman, S. C., Benotsch, E., Rompa, D., Gore-Felton, C., Austin, J., Luke, W., et al. (2001). Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization, substance use and psychiatric symptoms. Journal of Sex Research, 28, 1–9.
Kalichman, S. C., & Simbayi, L. (2004). Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care, 16, 572–580.
Kertzner, R. M. (2009). Social and psychological well-being in lesbians, gay men, and bisexuals: The effects of race, gender, age, and sexual identity. American Journal of Orthopsychiatry, 79, 500–510.
Koblin, B. A., Chesney, M. A., Husnick, M. J., Bozeman, S., Celum, C. A., Buchbinder, S., et al. (2003). High-risk behaviors among men who have sex with men in 6 US cities: Baseline data from the EXPLORE study. American Journal of Public Health, 93, 926–932.
Kurdek, L. A. (1988). Relationship quality of gay and lesbian cohabiting couples. Journal of Homosexuality, 15, 93–118.
Lamb, K. A., Lee, G. R., & DeMaris, A. (2003). Union formation and depression: Selection and relationship effects. Journal of Marriage and Family, 65, 953–962.
LaSala, M. C. (2004). Extradyadic sex and gay male couples: Comparing monogamous and nonmonogamous relationships. Families in Society, 85, 405–412.
LaSala, M. C. (2005). Monogamy of the heart: Extradyadic sex and gay male couples. Journal of Gay & Lesbian Social Services, 17, 1–24.
Levant, R. F., Majors, R. G., & Kelley, M. (1998). Masculinity ideology among young African American and European American women and men in different regions of the United States. Cultural Diversity and Mental Health, 4, 227–236.
Lim, S. H., Ostrow, D., Stall, R., Chmiel, J., Herrick, A., Shoptaw, S., et al. (2010). Changes in stimulant drug use over time in the MACS: Evidence for resilience against stimulant drug use among men who have sex with men. AIDS and Behavior, doi:10.1007/s10461-010-9866-x.
Manzoli, L., Villari, P., Pirone, G. M., & Boccia, A. (2007). Marital status and mortality in the elderly: A systematic review and meta-analysis. Social Science and Medicine, 64, 77–94.
Mastekaasa, A. (1992). Marriage and psychological well-being: Some evidence on selection into marriage. Journal of Marriage and the Family, 54, 901–911.
Miller, K. W., Wilder, L. B., Stillman, F. A., & Becker, D. M. (1997). The feasibility of a street-intercept survey method in an African-American community. American Journal of Public Health, 87, 655–658.
Mills, T. C., Paul, J., Stall, R., Pollack, L., Canchola, J., Chang, Y. J., et al. (2004). Distress and depression in men who have sex with men: The Urban Men’s Health Study. American Journal of Psychiatry, 161, 278.
Neff, J. A., Prihoda, T. J., & Hoppe, S. K. (1991). Machismo, self-esteem, education and high maximum drinking among Anglo, Black and Mexican-American male drinkers. Journal of Studies on Alcohol, 52, 458–463.
Pantalone, D. W., Bimbi, D., Holder, C. A., Golub, S. A., & Parsons, J. T. (2010). Consistency and change in club drug use by sexual minority men in New York City, 2002 to 2007. American Journal of Public Health, 100, 1835–1892.
Parsons, J. T., & Bimbi, D. S. (2007). Intentional unprotected anal intercourse among sex who have sex with men: Barebacking—from behavior to identity. AIDS and Behavior, 11, 277–287.
Parsons, J. T., & Grov, C. (in press). Gay male identities, desires, and behaviors. In C. J. Patterson & A. R. D’Augelli (Eds.), Handbook of psychology and sexual orientation. New York: Oxford University Press.
Peplau, L. A. (1981). What homosexuals want in relationships. Psychology Today, 15, 28–38.
Pleck, J. H., Sonenstein, F. L., & Ku, L. C. (1994). Attitudes towards male roles among adolescent males: A discriminant validity analysis. Sex Roles, 30, 481–501.
Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
Ritter, K. Y., & Terndrup, A. I. (2002). Handbook of affirmative psychotherapy with lesbians and gay men. New York: Guilford Press.
Robles, T. F., & Keicolt-Glaser, J. K. (2003). The physiology of marriage: Pathways to health. Physiology & Behavior, 79, 409–416.
Ross, C. E., Mirowsky, J., & Goldsteen, K. (1990). The impact of the family on health: The decade in review. Journal of Marriage and the Family, 52, 1059–1078.
Shoenborn, C. A. (2004). Marital status and health: United States, 1999–2002. Advance Data from Vital and Health Statistics (Vol. 351): CDC.
Stacy, J. (2011). Unhitched: Love marriage, and the family values from West Hollywood to western China. New York: New York University Press.
Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162.
Van de Ven, P., Prestage, G., Crawford, J., Grulich, A. E., & Kippax, S. (2000). Sexual risk behaviour increases and is associated with HIV optimism among HIV-negative and HIV-positive gay men in Sydney over the 4 year period to February 2000. AIDS, 14, 2951–2953.
Wells, B. E., Golub, S. A., & Parsons, J. T. (2011). An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men. AIDS and Behavior, 15, 509–520.
Williams, K., & Umberson, D. (2004). Marital status, marital transitions, and health: A gendered life course perspective. Journal of Health and Social Behavior, 45, 77–94.
Wilson, C. M., & Oswald, A. J. (2002). How does marriage affect physical and psychological health? A survey of the longitudinal evidence. Unpublished manuscript, Department of Economics, University of Warwick.
Acknowledgments
The Sex and Love Study v7.0 was supported by the Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), under the direction of Dr. Parsons. The authors acknowledge the contributions of other members of the CHEST Sex and Love v7.0 Project Team (Michael Adams, Anthony Bamonte, David S. Bimbi, Chris Hietikko, Catherine Holder, Kevin Robin, Anthony Surace, Julia Tomassilli, and Brooke Wells) and the Drag Initiative to Vanquish AIDS (DIVAs).
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Parsons, J.T., Starks, T.J., DuBois, S. et al. Alternatives to Monogamy Among Gay Male Couples in a Community Survey: Implications for Mental Health and Sexual Risk. Arch Sex Behav 42, 303–312 (2013). https://doi.org/10.1007/s10508-011-9885-3
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DOI: https://doi.org/10.1007/s10508-011-9885-3