XIX International AIDS Conference

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TUPE546 - Poster Exhibition


Three's a charm: three-way sexual encounters promote safety for gay male couples

C. Hoff1, C. Campbell1, A. Gomez1, P. Wilson2, K. Grisham2, T. Neilands3, D. Chakravarty3, S. Dworkin4

1Center for Research and Education on Gender and Sexuality, San Francisco State University, San Francisco, United States, 2Columbia Mailman School of Public Health, Columbia University, New York, United States, 3Center for AIDS Prevention Studies (CAPS), University of California - San Francisco, San Francisco, United States, 4University of California - San Francisco, San Francisco, United States

Background: Primary partnerships are increasingly a source of new HIV infections in the US. Evidence suggests that gay couples have unique prevention needs compared to single men. For example, while agreements about outside sexual partners are ubiquitous, some couples have difficulty adhering to them and break them; breaks are often undisclosed, potentially leaving both partners at risk. Three-way sexual encounters, where an outside partner is invited to have sex with the couple, are commonly reported. We explore how couples negotiate and experience three-ways and whether these encounters foster or hinder HIV risk.
Methods: Semi-structured, individual qualitative interviews were conducted with both members of 48 gay couples in the San Francisco and New York areas (n=96), recruited via purposive sampling and stratified by couples' race and HIV-status. The sample was composed of 17 White, 15 interracial Black-White, and 16 Black couples. Overall, 22 couples were HIV-negative and 26 were HIV-discordant. Interviews explored relationship history, decision-making about sex, sexual agreements, and sexual behavior.
Results: Three-way sexual encounters are desired and common among gay couples. Motivators include the ability to share an enhanced sexual encounter along with the primary partner and knowing what sexual behaviors transpired. Negotiating three-ways involve mutually agreeing on the outside partner, deciding whether/when condoms are used, and setting boundaries about sexual behavior. Satisfaction with three-ways stemmed from the flexibility of choosing the level of involvement, having the support of one's partner during the encounter, and ensuring that the encounter is safe.
Conclusions: Since three-way encounters are typically negotiated in advance, they equip primary partners with the ability to support each other in adhering to stated boundaries - something that may be more difficult when having sex independently with an outside partner. This negotiation process is an important point of intervention in HIV prevention programs for gay couples who desire three-ways.


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