Accordingly, a growing body of research has examined gay male couples, and sought to explore the relationship dynamics that contribute to risk behaviors both within and outside the primary partnership ( Beougher, et al., in press Hoff, Beougher, Chakravarty, Darbes, & Neilands, 2010 Hoff, et al., 2009 Moreau-Gruet, Jeannin, Dubois-Arber, & Spencer, 2001 Prestage, et al., 2008). The burden of HIV is especially great among MSM of color: African American and Latino men comprise 35% and 19% of new HIV infections, respectively ( CDC, 2008a).Īs the HIV epidemic has evolved over the past 3 decades, with preventive efforts struggling to keep pace, scholars have increasingly noted the difficulty in intervening with an individual alone, and called for research that examines the social, relational, and structural contexts in people's lives that sustain individuals' risk behaviors, or support precaution ( Díaz & Ayala, 2001 Sumartojo, 2000). Moreover, MSM represent the only risk group for whom the numbers of new infections continue to increase annually ( CDC, 2008a, 2008b). In 2006, gay men accounted for 48.1% of HIV/AIDS cases overall, and men who have sex with men (MSM) represented 51% of new HIV/AIDS diagnoses, not including MSM who inject drugs ( CDC, 2008a).
Gay men continue to make up the largest proportion of HIV/AIDS cases in the U.S. Providers should assess sexual function as a regular part of their work with gay couples who parent, and facilitate opportunities for men to discuss their sexual agreements both with their primary partners and with relevant healthcare providers. HIV-related sexual risk behavior was relatively rare, but nevertheless present in some men. Men reported that parenthood typically decreased their opportunities to engage in sex with outside partners, but also posed barriers to talking about these behaviors with their partners and healthcare providers. Additionally, couples reported negotiating agreements regarding sex with outside partners that closely resemble those documented in studies of gay couples who are not parents. These challenges alone did not generally result in greater infidelity or HIV risk, as most men reported successfully coping with such changes through a combination of acceptance and revaluing what is important in their relationships. Findings suggest that parenthood increases men's commitment to their primary relationship while simultaneously decreasing time and energy for relationship maintenance, and generally decreasing sexual satisfaction. We aimed to examine these issues in a qualitative analysis of interviews from 48 gay male couples who were actively parenting children. However, such changes might have even more profound implications for gay couples' health, and in particular their HIV risk, given the somewhat different ways in which they negotiate and tolerate sexual behaviors with outside partners. Emerging research suggests that gay couples who are parenting might experience similar challenges. Parenthood changes couples' relationships across multiple domains, generally decreasing relationship quality, sexual satisfaction, and sexual frequency.