Unprotected sex more likely in serious gay relationships, research suggests

The findings provide a new direction for prevention efforts in this population who account for nearly 70 percent of all new HIV/AIDS diagnoses in adolescents and young adults in the United States and who also have the highest increase in new infections.

"Being in a serious relationship provides a number of mental and physical health benefits, but it also increases behaviors that put you at risk for HIV transmission," said Brian Mustanski, associate professor in medical social sciences at Northwestern University Feinberg School of Medicine and lead author of a paper on the research, published online in the journal Health Psychology. "Men who believe a relationship is serious mistakenly think they don't need to protect themselves."

About 80 percent of gay young men who are HIV positive don't know it, because they aren't being tested frequently enough, he noted. "It isn't enough to ask your partner his HIV status," Mustanski said. "Instead, both people in a serious, monogamous couple relationship should go and receive at least two HIV tests before deciding to stop using condoms."

The new Northwestern research shows HIV prevention programs should be directed toward serious relationships rather than the current focus on individuals who hook up in casual relationships.

"We need to do greater outreach to young male couples," said Mustanski, who conducted the research when he was at the University of Illinois at Chicago. "This is one population that has really been left behind. We should be focusing on serious relationships."

To help reach this group, Mustanski plans to produce two videos for gay youth this summer that discuss having healthy relationships and HIV prevention. The videos will be available on www.impactprogram.org.

The study findings dovetail with recent Centers for Disease Control data showing the majority of HIV transmissions occur in serious relationships. Being in a committed relationship more strongly influenced whether a gay man had unprotected sex than using drugs with a partner, the latter doubling the risk. A new shift to focus research on committed gay couples is partly a result of the burgeoning same-sex marriage movement, Mustanski said.

The Northwestern study looked at the behaviors of a diverse population of 122 young men (16 to 20 years old when the study began) over two years in Chicago and the suburbs. The men are a subset of participants in Mustanski's ongoing longitudinal study on the sexual and mental health of lesbian, gay, bisexual and transgender (LGBT) youth. The study, named Project Q2, is the longest running longitudinal study of LGBT youth ever conducted.

Studying the health of sexual and gender minorities has become a new priority for the federal government. In March, the Institute of Medicine issued a report stating researchers need to engage LGBT populations in health studies.

To meet that goal, Northwestern has just entered a partnership with the Center on Halsted, the largest social service center in the Midwest for the LGBT community. Mustanski's research program on the sexual and physical health of sexual minorities -- called the IMPACT Program-- will now reside in the Center on Halsted, which has a large HIV testing program and youth program. The move will facilitate research with the LGBT community.

"This collaboration gives us a chance to learn from the staff of the Center about emerging issues in the community, so that we can make those issues a research priority," Mustanski said. "And we can share our latest findings on prevention and healthy relationships with the staff, so they can immediately apply that to their services. There is a lot that we can learn from each other."

"We are thrilled to have the IMPACT program at Center on Halsted," said Modesto Tico Valle, the chief executive officer of the Center. "LGBT people are often excluded from major research endeavors, and IMPACT's focus on our community's health and development is vital. By embedding itself in the Center, IMPACT will have firsthand access to a diverse array of LGBT people to inform their research. We, in turn, have an invaluable opportunity to put IMPACT's research findings into practice, improving our programs to better meet the needs of our clients."