One Love: Explicit Monogamy Agreements among Heterosexual Young Adult Couples at Increased Risk of Sexually Transmitted Infections

Abstract

HIV prevention strategies among couples include condom use, mutual monogamy, and HIV testing. Research suggests that condom use is more likely with new or casual partners, and tends to decline as relationships become steady over time. Little is known, however, about explicit mutual monogamy agreements and HIV testing within heterosexual couples. This study used data from 434 young heterosexual couples at increased risk of HIV and sexually transmitted infections (STIs) to assess (a) couple concordance on perceptions of a monogamy agreement, sustained monogamy, and HIV testing; and (b) the associations of relationship and demographic factors with monogamy agreement, sustained monogamy, and HIV testing. Results indicated only slight to fair agreement within couples on measures of monogamy agreement and sustained monogamy. Overall, 227 couples (52%) concurred that they had an explicit agreement to be monogamous; of those, 162 (71%) had sustained the agreement. Couples with greater health protective communication and commitment were more likely to have a monogamy agreement. Couples of Latino and Hispanic ethnicity and those with children were less likely to have a monogamy agreement. Only commitment was related to sustained monogamy. Having children, greater health protective communication, and perceived vulnerability to HIV and STIs were associated with HIV testing within the couple.

Acknowledgments

The PARTNERS Project was supported by cooperative agreements #U30/CCU 915062-1-0 and #U30/CCU 615166-1-0 with the Centers for Disease Control (CDC) and Prevention (S. Marie Harvey and Heather C. Huszti, Principal Investigators; Christine Galavotti, Katina A. Pappas-DeLuca, and Joan Marie Kraft, Project Officers). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

Notes

Note. Agreement % is the number of matching responses divided by number of couples.

^a Does not include couples who agreed that they had not discussed monogamy (n = 45).

^b Does not include couples in which both partners say they did not discuss or agree to monogamy (n = 51).

Note. N = 434. STI = sexually transmitted infection.

^a The denominator is couples who had a monogamy agreement (n = 227).

Note. OR = odds ratio; CI = confidence interval; STI = sexually transmitted infection.

^a N = 434.

^b n = 227.

*p < .05.

**p < .01.

***p < .001.