The Effect of HIV-Discordance on the Sexual Lives of Gay and Bisexual Men in Mexico City

Abstract

Drawing upon 44 in-depth interviews with men in HIV-discordant gay couples (only one man is HIV-positive) in Mexico, I explore whether being aware of the risk of primary infection or re-infection leads to protected sex. The results have policy implications, as the findings show that a significant number of men have participated in unprotected sex. An explanation is that these men perceive unprotected sex as an expression of commitment to their relationship. On the other hand, those who reported always using protection during sex perceive that guarding each other's health provides mutual benefit and shows their commitment to their relationship.

KEYWORDS:

• HIV-discordance
• condom use
• homosexuality
• meanings of sex
• sexual practices
• gay couples
• anal intercourse
• unprotected sex
• sexual foreplay
• Mexico

Acknowledgments

The author is especially grateful to the couples who generously opened their lives to this study. He also wishes to acknowledge various organizations that facilitated fieldwork in Mexico: Comunidad Unida en Respuesta al SIDA (CURAS), Clinica Condesa, Centro de Investigación y Terapia Avanzada en Inmunodeficiencia (CITAID), and Ave de Mexico. He thanks the physicians and health personnel that assisted in the process of recruitment: Eduardo Catalan, Lourdes Chi, Rocio Bonilla, Mauricio Ramos, Carmen Soler, Adan Flores, Blanca Garces, Jorge Rivera, Paula Gonzalez, Manuel Feregrino, Isolina Cardenas, Carlos Garcia de Leon, Sandra Treviño, and Rodolfo Perez, among many others. Many thanks also to Debra Umberson, Gloria Gonzalez-Lopez, Yolanda Padilla, Thomas Pullum, and Joseph Potter for their academic feedback.

This study was supported by the Andrew W. Mellon Fellowship in Demography of Developing Countries through the Population Research Center at the University of Texas at Austin.

Notes

1. The remaining five men who reported condom use all the time after awareness of HIV-discordance, did not explicitly report “mutual commitment to the relationship” as a reason for wearing condoms. Instead, they focused on fears of infection.