'Sometimes people let love conquer them': how love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making

• Authors: Tamar Goldenberg, Emory University; Catherine Finneran, Emory University; Karen Andes, Emory University; Robert Stephenson, Emory University
• Journal Title: Culture, Health and Sexuality
• Volume: Volume 17, Number 5
• Publisher: Taylor & Francis (Routledge): STM, Behavioural Science and Public Health Titles | 2015-05-28, Pages 607-622
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1080/13691058.2014.979884
• Subjects: Health Sciences, Public Health; Health Sciences, Epidemiology
• Keywords: Social Sciences; Family Studies; Social Sciences, Biomedical; Biomedical Social Sciences; HIV; risk; emotions; USA; men who have sex with men; HIV-POSITIVE MEN; YOUNG MEN; MALE COUPLES; ANAL INTERCOURSE; MINORITY STRESS; BISEXUAL MEN; GAY; BEHAVIOR; HEALTH; MOTIVATIONS

Abstract

Men who have sex with men account for a disproportionate burden of HIV incidence in the USA. Although much research has examined the drivers of sexual risk-taking, the emotional contexts in which men make sexual decisions has received little attention. In this three-phase, 10-week longitudinal qualitative study involving 25 gay and bisexual men, we used timeline-based interviews and quantitative web-based diaries about sexual and/or dating partners to examine how emotions influence HIV risk perceptions and sexual decision-making. Participants described love, intimacy, and trust as reducing HIV risk perceptions and facilitating engagement in condomless anal intercourse. Lust was not as linked with risk perceptions, but facilitated non condom-use through an increased willingness to engage in condomless anal intercourse, despite perceptions of risk. Results indicate that gay and bisexual men do not make sexual decisions in an emotional vacuum. Emotions influence perceptions of risk so that they do not necessarily align with biological risk factors. Emotional influences, especially the type and context of emotions, are important to consider to improve HIV prevention efforts among gay and bisexual men.