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Try out PMC Labs and tell us what you think. Learn More. Many gay male couples make agreements about whether or not to permit sex with outside Two horny guys seeking 3rd, yet little is known about the development and maintenance of these agreements, their impact on relationships, and whether they are an effective HIV prevention strategy. Using semi-structured, qualitative interviews, 39 gay male couples were asked about their sexual agreements and about other relationship dynamics that might affect their agreements. Analysis revealed a wide range of agreement types, all of which are presented along a continuum rather than as discrete.

For couples with open agreements, most placed rules or conditions limiting when, where, how often, and with whom outside sex was permitted. Although motivations for having agreements varied, HIV prevention did not rank as a primary factor for any couple. Most couples had congruous agreements; however, a small reported discrepancies which may increase HIV transmission risk.

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Two horny guys seeking 3rd couples handled breaks in their agreements also varied, depending on what condition was broken, whether it was disclosed, and the partner's reaction. Additional include differences in agreement type and motivations for having an agreement based on couple serostatus. Overall, agreements benefited couples by providing boundaries for the relationship, supporting a non-heteronormative identity, and fulfilling the sexual needs of the couple.

Future prevention efforts involving gay couples must address the range of agreement types and the meanings couples ascribe to them, in addition to tempering safety messages with the relationship issues that are important to and faced by gay couples. The consequences of what was once a casual understanding became increasingly risky, even life-threatening. At the time, most efforts were directed at single gay men, thus prevention messages were individually-focused.

These early messages were successful in substantially reducing sexual risk and HIV transmission among many gay men; however, as the epidemic has matured, needs have changed. While unprotected sex with a known seroconcordant primary partner may pose little immediate risk, if either partner engages in sex outside of the relationship, or if the couple is discordant, risk for one or both partners increases.

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In the early s, researchers in Australia reported on a trend whereby concordant negative gay couples either agreed to be monogamous or, if sex with outside partners was allowed, Two horny guys seeking 3rd always use condoms for anal sex or avoid anal sex with outside partners altogether.

The Victorian AIDS Council and the Gay Men's Health Centre in Australia developed a prevention campaign consisting of 10 steps for gay couples to follow if they wanted to safely discontinue using condoms. The steps included the following and more: get tested; wait three months and get re-tested; promise to either use condoms for, or avoid anal sex with, outside partners; and agree that either partner can insist on using condoms again. Reaction to the campaign from some U. At the very least, the Australian campaign seemed premature given there was so little research available on the success of negotiated safety as an HIV prevention strategy.

Although subsequent research has found that men who had negotiated safety agreements with their main partner were at less risk for HIV than those who did not Kippax et al. Couples who experience these difficulties may not benefit from the full protection negotiated safety agreements promise. Many questions remain about the agreements gay couples make about sex with outside partners and whether those agreements are effective in preventing HIV. However, before their effectiveness can be rigorously evaluated, it is important first to understand how agreements function in relationships and what motivates gay couples to make them.

The present study explored how agreements function in the context of gay male relationships, what motivates couples to make agreements about whether or not to allow sex with outside partners, and how couples manage those agreements when they are broken. Additionally, factors associated with couple serostatus and the impact it has on the agreement were addressed. Gay male couples were recruited from the San Francisco Bay Area over a three-month period from February to April Active i.

Recruitment material instructed those interested in participating to call a toll-free for more information. The goal of recruitment was to produce a diverse sample in terms of race or ethnicity as well as HIV status in an effort to reflect the demographics of the San Francisco Bay Area. Field research staff reached out specifically to community-based agencies that served gay men of color and HIV-positive gay men.

Callers were screened over the phone and partners were screened individually for eligibility. Eligibility criteria required that participants had to: have been in their relationship for at least three months, have been at least18 years old, have knowledge of their own and their partner's serostatus, and have had no legal record of domestic violence.

Couples were eligible to participate only after both partners were screened and found to have met the eligibility criteria. In total, 39 couples were eligible and went on to participate in the semi-structured interviews. While the overall sample of participants was diverse in terms of race or ethnicity as well as HIV status, the largest proportion were either Caucasian or concordant negative.

Ten couples were interracial. In terms of couple serostatus, 17 were concordant negative, 10 were concordant positive, and 12 were discordant. The mean relationship length was seven years, while the range was three months to 27 years. The mean participant age was 39 years, while the range was 21 to 63 years see Table I.

After a research staff member screened both partners and determined the couple was eligible, they were scheduled for a 60—90 minute semi-structured interview. Partners were interviewed separately to allow for the candid discussion of their relationship, agreement, and any reported breaks. Interviews examined the following topics: relationship history, relationship strengths and weaknesses, partner roles, a natural history of any agreement made about whether or not to allow sex with outside partners, whether those agreements had been broken, relationship support, and future goals see Appendix A, Interview Guide.

Interviewers were trained to guide the participants through the interview by posing questions in an open-ended, conversational tone, to probe for clarity when and where necessary, and to allow for emergent topics to arise. The training stressed the intent of each Two horny guys seeking 3rd in the guide Two horny guys seeking 3rd interviewers were not required to ask them in a particular order, giving the interviews a natural flow and participants the freedom to discuss other issues they felt were salient.

All Two horny guys seeking 3rd were audio tape recorded using cassette recorders and transcribed verbatim. The research staff member who conducted the interview was responsible for reviewing the accompanying transcript for accuracy e. Reviewed transcripts were grouped by couple and read by two research staff members. One served as primary reader, leading the preliminary analysis of the transcripts, while the other reader was secondary, giving feedback on that analysis. Throughout the process, different research staff members took the lead in analyzing transcripts.

In the preliminary analysis, readers summarized each partner's transcript, identified main areas of interest, and then created a new document that summarized both partners as a couple and identified main areas of interest for the couple.

Members of the study team discussed summaries at weekly meetings, at which point additions and corrections to the summaries could be made and any discrepancies between the two readers could be resolved.

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Themes that emerged from the summaries were used to identify and develop codes. Codes were developed by research staff members and fell into the following : agreements concerning sexual activity within the relationship, agreements concerning sexual activity outside the relationship, sexual behaviors within the relationship, sexual behaviors outside the relationship, perceptions of risk, gay identity, protective factors e.

Only the concerning sexual agreements and sexual behaviors with outside partners and relationship dynamics were utilized for the present analysis. Within thoseapproximately two dozen codes were applied to the data.

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Codes that focused on the agreement included the following: agreement type including those that were monogamous, allowed sex with outside partners, and allowed threesomesagreement motivation, maintenance of or commitment to the agreement, agreement acceptability, the explicitness or implicitness of the agreement, agreement change, broken agreements, disclosure of broken agreements, and agreement change.

Codes that focused on sexual behavior with outside partners included sexual preferences, reported incidences of oral and anal sex, incidences of unprotected sex, Two horny guys seeking 3rd sex roles. Finally, codes that focused on relationship dynamics included satisfaction, honesty, trust, intimacy, couple serostatus, and motivation.

Once codes were identified, research staff members applied them to selected sections of the transcripts to verify code definition and application consistency among team members. When agreement was found among research staff, which in some cases required revising the definition of certain codes, the transcripts were coded. The coding process began by having two research staff members coders code the same transcript independently of one another.

Afterwards, they met to compare their coded transcripts for discrepancies. Together with a third staff member, coders reconciled any discrepancies. This process was repeated until both coders demonstrated sufficiently consistent coding techniques approximately the first 10 transcripts coded. All subsequent interviews were coded by one coder only, rather than both simultaneously, and all were verified by a third staff member Frieze, Both coders, along with the third staff member, coded all 78 transcripts. Further analysis using Ethnograph version 5.

Interview data were sorted two ways: by couple to conduct side-by-side comparisons of partners' responses and by couple serostatus for comparison among the three serostatus groups. Agreement negotiation was highly organic process that was influenced by a wide range of issues, including the age of the individuals in the relationship, the length of the relationship, experiences in prior relationships, and individual levels Two horny guys seeking 3rd comfort talking about sensitive issues, such as sex.

For example, several participants described how their prior experiences in monogamous relationships led them, for one reason or another, to open or desire to open their current relationship and allow sex with outside partners. Not everyone described the same pattern. Coming from the opposite direction, one participant described Two horny guys seeking 3rd prior experience in open relationships and expressed his desire to close his current relationship which was open.

Agreement negotiation usually involved a mix of the following three scenarios: clarifying a current agreement or expectationopening a monogamous agreement, or renegotiating an agreement after it was broken. Clarifying a current agreement often happened at the beginning of the relationship, immediately after a break, or both. Opening a monogamous agreement usually took the form of gradually adding conditions that allowed one or both partners to have sex with outside partners.

An example of one such condition was allowing threesomes i. Renegotiating a broken agreement typically involved making a ly implicit agreement more explicit, adding a new agreement to existing ones, creating an entirely new agreement because the broken was effectively annulled, or some combination thereof.

Agreement types reported by participants fell along a continuum of more closed to more open, with considerable overlap. Thinking of agreements types as existing on a continuum, rather than in discretenot only captures the individual meanings participants ased to their agreements, but also the shifts that many couples reported experiencing over time.

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Reasons for Non-use of Condoms among Men-who-have-Sex-with-Men: A Comparison of Receptive and Insertive Role-in-Sex and Online and Offline Meeting Venue