Sexual agreement between gay couples can prevent spread of HIV and other STDs

The majority of gay men in relationships say they establish a "sexual agreement" with their partner, primarily to prevent the spread of HIV and other sexually transmitted diseases, according to a University of Michigan study.

Sexual agreements show promise for HIV prevention, but the down side is that only 57 percent of couples actually concur that they have agreements, says Jason Mitchell, assistant professor at the U-M School of Nursing. Further, among nearly half of the couples one or both men break their agreement, which outlines allowable sex-related behaviors in the relationship.

Many men fear disclosing breaking their agreement, which may inadvertently increase their risk and their partner's risk for HIV and other sexually transmitted diseases. While gay men account for only 2 percent of the population, they represent more than half of new and existing HIV cases, according to the Centers for Disease Control and Prevention.

The good news is that of the couples who concur about the existence and type of sexual agreement, 80 percent keep their agreements, Mitchell says.

"From a public health perspective, we need to encourage gay couples to have more honest and explicit discussions when establishing and honoring sexual agreements," Mitchell said. "Sexual agreements are not only advantageous from a prevention standpoint for couples, but the agreement can also help strengthen their relationship."

Further, the research highlights the need for strengthening HIV prevention among gay couples.

Mitchell's is the first known study to gather information from both male partners in relationships across the country. Mitchell recruited participants using paid Facebook advertisements targeting men 18 and older in a committed relationship with another man.