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Partnered YGBMSM may forgo condom use as a pathway to creating intimacy and trust with their partner. A substantial body of literature demonstrates that the desire for intimacy is one of the strongest motivators for engaging in condomless sex with a primary partner ( 14– 19), but, regardless of sexual orientation, many individuals report that condoms impede sexual intimacy ( 20, 21). Successful HIV prevention for same-gender male couples should encourage the uptake of condoms and PrEP, and/or sustained ART adherence and viral suppression for couples in which one or both partners are living with HIV. However, much of this work has focused on risk behaviors among adult same-gender male couples, and there is a dearth of research that has sought to understand the sexual risk behaviors and prevention needs of partnered YGBMSM. There is evidence that GBMSM in romantic relationships perceive themselves to be at lower risk of HIV infection ( 11, 12) and are less likely to routinely test for HIV ( 12, 13). High levels of HIV transmission within main partnerships have been attributed to a higher number of sex acts with main partners as compared to single episodes of sex with casual partners, more frequent receptive roles in anal sex with main partners, and lower condom use during anal sex with main partners ( 7– 10). Modeling studies have identified main partners as the source of approximately one-third to two-thirds of new HIV infections among GBMSM ( 7, 8) this proportion may be as high as 84% among YGBMSM ( 7). Thus, successful HIV prevention efforts for YGBMSM must recognize the roles of romantic partnerships in shaping their potential risk for HIV acquisition and provide YGBMSM with the skills to communicate with their sexual and romantic partners to promote their sexual health. A central part of this process is learning to negotiate sexual experiences that might increase their risk for HIV/ sexually transmitted infection (STI) acquisition ( 5, 6). Adolescence is a period of developmental transition, as young people explore the emergence of sexual and gender identities, and begin to engage in sexual or romantic relationships ( 4). regular HIV testing and sustained pre-exposure prophylaxis (PrEP) use) and to decrease sexual risk-taking (i.e., engaging in condomless anal sex CAS - a primary risk factor for HIV transmission) ( 3). Central to reducing HIV incidence among YGBMSM are HIV prevention interventions that seek to encourage engagement in HIV prevention strategies (i.e.
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Young gay, bisexual and other men who have sex with men (YGBMSM) account for a disproportionate number of new HIV infections in the United States (US), representing 72% of new HIV infections in people between the ages of 13 and 24 and 30% of new infections among all gay, bisexual and other men who have sex with men (GBMSM) ( 1, 2). Participants noted the absence of inclusive sexual education for them thus, findings suggest that the provision of relationship skills training are requisites for HIV prevention interventions with YGBMSM in the US. Participants described that interventions were needed to address skills regarding: ( 1) implicit versus explicit communication about sexual agreements ( 2) boundary setting and identifying signs of abusive relationships and ( 3) relationship dynamics (e.g., trust). Between July and November 2018, we conducted in-depth interviews with 30 young partnered YGBMSM (mean age=17.8, SD=1.1).
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In this qualitative study, we explored partnered YGBMSM’s perceptions of existing HIV prevention interventions to inform the design of a relationship-focused HIV prevention intervention. Although there has been a growing focus on dyadic HIV prevention interventions for male couples, the unique needs of partnered YGBMSM have been largely overlooked. Young gay, bisexual, and other men who have sex with men (YGBMSM) are a priority population for HIV prevention efforts.