ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

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This morning we saw a series of presentations from the Monopoly Study, which is a national Australian study that looked at how gay and bisexual men think about and conduct their relationships. They looked at whether gay men have explicit relationship agreements with their regular partners, particularly around issues like monogamy. They also presented finding around why and when couples change their relationship agreements from monogamous to open and vice versa.

Some interesting points included:

  • There is inconsistent classification of sexual partners in the literature. Generally in Australia partners are classified as either "regular" or "casual", but the definition of these categories is inconsistent. Particularly, they highlighted that "fuckbuddies" can be placed in either the regular or casual partner category, and perhaps clinicians and data collectors need to consider this group of partners as separate to either regular or casual partners.
  • Young men have shorter relationships than their older counterparts.
  • Young men tend to assume that being in a relationship means that the relationship is monogamous, so they don't tend to have explicit relationship agreements. There was some discussion on why this may be so. One thought was that these days young gay men tend to have more heterosexual friends than in previous generations, and hence they tend to have views on relationships that mirror their heterosexual counterparts. I think that perhaps this may also underlie the change in relationships amongst young heterosexuals, where it seems that young heterosexual couples now more often make explicit agreements around monogamy vs having an open relationship. Another possible contributor to the lack of relationship agreements among young gay couples is the ongoing marriage equality campaign. I think it's fair to say that the marriage equality campaign in Australia tends to promote monogamous gay relationships as being "the norm", and tend to ignore the many other possible types of gay relationships. Such campaigns may have altered the perception of young gay men on what is expected in a gay relationship, and hence they don't feel the need to have an explicit agreement.
  • Older men tend to have explicit relationship agreements. The explanation offered was that many gay men over time come to the realisation that relationships are complex, and that the supposed "rules" dictated by social norms are not concrete. As such, they feel that it's important to discuss the needs of both partners, and that an agreement is reached, which is may subsequently be revised when the couple's needs change.

So what does all of this mean for clinicians?

  1. It may be useful to ask patients about fuckbuddies when talking about their relationships, and to ask what agreements people have with their fuckbuddies. In the "casual" vs "regular" linguistic dichotomy, fuckbuddies may get lumped in the "casual" category, and thus not get the attention they deserve.
  2. We must ask young gay guys whether they have explicit relationship agreements with their regular partners and fuckbuddies, as this data shows that they often assume that their relationships are monogamous. The assumption of monogamy may place them at increased risk of HIV and STIs.