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. Author manuscript; available in PMC: 2022 May 1.
Published in final edited form as: Arch Sex Behav. 2020 Mar 3;50(4):1689–1700. doi: 10.1007/s10508-019-01621-w

Arrangements versus Agreements: Evaluating two approaches to measuring male couples’ rules and understandings around sex with outside sex partners

Trey V Dellucci a, Cheryl Carmichael b, Tyrel J Starks a,c
PMCID: PMC7809916  NIHMSID: NIHMS1627517  PMID: 32128651

Abstract

One-to-two thirds of new HIV infections among sexual minority men occur within the context of main partnerships. This has led to increasing attention to the rules and boundaries male couples form around sex with outside partners as a mechanism to manage HIV risk. These rules and boundaries have generally been operationalized either as a sexual agreement – the decisions couples make together about their sexual boundaries with outside partners – or a sexual arrangement – how couples handle sex outside the relationship, which may or may not involve an implicit or explicit consensus between partners. The goal of the current study was to examine the correspondence of these two approaches to the operationalization of rules and boundaries. Additionally, the study tested whether agreements and arrangements were differentially associated with dyadic communication and sexual behavior with casual partners. Results indicated a high level of correspondence among assessment methods. Similarly, patterns of sexual behaviors with casual partners were consistent across both sexual agreements and sexual arrangements. In contrast, patterns of communication varied as a function of assessment type. Specifically, constructive, avoidant, and sexual communication varied across sexual agreement types; whereas sexual arrangement types only differed with respect to constructive communication. These findings suggest that there is substantial overlap between arrangements and agreements. Findings particularly related to associations with sexual behavior may largely generalize across these methods of operationalization. In contrast, survey-reported sexual agreements were a more sensitive correlate of dyadic communication.

Keywords: Sexual agreements, sexual arrangements, Gay male couples, dyadic communication, relationship functioning

BACKGROUND

Sexual minority men (SMM) are disproportionately affected by HIV infection. In 2017, SMM accounted for 66% of new HIV infections (Centers for Disease Control and Prevention, 2019). It is estimated that between 35–68% of new HIV infections among SMM occur between main partners (Goodreau et al., 2013; Sullivan, Salazar, Buchbinder, & Sanchez, 2009). Same-sex male couples, particularly partnered men between 18 and 29 years old, are vulnerable to HIV because they engage in higher number of sex acts, more frequent receptive roles, and are more likely to engage in condomless anal sex (CAS) (Cohen et al., 2016; Sullivan et al., 2009).

In the past decade, relationship science has focused on the establishment of sexual agreements between partners as one method a couple may use to reduce HIV risk and to promote overall relationship wellbeing (e.g. Hoff & Beougher, 2010; Hoff, Campbell, Chakravarty, & Darbes, 2016; Lewis, Gladstone, Schmal, & Darbes, 2006). Sexual agreements are the decisions couples make about their sexual behaviors together and the limitations and boundaries of sex with outside partners (Hoff & Beougher, 2010; Mitchell, 2014a, 2014b; Stephenson, White, & Mitchell, 2015). These agreements can be either “implicit” – assumed without an actual discussion between partners – or “explicit” – established after a discussion (Hoff & Beougher, 2010; Hoff et al., 2016).

Studies have shown that sexual agreements between partnered SMM are common. Estimates indicate between 58 to 99% of couples have a sexual agreement (e.g. Cuervo & Whyte IV, 2015; Gass, Hoff, Stephenson, & Sullivan, 2012; Hoff & Beougher, 2010; Hoff, Beougher, Chakravarty, Darbes, & Neilands, 2010; Mitchell, Harvey, Champeau, Moskowitz, & Seal, 2012; Mitchell & Petroll, 2013). Couples often establish a sexual agreement to promote trust and honesty within their relationship (Hoff et al., 2009), and as a means of negotiating safety by discussing what – if any – sexual behaviors are allowed with casual partners (Hoff et al., 2010).

Across both dyadic and individual studies of partnered men, the most common survey-based method of assessing a couple’s sexual agreement is to have the respondent first report on whether or not he “discussed a sexual agreement with his partner” and then to “describe the sexual agreement he has with his partner.” Typical response options include whether they allow sex with outside partners or do not allow sex with outside partners (see review: Rios-Spicer, Darbes, Hoff, Sullivan, & Stephenson, 2019). Most studies which utilize this approach of assessing sexual agreements distinguish between two large sub-categories of explicit sexual agreements (e.g. Hoff et al., 2009; Mitchell & Petroll, 2013; Stephenson et al., 2015). In exclusive or monogamous agreements, sex is restricted to the primary relationship and no sex with casual partners is permitted. Non-exclusive, non-monogamous, or open sexual agreements permit some sexual activity with partners outside their relationship. These agreement types are common among sexual minority partnered men with 31% to 64% of couples identifying a monogamous agreement and 27% to 63% identifying an open agreement (e.g. Gass et al., 2012; Mitchell, Harvey, Champeau, Moskowitz, et al., 2012; Mitchell, Harvey, Champeau, & Seal, 2012; Mitchell & Petroll, 2013).

It is possible for couples to have never explicitly discussed a sexual agreement, and yet have an implicit understanding about the rules or behaviors around sex with outside partners. A modest number of studies have specifically assessed for this characteristic by asking if a respondent’s sexual agreement was “implied or explicit” (Mitchell, 2012; Mitchell, Harvey, Champeau, & Seal, 2012). Alternatively, others have asked if the couple had “openly discussed the agreement” (Feinstein, Dellucci, Sullivan, & Mustanski, 2018). These implicit agreements make up 16 to 23% of established sexual agreements (Feinstein et al., 2018; Mitchell, Harvey, Champeau, Moskowitz, et al., 2012).

Finally, dyadic studies including both members of the couple are also able to detect discrepant sexual agreements among couples. A discrepant agreement exists when each partner has different perceptions of their sexual agreement. For example, one partner may perceive that they have a monogamous agreement, while the other perceives an open sexual agreement in the relationship. These couples represent a minority with estimates around 8% having a discrepant sexual agreement (Hoff et al., 2010).

As an alternative to the assessment of sexual agreements – which assumes some mutual consensus about the rules or limitations on sex with outside partners – some survey-based research has assessed sexual arrangements. Unlike the assessment of explicit sexual agreements, which requires that the couple has had some discussion around the rules and understandings of sex with outside partners, researchers interested in a couple’s sexual arrangement are assessing the behaviors occurring with outside partners despite any mutual agreement between partners. In these studies, couples are asked to characterize the ways in which they handle sex outside their relationship and are typically categorized as having one of four sexual arrangements. Couples who describe not having sex with others are classified as having a monogamous sexual arrangement, and couples who respond with either one or both partners engaging in sex outside the relationship as having a non-monogamous sexual arrangement. More recently studies have distinguished between subtypes of non-monogamous arrangements (e.g. Grov, Starks, Rendina, & Parsons, 2014; Parsons & Starks, 2014; Parsons, Starks, Dubois, Grov, & Golub, 2013; Starks, Robles, et al., 2019). Couples who only participate in sex with causal partners while each member of the couple is present are classified as having a monogamish sexual arrangement. Couples in which sex occurs with a causal partner regardless of the presence of both partners are described as having an open sexual arrangement. Finally, dyadic studies are also able to classify couples as having a discrepant sexual arrangement if one partner reports engaging in sex outside the relationship and the other partner reports that neither member of the couple is having sex outside the relationship.

The establishment of rules and limitations around sex with outside partners are often conceptualized within the framework of Couples Interdependence Theory (CIT; Goldenberg, Finneran, Andes, & Stephenson, 2015; Lewis et al., 2006). According to CIT, partners in a positive functioning relationship will consider how their individual actions affect their partner and how their actions affect the relationship as a whole (Rusbult & Van Lange, 2003). This transformation of motivation increases engagement in behaviors that benefit the interest of the relationship and provides a context for the creation of joint goals – or accommodation (Rusbult, Verette, Whitney, Slovik, & Lipkus, 1991; Yovetich & Rusbult, 1994).

Sexual agreements and sexual arrangements are viewed as a joint goal requiring some effort from both partners to regulate sexual behavior (Hoff, Chakravarty, Beougher, Neilands, & Darbes, 2012; Neilands, Chakravarty, Darbes, Beougher, & Hoff, 2009). When viewed as a joint (or shared) goal, communication between partners is inherent to the successful formation of a congruent sexual agreement – when each partner has the same perceptions of their sexual agreement. Couples with a congruent perception of their agreement are likely able to communicate more constructively, while those with discrepant sexual agreements may avoid or withhold information from discussions more often (Hoff et al., 2010). Similarly, couples with a congruent sexual agreement are more effective at discussing topics related to sexual health than couples without a sexual agreement (Feinstein et al., 2018).

To our knowledge, no studies have empirically tested communication skill differences across sexual agreement groups, and only one has such across sexual arrangements (Parsons, Starks, Gamarel, & Grov, 2012). Parsons et al. (2012) found no differences between monogamous, monogamish, and open sexual arrangement types and sexual communication. The findings of Parsons et al. (2012) are limited by the relatively narrow focus on sexual communication, which represents only one aspect of communication more broadly.

The majority of studies examining sexual agreements and arrangements have tested their association with sexual behavior with outside partners and the occurrence of sexual HIV transmission risk behavior specifically. With regard to sexual agreements, studies have consistently found greater HIV-risk among couples with non-monogamous sexual agreements (Hoff et al., 2012; Mitchell, Champeau, & Harvey, 2013; Mitchell, Harvey, Champeau, & Seal, 2012). These results are consistent with studies of sexual arrangements which have found fewer casual sex partners and fewer instances of CAS with a casual partner among those with monogamous sexual arrangements compared to those with an open and monogamish arrangements (Parsons et al., 2013; Starks, Robles, et al., 2019).

Despite broad interest in sexual agreements in research on male couples particularly, no study has examined the extent to which the distinction between sexual arrangements and agreements is meaningful. While a comparison of findings suggests that the two methods of operationalizing sexual rules and boundaries yield similar associations with sexual behavior with casual partners, CIT would suggest that differences may exist in terms of associations with dyadic communication given the necessary role of communication in the establishment of a sexual agreement.

The purpose of the following study was three-fold. First, it aimed to examine the correspondence of various approaches to the assessment of the rules and understandings couples form about sex with partners outside their relationship. Specifically, the study examined three types of reported discrepancies: 1) between partners in terms of their explicit sexual agreement, 2) between partners and their behavioral sexual arrangement, and 3) between a couple’s explicit sexual agreement and their behavioral arrangement. Second, the study sought to test whether sexual agreements and sexual arrangements were differentially associated with dyadic communication. Third, the study sought to test whether sexual agreements and sexual arrangements were differentially associated with sexual behaviors with casual partners.

It was hypothesized that there would be a high level of correspondence between survey-reported sexual agreements and survey-reported sexual arrangements. Additionally, survey-reported sexual agreements were hypothesized to be a more sensitive correlate of dyadic communication than survey-reported sexual arrangements. Finally, it was expected that patterns of HIV transmission risks behaviors would be similar across survey-reported sexual agreements and survey-reported sexual arrangements.

METHODS

Procedures

Data were utilized from the baseline assessment of a larger study, We Test. The We Test study is a randomized controlled trial (RCT) examining the efficacy of adjunct components to Couples HIV Testing and Counseling (CHTC). Participants were recruited via online platforms and community outreach in the New York City area. Eligible couples were required to be in a relationship for at least 3-months and had to have been sexually active in the prior 3-months. Both partners had to be at least 18 years of age, identify as a cisgender male, live in the New York City area, and be able to communicate in English. At least one partner in the couple had to be between 18 to 29 years old, self-report a negative or unknown HIV status, and report at least one instance of an illicit substance (including marijuana) use in the past 30-days. Couples were excluded if either partner reported physical or sexual intimate partner violence and indicated that they did not feel safe in their current relationship.

Participants were recruited into the study through both online and outreach-based methods throughout the New York City area between January 2016 and August 2017. Online recruitment included distribution of study information through listservs and through paid advertisements via location-based dating apps such as Grindr. Paid advertisements included messaging such as “We Test to stay together,” “We Test to protect each other,” and “We Test and then we talk.” Each advertisement also included a photograph of two men representing a happy couple. Outreach recruitment included study staff attendance at community-based events and social scenes frequented by GBM. Study staff provided flyers with similar messaging as the online advertisements to prospective participants.

A total of 365 individual SMM were screened for eligibility, of which 112 (30.7%) were eligible and were then asked to schedule a baseline appointment together. A total of 70 (62.5%) eligible couples attended and completed a baseline appointment. Partners were consented separately and completed computer assisted self-interviews (CASI) on Qualtrics independently in private rooms. Each partner in the couple was compensated $30 for completing the baseline survey.

Measures

Demographics.

Participants reported their age, race and ethnicity (Black, Latinx. White, Other/Mixed), income (below $30,000 and $30,000 or above), HIV status, PrEP uptake, and relationship length (in months). In cases when partners’ estimation of relationship length differed, responses were averaged.

Dyadic Communication

Dyadic communication was assessed using the Communication Patterns Questionnaire (CPQ) (Christensen & Shenk, 1991). The CPQ consists of two subscales, constructive communication and avoidant communication. Constructive communication consists of three items and had acceptable internal consistency (α = 0.74). A sample item includes “During a discussion of an issue or problem, both of us express our feelings to each other.” Avoidant communication consists of eight items and also had good internal consistency (α = 0.78). A sample item includes “When an issues or problem arises, both of us avoid discussing the problem.” For each item on both subscales, participants rated how likely the situation was to occur on a Likert-type scale ranging from 1 (very unlikely) to 9 (very likely). Higher scores on each subscale indicate a greater likelihood of using that communication style during conflict interactions.

Sexual communication between partners was assessed using the Dyadic Sexual Communication (DSC) questionnaire (Catania, 1998). The DSC consists of 13-items and had good internal consistency (α = 0.82). Sample items include “Talking about sex is a satisfying experience for both of us” and “Some sexual matters are too upsetting to discuss with my partner.” Items were coded such that higher scores indicated better communication. For each item participants rated how much they agreed with the statement on a Likert-type scale ranging from 1 (strong disagree) to 6 (strongly agree).

Sexual behavior
Any sex with a casual partner.

Participants reported on the number of times they engaged in insertive and receptive anal sex with a casual partner with and without their main partner present in the past 90-days. Responses were aggregated into a single dichotomous variable that indicated any sex with a casual partner.

CAS with casual partners.

Participants who reported having a casual sex partner in the past 90-days were then asked to report on the number of times they had CAS. Responses were aggregated into a single dichotomous variable that indicated any CAS with a casual partner.

Rules and understandings about sex with outside partners
Sexual arrangement.

A couple’s sexual arrangement was assessed using a single item: “regardless of any sexual agreements you and your partner have which of the following best characterizes the way you handle sex outside your relationship.” Response options included “neither of us have sex with others,” “only I have sex with others,” “only he has sex with others,” “we only have sex with others together,” “we both have sex with others separately and together,” and “we both have sex with other separately.”

Survey-reported sexual arrangements were classified couples into 1 of 4 categories based on their responses. Couples were classified as Monogamous (n = 28, 40.0%) if both partners responded “neither of us have sex with others.” Couples were classified as Monogamish (n = 12, 17.1%) if both partners responded “we only have sex with others together,” or if one partner responded “we only have sex with others together” and the other partner responded “neither of us have sex with others.” Couples were classified as Open (n = 25, 35.7%) if they responded “only I have sex with others,” “only he has sex with others,” or “we both have sex with others separately and together,” or “we both have sex with others separately.” Couples in which one partner identified a monogamous or monogamish arrangement and the other partner identified an open arrangement were classified as discrepant (n = 5, 7.1%).

Explicit Sexual agreement.

Sexual agreements were assessed using two items. The first item asked, “Have you and your partner discussed an agreement about how you handle sex outside the relationship?” Response options included “no” and “yes”. If the participant responded “yes,” he was then asked, “how would you describe your sexual agreement with your partner?” Response options included “monogamous: we agreed not to have sex with other people”, “we agreed to only have sex with other people if together”, and “open: we agreed to sex with others independently.”

Couples were then classified into 1 of 5 agreement categories based on their responses. Couples were classified as Did Not Discuss (n = 12, 17.1%) if both partners responded reported that they “did not discuss an agreement about how you handle sex outside the relationship.” Among those couples who discussed an agreement, men were classified as Monogamous (n = 17, 24.3%) if both partners “agreed to not have sex with other people,” Monogamish (n = 14, 20.0%) if both partners “agreed to only have sex with other people together” or if one partner “agreed to only have sex with other people together” and the other partner agreed “to not have sex with other people,” Open (n = 20, 28.6%) if both partners “agreed to have sex with others independently,” and Discrepant (n = 7, 10.0%) if one partner reported having agreed to a Monogamous or Monogamish sexual agreement and the other partner reported an open agreement.

Implicit Sexual Agreement.

The measures for both sexual arrangement and sexual agreement were utilized to determine a proxy for an implicit sexual agreement. Couples who did not discuss an explicit sexual agreement but reported a congruent sexual arrangement were considered to have come up to have an implicit understanding about the rules allowed with outside sexual partners.

Analytic Plan

First, the bivariate associations between sexual arrangements and agreements were examined using χ2 tests of independence. To account for interdependence the χ2 tests of independence were assessed at the couple level. Subsequently, Generalizing Estimating Equations (GEE) in SPSS 25 were utilized to examine the associations between both explicit sexual agreements and behavioral sexual arrangements with communication and sex with casual partners to account for the nesting of partners within couples using the Actor Partner Interdependence Model (APIM) framework (Kenny, Kashy, & Cook, 2006). The actor effect represents the association between one’s score on a dependent variable and an independent variable. The partner effect represents the association between the dependent variable and his partner’s score on an independent variable. All GEE analyses controlled for person level factors including the actor and partner effects of age, race, and HIV status and couple level factors including relationship length when examining correlates of dyadic communication and sexual behaviors with casual partners. Actor and partner level PrEP uptake was added as an additional covariate in models examining correlates of sexual behaviors with casual partners. GEE models were utilized to examine survey-reported agreements and arrangements as correlates of dyadic communication and sexual behaviors with casual partners. The first three models included all covariates and sexual agreements as predictors of 1) constructive communication, 2) avoidant communication, and 3) sexual communication separately. Two subsequent GEE models included all covariates and sexual agreements as predictors of 1) having at least one casual partner in the past 90-days and 2) having any CAS with a casual partner in the past 90-days. Finally, each of these models were then replicated with sexual arrangements, in place of sexual agreements, as predictors of each outcome separately.

RESULTS

Participants

Table 1 includes a detailed summary of participant demographics. Participants included 70 same-sex male couples (n = 140 individuals). The average age of participants in the sample was 26.84 (SD = 6.23), and the majority of couples were comprised of both partners 18 to 29 (n = 50, 71.4%). The largest age discrepancy between partners was 61 years. The majority of the sample identified a race or ethnicity other than White, completed at least a 4-year degree, earned less than $30,000 per year, and was HIV negative. Eleven couples were serodiscordant and the average relationship length was 26.51 months (SD = 24.69).

Table 1.

Summary of Demographics

Individual Level (N = 140) N (%) κ
Race
 White 64 45.7 0.67**
 Black 35 25.0 0.74**
 Latino 23 16.4 0.28*
 Other 18 12.9 0.11
Sexual Orientation −0.10
 Gay 127 90.7
 Bisexual 13 9.3
Education 0.42**
 less than a four year degree 53 37.9
 at least a four year degree 87 62.1
Income 0.31
 less than 30k per year 36 51.4
 at least 30k per year 34 48.6
HIV −0.07
 Negative 130 92.9
 Positive 10 7.1
Couple Level (N =70) M SD ICC
Relationship length 26.51 24.69 .99**
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*

p < .05

*

p < .001

Correspondence between sexual agreements and arrangements

The correspondence between explicit sexual agreements and sexual arrangements was statistically significant, χ2 (12) = 97.33, p < .001 (see Table 2). Forty-five couples (64.3%) indicated a behavioral sexual arrangement that was congruent with their explicitly discussed sexual agreement. The majority of couples who reported having explicitly discussed a monogamous sexual agreement also reported having a behavioral monogamous sexual arrangement (n = 15, 88.2%). Similarly, the majority of couples who reported having explicitly discussed a monogamish sexual agreement also reported a behavioral monogamish sexual arrangement (n = 11, 78.6%), and the majority of couples who reported explicitly having explicitly discussed an open sexual agreement reported having a behaviorally open sexual arrangement (n = 19, 95%).

Table 2.

Correspondence between survey-reported sexual agreement and survey-reported sexual arrangement

Sexual arrangement in baseline survey
Total n (%) Monogamous n (%) Monogamish n (%) Open n (%) Discrepant n (%)
n 70 (100) 28 (40.0) 12 (17.1) 25 (35.7) 5 (7.1)
Sexual agreement at baseline
 Monogamous 17 (24.3) 15 (88.2) 0 (0.0) 0 (0.0) 2 (11.8)
 Monogamish 14 (20.0) 2 (14.3) 11 (78.6) 1 (7.1) 0 (0.0)
 Open 20 (28.6) 1 (5.0) 0 (0.0) 19 (95.0) 0 (0.0)
 Discrepant 7 (10.0) 2 (28.6) 0 (0.0) 3 (42.9) 2 (28.6)
 Didn’t Discuss 12 (17.1) 8 (66.7) 1 (8.3) 2 (16.7) 1 (8.3)
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Note. χ2 (12) = 97.33, p = .000

Six couples (8.6%) reported an explicitly discussed sexual agreement that was different from their behavioral sexual arrangement. Two couples reported having explicitly discussed a monogamous sexual agreement but reported a behaviorally discrepant sexual arrangement (33.3%). Similarly, two couples indicated having explicitly discussed a monogamish sexual agreement but reported a behavioral monogamous sexual arrangement (33.3%). One couple indicated an explicitly discussed monogamish sexual agreement but reported a behaviorally open sexual arrangement (16.7%). Finally, one couple (16.7%) reported an explicitly discussed open sexual agreement but reported a behaviorally monogamous sexual arrangement.

Seven additional couples (10.0%) indicated they had explicitly discussed their sexual agreement but were discrepant in their reporting of their sexual agreement. Of the couples who reported discrepant sexual agreements, 42.9% (n = 3) of couples reported a behaviorally open sexual arrangement and 28.6% (n = 2) reported a behaviorally monogamous sexual arrangement. The remaining two couples (28.6%) (n = 2) also reported a behaviorally discrepant sexual arrangement.

Implicit sexual agreements.

An additional 12 couples (17.1%) of couples reported not having explicitly discussed a sexual agreement together. All but one of these reported a sexual arrangement that was congruent with their implicit agreement. This suggests that these couples have an assumed understanding about the rules and behaviors around sex with outside partners, which may be a proxy for implicit sexual agreement. The majority of these couples identified a monogamous sexual arrangement (n = 8, 66.7%), followed by open (n = 2, 16.7%), and monogamish (n = 1, 8.3%). Finally, one couple reported a discrepant sexual arrangement.

Sexual agreements and arrangements as correlates of dyadic communication

Table 3 contains the results of GEE models testing associations between survey-reported agreements and measures of dyadic communication. Both subscales of the CPQ and sexual communication varied across explicitly discussed sexual agreements. Couples with open sexual agreements had better communication skills than other groups. Specifically, couples with open sexual agreements scored higher on constructive communication (M = 22.40, SE = 0.63) than those with monogamish (M = 20.82, SE = 0.85) and discrepant (M = 19.75, SE = 0.57) agreements, Wald x2 (4) = 10.71, p = 0.03. Similarly, those with open sexual agreements (M = 23.56, SE = 1.74) scored lower on avoidant communication than those with monogamish agreements (M = 30.59, SE = 2.39) and those who did not explicitly discuss a sexual agreement (M = 31.10, SE = 2.48), Wald x2 (4) = 10.01, p = 0.04.. Finally, those with discrepant sexual agreements (M = 54.99, SE = 1.78) had fewer skills in sexual communication than any other sexual agreement group, Wald x2 (4) = 13.82, p = 0.00.

Table 3.

Survey reported sexual agreements as predictors of dyadic communication and HIV transmission risk behaviors

Monogamous (n = 17) Monogamish(n = 14) Open (n = 20) Discrepant (n = 7) Did not Discuss (n = 12) Wald χ 2 (4)
M SE M SE M SE M SE M SE
Constructive Communication 20.82a,b (0.85) 20.25a (0.85) 22.40b (0.63) 19.75a (0.57) 20.64a,b (0.93) 10.72*
Avoidant Communication 29.90a,b (2.34) 30.59a (2.39) 23.56b (1.74) 27.84a,b (1.48) 31.10a (2.48) 10.01*
Sexual Communication 62.69a (1.41) 61.26a (2.38) 63.94a (2.27) 54.99b (1.78) 61.36a (2.10) 13.82*
% SE % SE % SE % SE % SE Wald χ 2 (4)
≥ 1 CP 2.00a (0.23) 55.00b (2.74) 61.00b (2.64) 36.00a,b (2.53) 37.00b (2.58) 10.51*
≥ 1 CAS with a CP 1.00a (0.22) 31.00b (3.28) 28.00b (3.09) 10.00a,b (1.34) 14.00a,b (1.81) 7.16
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Notes. All analyses controlled for race, HIV status, age, and relationship length; Superscripts note mean differences across rows at p < .05

With respect to covariates of communication in models including couples’ explicitly discussed sexual agreements, no actor scores were associated with constructive communication (age (B = 0.02, SE = 0.07, p = 0.81), race (B = 0.54, SE = 1.05, p = 0.27), or HIV status (B = 2.10, SE = 1.72, p = 0.22). Similarly, no partner scores were associated with constructive communication (age (B = 0.06, SE = 0.06, p = 0.35), race (B = 1.77, SE = 1.14, p = 0.12), or HIV status (B = −1.59, SE = 1.39, p = 0.25). At the couple level, relationship length (was not associated with constructive communication (B = −0.27, SE = 0.02, p = 0.09). Similarly, no actor scores was associated with avoidant communication (age (B = −0.17, SE = 0.20, p = 0.41), race (B = −1.26, SE = 2.26, p = 0.58), or HIV status (B = −3.02, SE = 4.33, p = 0.49). In contrast, having a white partner was negatively associated with avoidant communication (B = −7.89, SE = 2.20, p = 0.00). No other partner scores were associated with avoidant communication (age (B = 0.24, SE = 0.19, p = 0.20), HIV status (B = −0.62, SE = 4.10, p = 0.88). At the couple level, relationship length was positively associated with avoidant communication (B = 0.12, SE = 0.48, p = 0.01). Finally, no actor scores were associated with sexual communication (age (B = 0.03, SE = 0.15, p = 0.84), race (B = 0.80, SE = 2.03, p = 0.70), HIV status (B = −0.27, SE = 3.60, p = 0.94). Similarly, partner scores were not associated with sexual communication (age (B = −0.30, SE = 0.15, p = 0.84), race (B = 3.68, SE = 2.24, p = 0.10), HIV status (B = −2.90, SE = 3.66, p = 0.43). However, relationship length at the couple level was negatively associated with sexual communication (B = −0.10, SE = 0.05, p = 0.04).

Table 4 contains the results of GEE models testing associations between a couple’s reported behavioral sexual arrangement and measures of dyadic communication. Only constructive communication varied significantly across arrangement groups. Couples who had discrepant sexual arrangements (M = 17.42, SE = 1.23) reported lower constructive communication skills than those with monogamous (M = 21.11, SE = 0.46), open (M =21.87, SE = 0.63), and monogamish (M = 17.42, SE = 1.73) sexual arrangements, Wald x2 (3) = 10.70, p = 0.01. Neither avoidant communication nor sexual communication differed significantly across sexual arrangement groups.

Table 4.

Survey reported sexual arrangements as predictors of dyadic communication and HIV transmission risk behaviors

Monogamous (n = 28) Monogamish (n = 12) Open (n = 25) Discrepant (n = 5) Wald χ 2 (3)
M SE M SE M SE M SE
Constructive Communication 21.11a (0.46) 20.54a (0.98) 21.87a (0.63) 17.42b (1.23) 10.70*
Avoidant Communication 28.47 (1.58) 30.99 (2.67) 24.80 (1.75) 34.62 (3.93) 7.15
Sexual Communication 60.58 (1.44) 64.54 (2.38) 62.91 (1.92) 60.00 (2.87) 6.33
% SE % SE % SE % SE Wald χ 2 (2)
≥ 1 CP 11.00a (1.22) 77.00b (2.22) 64.00b (2.94) † 17.42**
≥ 1 CAS with a CP 2.00a (0.35) 38.00b (3.89) 32.00b (3.60) † 13.97*
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Notes. All analyses controlled for race, HIV status, age, and relationship length; Superscripts note mean differences across rows at p < .05

†

Zero cases of casual partners

With respect to covariates of communication in models including couple’s reported behavioral sexual arrangements, no actor scores were associated with constructive communication (age (B = 0.04, SE = 0.08, p = 0.63), race (B = 0.54, SE = 1.03, p = 0.60), HIV status (B = 1.51, SE = 1.66, p = 0.36). No partner scores were associated with constructive communication (age (B = 0.08, SE = 0.06, p = 0.18), race (B = 1.77, SE = 1.12, p = 0.12), HIV status (B = −2.18, SE = 1.47, p = 0.14). At the couple level, relationship length was not associated with constructive communication (B = −0.03, SE = 0.01, p = 0.05). Similarly, no actor scores were associated with avoidant communication (age (B = −0.21, SE = 0.22, p = 0.34), race (B = −1.65, SE = 2.27, p = 0.47), HIV status (B = −1.82, SE = 4.40, p = 0.68). In contrast, having a white partner was negatively associated with avoidant communication (B = −8.28, SE = 2.24, p = 0.00). No other partner score was associated with avoidant communication (age B = 0.20, SE = 0.19, p = 0.29) HIV status (B = 0.58, SE = 4.01, p = 0.89). At the couple level, relationship length was positively associated with avoidant communication (B = 0.14, SE = 0.05, p = 0.01). Finally, no actor scores were associated with sexual communication (age (B = 0.05, SE = 0.16, p = 0.78), race (B = 0.62, SE = 2.01, p = 0.76), HIV status (B = −1.31, SE = 3.52, p = 0.71). No partner were associated with sexual communication (B = −0.08, SE = 0.18, p = 0.67), race (B = 3.51, SE = 2.26, p = 0.12), HIV status (B = −3.93, SE = 3.45, p = 0.25). In contrast, relationship length at the couple level was negatively associated with sexual communication (B = −0.11, SE = 0.05, p = 0.02).

Sexual agreements and arrangements as correlates of HIV transmission risk behaviors

Table 3 contains GEE models examining between group differences in survey-reported sexual agreements and HIV transmission risk behaviors. Couples who reported having a monogamous sexual agreement (M = 0.02, SE = 0.23) were significantly less likely to have had sex with a casual a partner in the past 3-months compared to couples with a monogamish (M = 0.55, SE = 2.74) or open agreement (M = 0.61, SE = 2.64) and to couples who had no sexual agreement (M = 0.37, SE = 2.58), Wald x2 (4) = 10.51, p = 0.03. Couples did not differ significantly in engaging in CAS with casual partner across agreement types, Wald x2 (4) = 7.16, p = 0.13.

With respect to covariates of sexual behaviors with casual partners in models including survey reported sexual agreements, no actor effects were associated with having at least one casual partner in the past 90-days (age (B = −0.01, SE = 0.03, p = 0.72), HIV status (B = 0.69, SE = 0.87, p = 0.42), PrEP uptake (B = 0.45, SE = 0.37, p = 0.22). No partner effects were associated with having at least one casual partner in the past 90-days (age (B = 0.04, SE = 0.04, p = 0.30), HIV status (B = 0.44, SE = 0.86, p = 0.61), PrEP uptake (B = −0.02, SE = 0.37, p = 0.96). At the couple level, relationship length was not associated with having a casual partner (B = −0.01, SE = 0.01, p = 0.80). In contrast, actor PrEP uptake was significantly associated with having CAS, specifically, with a casual partner in the past 90-days (B – 1.35, SE = 0.60, p = 0.03). No other actor effects were associated with having CAS with a casual partner in the past 90-days (age (B = −0.02, SE = 0.06, p = 0.78), race (B = −0.31, SE = 0.51, p = 0.55), HIV status (B = −0.11, SE = 0.99, p = 0.91). No partner effects were associated with having CAS with a casual partner in the past 90-days (age (B = −0.03, SE = 0.04, p = 0.49), HIV status (B = 1.33, SE = 1.22, p = 0.28), or PrEP uptake (B = 0.08, SE = 0.64, p = 0.90). At the couple level, relationship length was not associated with having CAS with a casual partner (B = −0.03, SE = 0.02, p = 0.09).

Table 4 contains GEE models examining between group differences in survey reported sexual arrangements and HIV transmission risk behaviors. Couples with a discrepant sexual arrangement did not report any casual partners and were therefore excluded from these analyses. Consistent with survey–reported sexual agreements, couples who reported having a monogamous sexual arrangement (M = 0.11, SE = 1.22) were least likely to have had sex with a casual partner compared to monogamish (M = 0.77, SE = 2.22) and open (M = 0.64, SE = 2.94) sexual arrangements, Wald x2 (2) = 17.42, p = 0.00. Similarly, couples who reported having a monogamous sexual arrangement were less likely to have had CAS with a casual partner compared to the other sexual arrangement types, Wald x2 (2) = 13.97, p = 0.01. Couples with monogamish and open sexual arrangements did not differ behaviorally from one another in their reports of having at least one casual partner or CAS with a casual partner in the past 3-months.

With respect to the association between covariates of having a casual partner in the past 90-days in the models including survey reported sexual arrangements, no actor effects were significant associated with having at least one casual partner in the past 90-days (age (B = −0.01, SE = 0.01, p = 0.47), HIV status (B = 0.78, SE = 0.94, p = 0.40), PrEP uptake (B = 0.21, SE = 0.40, p = 0.61). Similarly, no partner effects were significantly associated with having at least one casual partner in the past 90-days (age (B = 0.01, SE = 0.04, p = 0.62), HIV status (B = 0.84, SE = 1.18, p = 0.48), PrEP uptake (B = −0.14, SE = 0.37, p = 0.70). At the couple level, relationship length was not significantly associated with having a casual partner in the past 90-days (B = −0.01, SE = 0.01, p = 0.47). These results resembled the association between covariates as correlates of having CAS with a casual partner in the past 90-days. Specifically, there were no associations between actor effects and having CAS with at least one casual partner in the past 90-days (age (B = 0.01, SE = 0.06, p = 0.98), HIV status (B = 00.39, SE = 1.07, p = 0.72), PrEP uptake (B = 1.25, SE = 0.64, p = 0.05). No partner effects were associated with having CAS with at least one casual partner in the past 90-days (age (B = −0.01, SE = 0.05, p = 0.90), HIV status (B = 1.08, SE = 1.24, p = 0.38), PrEP uptake (B = −0.20, SE = 0.65, p = 0.76). At the couple level, relationship length was also not associated with having CAS with a casual partner (B = −0.04, SE = 0.02, p = 0.50).

Post-Hoc Power Analyses

A series of repeated measure ANOVAS were conducted post-hoc as a proxy for estimating power in models of sexual agreements and sexual arrangements on each communication outcome independently. The first three models included all covariates and sexual agreements as predictors of the average between actor and partner scores of 1) constructive communication, 2) avoidant communication, and 3) sexual communication separately. These models were then reproduced with sexual arrangements, in place of sexual agreements, as predictors of each outcome. Results revealed that a sample of 70-shared units were stable with modest power ranging from 0.29 to 0.65. Effect sizes for communication were small (ηp2 = 0.05 to 0.14).

DISCUSSION

Survey-reported sexual agreements and sexual arrangements, in many respects, provided similar information. Overall, there was a correspondence between explicit sexual agreement and sexual arrangement types. The majority of couples who did not explicitly discuss their sexual agreement together reported congruent sexual arrangements, which provides some indirect evidence of a potential implicit agreement about the rules and boundaries of sex with outside patterns. Additionally, the current study found that patterns of HIV risk behaviors were consistent across both sexual agreements and sexual arrangements. Specifically, couples who identified their sexual agreement and arrangement as monogamous were less likely to report a recent casual partner or recent CAS with a casual partner compared to other agreement and arrangement types. In contrast, there were meaningful differences in the patterns of communication across the two constructs. Where present, these differences are consistent with the assertion that sexual agreements have a relatively higher communication demand.

These results generally suggest that the literature on rules and understandings around sex which has previous distinguished between arrangements (e.g. Parsons & Starks, 2014; Starks, Robles, et al., 2019) and agreements (e.g. Hoff et al., 2012; Mitchell, Harvey, Champeau, & Seal, 2012) can, in many respects be unified. There was considerable correspondence between these two approaches to the operationalization of the construct, particularly with respect to arrangements and explicit agreements. The current study found that 88% and 95% of couples with an explicit monogamous or open sexual agreement also reported a monogamous or open sexual arrangement specifically. Similarly, there was high correspondence between monogamish sexual agreements and arrangements.

The current study also found that the majority of couples who did not explicitly discuss a sexual agreement also reported a congruent sexual arrangement. This finding is consistent with previous research which has suggested that couples are able to come to a mutual understanding about the rules and boundaries of sex outside the main partnership without having an explicit conversation about their sexual agreement directly (Hoff & Beougher, 2010; Mitchell, 2012; Mitchell, Harvey, Champeau, & Seal, 2012). This highlights the need for researchers to probe for the nature of potential understandings even among couples who deny having an explicit agreement. One method of doing so is for researchers to utilize measures of both explicit sexual agreements and sexual arrangements in their studies.

Patterns of couple’s HIV-risk behaviors were consistent across assessment type. Across assessments, couples in monogamous relationships reported the fewest sexual behaviors with casual partners overall. These results are consistent with previous studies which have found that non-monogamous relationships are associated with greater HIV risk than those in monogamous relationships (e.g. Hoff et al., 2012; Mitchell, Harvey, Champeau, & Seal, 2012; Starks, Robles, et al., 2019). Additionally, this provides evidence that the establishment of rules around sex with outside partners is one method that can reduce HIV risk within the couple (e.g. Hoff & Beougher, 2010; Hoff et al., 2016; Lewis et al., 2006) and offers a promising area for clinical interventions focused on preventing HIV transmission (Newcomb et al., 2017; Starks, Dellucci, et al., 2019).

The measure of explicitly discussed sexual agreements was more sensitive of group differences across various domains of communication. Between arrangement group differences were only observed in constructive communication while between agreement group differences were observed in constructive and avoidant communication and the specific measure of sexual communication. These findings were generally consistent with hypotheses implied in CIT (Rusbult & Van Lange, 2003) and findings from previous studies (Feinstein et al., 2018; Hoff et al., 2010).

Couples who had explicitly discussed having an open sexual agreement had more adaptive communication skills. In addition to being less likely to avoid difficult conversations, these couples were better communicators on topics related to sex and were more likely to constructively discuss general conflict together. In contrast, couples who were discrepant in their sexual agreement were less able to discuss topics around sexual desires and sexual satisfaction, and were less likely to communicate constructively in regards to conflict. It is possible that couples who allow sex with outside partners may be better equipped to navigate difficult conversations successfully than those who are unable to form a congruent sexual agreement. This is consistent with the notion that communication is a cornerstone for utilizing sexual agreements with outside partners (Mitchell, Harvey, Champeau, Moskowitz, et al., 2012) and further underscores the notion that open relationships are not inherently a sign of dysfunction within the relationship (LaSala, 2005; Shernoff, 2006).

Interestingly, couples who had implicitly formed (not discussed) a sexual agreement were similar communicators to those with explicit sexual agreements, with one exception. Compared to those with open agreements, those with an implicit sexual agreement tended to avoid stressful conversations. Despite this, these couples were able to discuss difficult conversations constructively and were able to talk about their sexual desires and sexual satisfaction, suggesting that couples with implicit agreements are not inherently poor communicators.

This is the first study to examine differences between multiple domains of communication across sexual arrangement types. Consistent with CIT (Rusbult & Van Lange, 2003), couples with discrepant arrangements were less equipped to discuss stressful conversations or conflict constructively compared to couples with congruent sexual arrangements. The current study also found that there were no differences between sexual arrangements and sexual communication, which is consistent with the previous study (Parsons et al., 2012). Together, this suggests that positive communication – regardless of one’s ability to discuss sexual desire and satisfaction – between partners may be essential for couples to have a similar understanding about the rules and understandings around sex with or without the establishment of a sexual agreement.

These findings have implications for the assessment of the rules and understandings couples have about sex with partners outside the main relationship in survey-based research. First, the current study provides evidence for utilizing both measures of sexual agreements and sexual arrangements in a single study. Measuring both allows for a nuanced assessment of congruent understandings around sex among couples who have assumed or implicit sexual agreements. Second, in the case that a study requires fewer survey-based measures, the current study found considerable correspondence between sexual agreements and sexual arrangements, suggesting that similar information is provided by either measure. In instances where researchers need to simplify their measures, the arrangement variable yields fewer categories because it collapses implicit and explicit agreements. This makes it a more crude measure, but results in a simpler nominal variable (one with fewer categories) which may be preferable in studies where brevity is more important than nuance. In contrast, studies that are interested in aspects of dyadic communication, that might be related to accommodation, may benefit from the nuance obtained in the sexual agreement question compared to sexual arrangement, because the assessment of sexual arrangements inherently lump together both explicit and implicit sexual agreements, which may blur meaningful differences in communication across various rules and understandings around sex with outside partners.

The current study is not without limitations. First, the current study does not include a measure for implicit sexual agreements. Therefore, we cannot say with complete certainty that there are implicit sexual agreements among couples who did not explicitly discuss an agreement. Despite this limitation, the current study did demonstrate a novel use of arrangements to obtain data on the congruence of impressions among men who did not discuss an agreement – which may be a proxy for implicit sexual agreements. Second, participants were required to participate together, which may bias the sample towards couples with better communication skills (Starks, Millar, & Parsons, 2015). Third, the current sample under-represents HIV positive men because at least one partner had to be HIV negative at baseline. Therefore, these results may not generalize to seropositive couples. Similarly, this study focused on couples in the New York City area, which may limit these results to sexual minority men in urban areas. Fourth, the majority of participants in the current study were YMSM between 18 and 29 years old. Therefore, the results of the current study may better reflect YMSM and may not generalize to older MSM. Fifth, at least one partner in the couple was required to have used a illicit substance in the past 30-days. It is possible that the results from the current study do not generalize to couples in which both partners are non-substance users. Specifically, rates of monogamous sexual agreements and arrangements may be higher among main partners who do not use substances (Parsons & Starks, 2014). Fifth, post-hoc analyses revealed that power was modest, therefore null hypothesis should be interpreted with caution. Finally, rates of CAS were low across the entire sample and therefore the findings from the current study may not generalize to riskier couples.

Despite these limitations, the findings from the current study provide meaningful information on the methodological distinction between arrangements and agreements might impact conclusions about the rules and limitations of sex with outside partners within a couple. Couple’s reported sexual agreements largely corresponded with their reported sexual-arrangements and both sexual agreements and sexual arrangements produced similar patterns in their association with HIV risk behaviors. Despite these similarities, sexual agreements manifest a stronger association with various domains of communication, suggesting that the while these methods of assessment are highly similar, the distinction between them is potentially non-trivial.

Acknowledgement:

Collection of these data was supported by a National Institute on Drug Abuse grant (R34 DA036419; PI Starks).The analyses of these data was supported by a National Institute on Drug Abuse grant (R34 DA043422; PI Starks).The authors acknowledge the contributions of the We Test Project Team, particularly Jeffrey Parsons, Patrick Sullivan, Robert Stephenson, Nahuel Smith Becerra, Mark Pawson, Andrew Cortopassi, Chris Hietikko, and Scott Jones. We also thank Rich Jenkins for his support of the project as well as PRIDE Research Consortium staff, recruiters, interns and our participants who volunteered their time.

Footnotes

Compliance with Ethical Standards

Conflict of interest: The authors declare that they have no conflict of interest.

Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution at which the studies were conducted.

Informed Consent: Informed consent was obtained from all individual participants included in the study.

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