Table 3.

Exemplary quotes of couples’ perceived facilitators of decision-making toward the use of HIV prevention strategies

	Communication	Information / Resources
Seroconcordant positive	Concurrent
	Partner A: After we have talked about it, after talking about I guess sitting down and trying to decide what strategies I like, what strategies he like, prevention strategy, just come together as one and making a decision. Partner B: “Going over all the research, all the prevention strategies we could to come up with a plan of this is what we’re going to do. This is how we’re going to prevent it and stay safe.”	Partner A: “Research the different options.” Partner B: “A resource or tool that was online to learn more details about different types of prevention strategies and how they work to see which one is best in my situation; someone to talk to.”
Seroconcordant positive	Divergent
	Partner A: “Going to our separate doctors.” Partner B: “Being on the same page and talking.”	Partner A: “I want a pros and cons list.” Partner B: “Having someone else there. A third party but you also have to know the facts.”
Seroconcordant negative	Concurrent
	Partner A: I think just kind of continued dialogue about where we are and the sex that we’re having. If that changes, I don’t anticipate it, but if ... we started having outside couples either kind of separately or together or something, then that would kind of be another conversation that we would just have. Partner B: I guess just talking through it would be the easiest way to do it. You know, if he had a problem with something, or I had a problem with something, we would talk about it and change the way we protect ourselves.	Partner A: I feel like talking to my doctor individually and then him talking to his doctor about ... But both, essentially, discussing beforehand and after what we discussed with our physicians and stuff like that.” Partner B: I feel like doubling back to education. Just having some kind of platform out there that’s more ... obviously things like Grinder are huge with the gay area, the gay community, not the gay area. And I feel like maybe having some kind of platform like that to reach out to these people and just give them little tidbits on how to keep themselves protected and how to keep themselves safe would be huge. Because especially in smaller areas, there’s no resource really unless you reach out.”
Seroconcordant negative	Divergent
	Partner A: “We both give each other quite a bit of leeway with our personal health decisions, but it is something that we would inform each other about going into it.” Partner B: “A conversation that establishes limits and boundaries I think would be the most helpful there, you know, I’m going to indulge this for you, but here are my terms,’ sort of thing. And just making sure that everyone’s comfortable with what’s going to happen. And should any partner want to withdraw from the activity at any point, they feel comfortable doing so, and they don’t feel embarrassed or I guess nervous to not want to back out for themselves.”	Partner A: For me, what would help me decide is the research and the facts and the data. I’m just like an analytical person. For him, it would probably be the emotion behind it. He definitely wants to either feel comfortable or have like a pleasurable feeling during sex. Condoms may not be the best option for him unless there’s like a certain condom that you can still feel the sensation, which I did find, which in my opinion is SKYN. But I think like, yeah, for me, it’s more the data. For him, it’s more the feelings. Partner B: I think that we have ... since not using condoms, I don’t know. I think that we just feel really close to each other and I think that whatever strategy would allow us to maintain that closeness is what we would take. So we don’t use condoms, and I think that if I was to pick any strategy out of any of them it would probably be just to take PrEP because therefore it would not ... that sense of intimacy that maybe putting a condom on can kind of interrupt. And I’m not an advocate for not using condoms, but I think that sometimes there’s moments where you are in an intimate setting that maybe you don’t have access to a condom or would maybe interrupt what you guys were doing.”
Serodiscordant	Concurrent
	Partner A: “Talking to each other; asking each other questions; checking in with each other and reminding each other to take their meds like they already do.” Partner B: “Having a conversation with hi doctor and with also with my doctor with partner present.”	Partner A: “It’s important that I that understand not only what the medication’s intended to do, but the effects of it on my system and how to go about thinking about that choice because that’s something that will only affect him.” Partner B: “Getting opinions other than just our opinions, but professional opinions as well.”
Serodiscordant	Divergent
	Partner A: Nothing else aside from communication.” Partner B: Sitting down with a doctor and getting concrete answers	Partner B: “Open communication and making sure that each person understands the others concerns and then making sure they address them.” Partner B: “Have information that we don’t already have like side effects and getting HIV while on PrEP.”