Non-primary sexual partners: overlooked sources of social support for gay and other men who have sex with men

Jorge Soler, Theo Sandfort, Victoria Frye, Vijay Nandi, Emily Greene, Hong-Van Tieu


Background: Among the social networks of gay men and other men who have sex with men (GMSM), sources of social support examined typically include family and friends in addition to primary (i.e., romantic) sexual partners, with types of support ranging from psychological to material. The role of non-primary sexual partners (casual partners, friends with benefits, hookups, etc.) as sources of support, however, remains overlooked and understudied. The current study is among the first to examine quantitatively the presence and supportive roles of non-primary sexual partners in the social support and sexual networks of GMSM. Methods: Data are derived from NYCM2M, a cross-sectional social epidemiological study examining the influence of neighborhood characteristics on sexual behaviors, substance use, and depression among GMSM living in New York City. Study participants completed a computer-based self-interview survey and an interviewer-administered egocentric social support and sexual network inventory. Participants listed up to 10 network alters, describing their gender, support they provide (emotional, financial, medical, and/or companionship), relationship to the participant (sexual partner, family, friend, or other), and relationship type if a sexual partner (primary/main, steady non-primary, casual, exchange, trade, or anonymous). Bivariate associations were used to examine differences in types of support received and in tie strength among 3 participant–sexual partner groups: participants with primary partners only, non-primary partners only, or both. Results: Among 1,427 GMSM study participants, 49% (n=704) reported at least one male sexual partner in their social support network. GMSM reporting any sexual partners had significantly (p<.001) larger networks overall (M=6.4 vs. M=5.5) but fewer friendship ties (M=2.9 vs. M=3.5) compared to those reporting no sexual partners. Among those reporting sexual partners, 26% had only non-primary partners, 58% had only primary partners, and 16% had both partner types. More GMSM with both partner types received emotional and financial support as compared with GMSM with only primary or non-primary partners; more GMSM with only primary partners received medical support (p<.001). GMSM with only non-primary partners were least likely to receive support (p<.001) but most of them still received emotional (64%), medical (53%), and financial (53%) support from them. Communication was most and least frequent with primary and non-primary partners, respectively (p<.001). Participants with both partner types knew their sex partners longer (6.4 years) compared to participants with only primary or non-primary partners (4.8 years) (p<.024). Discussion: Non-primary sexual partners are key sources of social support for GMSM in our study. Overall, one in five GMSM received emotional, financial, medical, and/or companionship support from non-primary sexual partners. Our findings align with previous qualitative evidence highlighting the supportive roles of non-primary sexual partners in the lives of GMSM. Future quantitative research on social support and social networks among GMSM should be inclusive of non-primary sexual partners and examine the concurrent supportive and sexual ties to these partners. Public health research on the impact of social networks in HIV transmission among GMSM continues to increase. As social network interventions become an important strategy for HIV prevention, a better understanding of GMSM’s relationships also becomes critical.

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