Pre-Expose Prophylaxis and Non-Monogamous, HIV Negative Gay Men in Serodiscordant Relationships

HIV transmission continues to increase for Gay men, especially for those Gay men in nonmonogamous serodiscordant relationships. As the use of PreExposure Prophylaxis (PrEP) increases, much less is known about how PrEP is creating social meaning and transforming the sexual behaviors of HIV negative, non-monogamous Gay men. Accordingly, the purpose of this study was to investigate the meaning making experiences of Gay men in nonmonogamous serodiscordant relationships. Using the Minority Stress Model, Resiliency Theory, and Queer Theory as theoretical frameworks, the research question for the study focused on how HIV negative Gay men who are on PrEP and involved in nonmonogamous serodiscordant relationships navigate their sexual lives. Interpretative Phenomenological Analysis was employed within a purposeful sample of 13 Gay men. The two themes of resiliency and reframing emerged from the descriptive coding, member checking, and triangulation of the data. Of the two themes identified, participants noted pre-PrEP resiliency strategies including looks and trust, while current PrEP strategies included strategic positioning, getting educated about HIV and PrEP, and dating undetectable men. Reframing experiences included marketability, greater feeling of sexual freedom and responsibility, new rules around nonmonogamy, increased sexual confidence, and new masculine terms for condomless anal sex. Findings and recommendations from the study may advance positive social change when researchers and practitioners combat stigma, understand perceived lower risk of HIV transmission through new resiliency techniques, and facilitate the reframing of sex within an individual, relational, and Gay cultural context