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<p>HIV protection depends on the consent and cooperation of sexual partners, which requires negotiation. Early HIV-related research identified condom negotiation strategies. However, strategies used specifically among men having sex with men (MSM) remained underexamined. This project explored how HIV-negative MSM negotiate their protection from HIV when having sex with non-steady partners, considering current risk reduction practices, the availability of several effective biomedical prevention options, the strong presence of STIs and prevailing online dating. We conducted in-person interviews with a maximum variation sample of 29 MSM, aged 21–80, combining narrative interviewing with a virtual-reality serious game and a series of standardized questions. We analyzed the interview data using content analysis, combining deductive and inductive approaches. We identified three categories of negotiation strategies used in chats, during in-person dates or when having sex: (i) <i>subject-centered strategies</i> anchored in the will and determination of MSM; (ii) <i>strategies centered on sexual arousal</i>, asserting MSM’s preferred protection strategy; (iii) <i>strategies centered on risk communication</i>. Further, we identified actions that interrupt negotiations and directly enforce protection or bypass negotiations. Participants combined several strategies during negotiations. The strategies also demonstrated versatility: most were used for various aims and were not systematically related to a specific personal protection strategy. This study posits an elaborate range of HIV-protection negotiation strategies used by MSM, including strategies not previously described. It contributes to a more nuanced understanding of negotiation strategies and encourages prevention professionals to reflect on the attention given to negotiation strategies in prevention offers.</p>

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Negotiating HIV Protection in the Era of Online Dating and Pre-Exposure-Prophylaxis (PrEP): Insights into How Men Having Sex with Men (MSM) Living in Switzerland Negotiate their HIV Protection with Non-steady Partners

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Daniel Gredig,
  • Daniele Bigoni,
  • Jasmina Bogdanovic,
  • Patrick Weber

摘要

HIV protection depends on the consent and cooperation of sexual partners, which requires negotiation. Early HIV-related research identified condom negotiation strategies. However, strategies used specifically among men having sex with men (MSM) remained underexamined. This project explored how HIV-negative MSM negotiate their protection from HIV when having sex with non-steady partners, considering current risk reduction practices, the availability of several effective biomedical prevention options, the strong presence of STIs and prevailing online dating. We conducted in-person interviews with a maximum variation sample of 29 MSM, aged 21–80, combining narrative interviewing with a virtual-reality serious game and a series of standardized questions. We analyzed the interview data using content analysis, combining deductive and inductive approaches. We identified three categories of negotiation strategies used in chats, during in-person dates or when having sex: (i) subject-centered strategies anchored in the will and determination of MSM; (ii) strategies centered on sexual arousal, asserting MSM’s preferred protection strategy; (iii) strategies centered on risk communication. Further, we identified actions that interrupt negotiations and directly enforce protection or bypass negotiations. Participants combined several strategies during negotiations. The strategies also demonstrated versatility: most were used for various aims and were not systematically related to a specific personal protection strategy. This study posits an elaborate range of HIV-protection negotiation strategies used by MSM, including strategies not previously described. It contributes to a more nuanced understanding of negotiation strategies and encourages prevention professionals to reflect on the attention given to negotiation strategies in prevention offers.