Couples Exploring Non-Monogamy: Guidelines for Therapists

A population that is potentially challenging for couple and family therapists to work with is that of couples who want to explore non-monogamy. For many therapists, non-monogamy challenges personal values and beliefs, and there is little in the literature to support therapists in achieving cultural competency in this area. B

Based on a review of Western clinical literature over the past 20 years, and on the author's clinical experience, the author provides therapists with guidelines to use with couples who want to explore the possibility of becoming non-monogamous. 

The guidelines include: 

1. Educate oneself about non-monogamy, 
2. Identify one's own values and beliefs related to non-monogamy, 
3. Work with the couple's definition of non-monogamy, 
4. Be aware that partners may have varying concerns about non-monogamy, 
5. Address infidelity if present, 
6. Avoid assumptions about the ways non-monogamy will impact the relationship; and 
7. Recognize that opening a relationship is an ongoing process.

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By:  Bairstow A1.

• 1 Widener University , Toronto , Ontario , Canada.
• J Sex Marital Ther. 2016 Mar 30:0. 

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Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

HIV self tests (HIVST) have the potential to increase testing among young adults. However, little is known about high-risk young adults' perception of the HIVST as a risk reduction tool and how they would use the HIVST in their everyday lives. 

Our study sought to examine these factors. Twenty-one ethnically diverse participants (ages 18-24) used the HIVST at our study site, completed surveys, and underwent an in-depth interview. Descriptive statistics were used to analyze the survey responses, and interview data were coded using constructs from the information-motivation-behavioral skills model. Information deficits included: how to use the HIVST and the "window period" for sero-conversion. 

Motivations supporting HIVST use included: 

• not needing to visit the clinic, 
• fast results, 
• easy access, and 
• use in non-monogamous relationships. 

Behavioral skills discussed included: 

• coping with a positive test, 
• handling partner violence after a positive test, and 
• accessing HIV services. 

These findings can inform the use of the HIVST for improving HIV testing rates and reducing HIV risk behavior.

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By:  Brown W 3rd1,2, Carballo-Diéguez A1,3, John RM4, Schnall R5.

• 1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
• 2Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, USA.
• 3Psychiatry, Mailman School of Public Health, Columbia University, New York, USA.
• 4School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA.
• 5School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA. rb897@columbia.edu. 

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A Comparison of Sexual Health History and Practices among Monogamous and Consensually Nonmonogamous Sexual Partners

Although consensually nonmonogamous (CNM) relationships are presumed to be far riskier for partners' sexual health compared with monogamous relationships, the disparity between them may be smaller than assumed. A growing body of research finds that many partners who have made monogamy agreements cheat, and when they do, they are less likely to practice safe sex than CNM partners.

Extant comparisons of monogamous and CNM relationships are rare and have yet to establish whether rates of sexually transmitted infections (STIs) and STI testing differ between these groups. The present research compared self-reported STI history, lifetime number of sex partners, and condom use practices among monogamous and CNM partners.

Participants (N = 556) were recruited for an online survey of "attitudes toward sexual relationships." Approximately two-thirds of the sample reported current involvement in a monogamous relationship, with the remainder indicating involvement in a CNM relationship.

All participants completed a questionnaire that included measures of condom use practices with primary and extra-pair partners, as well as their STI history.

• CNM partners reported more lifetime sexual partners than individuals in monogamous relationships. 
• In addition, compared with monogamous partners, CNM partners were more likely to 
• report using condoms during intercourse with their primary partner; 
• report using condoms during intercourse with extradyadic partners; and 
• report having been tested for STIs. 
• Approximately one-quarter of monogamous partners reported sex outside of their primary relationship, 
• most of whom indicated that their primary partner did not know about their infidelity. 
• The percentage of participants reporting previous STI diagnoses did not differ across relationship type.

CNM partners reported taking more precautions than those in monogamous relationships in terms of greater condom use during intercourse with all partners and a higher likelihood of STI testing. Thus, although persons in CNM relationships had more sexual partners, the precautions they took did not appear to elevate their rate of STIs above an imperfect implementation of monogamy. 

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By: Lehmiller JJ1.

• 1Department of Counseling Psychology, Ball State University, Muncie, IN, USA. 

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