In recent years, negotiated safety as a risk assessment and reduction strategy has been a focus of research.
Two main themes emerged from the in-depth interviews: Couples often feel that the love and intimacy needs that romantic relationships meet supersede health concerns, and many couples reduce their STD risk through negotiated safety and similar strategies.
In comparing Jose and Linda with other couples, we can see that negotiated safety may be viewed as a continuum of levels of risk assessment and potential responses to risk.
While it is clear that several couples consciously engaged in negotiated safety or other strategies to assess or reduce their risk at the beginning of the relationship, their use of these strategies apparently was not consistent throughout the relationship.
Given the importance of establishing and maintaining committed, romantic relationships, risk assessment and reduction strategies such as negotiated safety must be reconceptualized and communicated to high-risk heterosexuals as a way of increasing intimacy and strengthening relationships.
(28.) Crawford JM, et al., Negotiated safety and other agreements between men in relationships: risk practice redefined, International Journal of STD and AIDS, 2001, 12(3): 164-170.
(30.) Guzman R et al., Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men, Journal of Acquired Immune Deficiency Syndromes, 2005, 38(1):82-86.
Negotiated safety (Kippax et al., 1993) is an agreement between two men in a relationship to go through the process of discussion, inner contemplation, and more discussion, which leads them to decide whether to stop using condoms when they have anal sex.
For couples I work with who are considering adopting a negotiated safety agreement, I always refer them to the Freedoms[R] site (http://freedoms.
This is a shift towards recognition of negotiated safety
, of relationship contracts about outside sex, safety-catch-free sex between positive partners, and AIDS Council campaigns based on mutual HIV testing, informed consensual decisions and the explicit public discussion of sexual sociology.