Although HIV is contracted by individuals, it is typically transmitted in dyads. Most efforts to promote safer sex practices, however, focus exclusively on individuals. The goal of this paper is to provide a theoretical framework that specifies how models of dyadic processes and relationships can inform models of HIV-prevention. At the center of the framework is the proposition that safer sex between two people requires a dyadic capacity for successful coordination. According to this framework, relational, individual, and structural variables that affect the enactment of safer sex do so through their direct and indirect effects on that dyadic capacity. This dyadic perspective does not require an ongoing relationship between two individuals; rather, it offers a way of distinguishing between dyads along a continuum from anonymous strangers (with minimal coordination of behavior) to long-term partners (with much greater coordination). Acknowledging the dyadic context of HIV-prevention offers new targets for interventions and suggests new approaches to tailoring interventions to specific populations.
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Acknowledgments We gratefully acknowledge James Jaccard (Florida International University), David Perez-Jimenez (University of Puerto Rico), and Gail E. Wyatt (UCLA), who contributed significantly to the discussions that led to the writing of this article. This manuscript was supported by U.S. Public Health Service grant R13-MH080619 and benefited from comments provided by attendees at the funded conference.
- Interpersonal relationships
- Safer sex