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Exploratory Study of Communication As a Psychosocial Factor Influencing Safer Sex Experiences Among Individuals Who Identify As Polyamorous

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Exploratory Study of Communication As a Psychosocial Factor Influencing Safer Sex Experiences Among Individuals Who Identify As Polyamorous University of New Mexico UNM Digital Repository Communication ETDs Electronic Theses and Dissertations Summer 7-15-2020 Exploratory Study of Communication as a Psychosocial Factor Influencing Safer Sex Experiences Among Individuals Who Identify as Polyamorous Cecilia Brooke Cholka University of New Mexico Follow this and additional works at: https://digitalrepository.unm.edu/cj_etds Part of the Health Communication Commons Recommended Citation Cholka, Cecilia Brooke. "Exploratory Study of Communication as a Psychosocial Factor Influencing Safer Sex Experiences Among Individuals Who Identify as Polyamorous." (2020). https://digitalrepository.unm.edu/cj_etds/132 This Dissertation is brought to you for free and open access by the Electronic Theses and Dissertations at UNM Digital Repository. It has been accepted for inclusion in Communication ETDs by an authorized administrator of UNM Digital Repository. For more information, please contact [email protected], [email protected], [email protected]. Cecilia Brooke Cholka Candidate Communication and Journalism Department This dissertation is approved, and it is acceptable in quality and form for publication: Approved by the Dissertation Committee: Christina Perry, Ph.D., Chairperson Ilia Rodríguez, Ph.D. Kathy Isaacson, Ph.D. Yangsun Hong, Ph.D. i EXPLORATORY STUDY OF COMMUNICATION AS A PSYCHOSOCIAL FACTOR INFLUENCING SAFER SEX EXPERIENCES AMONG INDIVIDUALS WHO IDENTIFY AS POLYAMOROUS by CECILIA BROOKE CHOLKA B.A., Psychology, Trinity University, 2009 M.A., Clinical Psychology, University of Texas El Paso, 2012 DISSERTATION Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Communication The University of New Mexico Albuquerque, New Mexico July 2020 ii EXPLORATORY STUDY OF COMMUNICATION AS A PSYCHOSOCIAL FACTOR INFLUENCING SAFER SEX EXPERIENCES AMONG INDIVIDUALS WHO IDENTIFY AS POLYAMOROUS by Cecilia Brooke Cholka B.A., Psychology and Theater, Trinity University, 2009 M.A., Clinical Psychology, University of El Paso Texas, 2012 Ph.D., Communication, University of New Mexico, 2020 ABSTRACT Even with over three decades of research on and promotion of safer sex, the rates of sexually transmitted infections continue to rise in the United States (CDC, 2017). Although communication about risk and protective factors is key to the promotion of safer sex behaviors, the meaning and impact of such communication is contingent upon culturally grounded understandings of safer sex among individuals of diverse sexual subcultures. This dissertation focuses on individuals who self-identified as polyamorous, a style of non-monogamy, and their understandings and experiences with safer sex. Drawing on the application of the AIDS Risk Reduction Model and narrative inquiry methodology, this research explored sexual risk profiles; safer sex experience narratives; the importance of safer sex communication; and the relationship between safer sex communication and relationship negotiation among polyamorous partners. Based on a survey and thematic analysis of in-depth interviews with 13 polyamorous individuals, the research shows: 1) low rates of self-reported actual and perceived risk among iii participants; 2) narrative emphasis on the complexities involved in safer sex decisions; 3) the importance of using safer sex communication strategies to increase safer sex practices; and 4) the significance of relationship negotiation as a particular communication strategy used to sustain relationships and engage in safer sex conversations. The analysis of findings suggests implications for health communication research and intervention. There is an apparent need to look beyond biological factors to include psychosocial and emotional factors in safer sex decisions. Also, the consideration of relational challenges to safer sex behaviors (e.g. phase of the relationship, relationship dynamics, among others) are key to the understanding of contextual factors that ultimately influence individual behavior and decisions about safer sex. iv TABLE OF CONTENTS LIST OF TABLES..…………………………………………………………………….. ix CHAPTER 1 INTRODUCTION ........................................................................................ 1 Problem Statement .......................................................................................................... 1 Identifying Risk and Protective Factors .......................................................................... 4 Safer Sex Communication .............................................................................................. 5 Research on Polyamory .................................................................................................. 6 Significance of the Study ................................................................................................ 7 Definition of Key Concepts ............................................................................................ 8 Chapter Outline ............................................................................................................. 10 CHAPTER 2 LITERATURE REVIEW ........................................................................... 12 STI Health Crisis ........................................................................................................... 12 Prevalence of the STI health crisis. ........................................................................... 12 Risk factors. .............................................................................................................. 15 Protective factors. ..................................................................................................... 17 Interventions. ............................................................................................................ 19 Safer Sex Communication ............................................................................................ 21 Counterpoint. ............................................................................................................ 24 Communication leads to condom use. ...................................................................... 25 Differences between groups in safer sex communication. ........................................ 26 v Safer sex communication and trust. .......................................................................... 30 Polyamory ..................................................................................................................... 31 Monogamy. ............................................................................................................... 31 Consensual non-monogamy. ..................................................................................... 33 Monogamy vs. polyamory. ....................................................................................... 34 Contextualizing polyamory. ...................................................................................... 35 Poly relationships. ..................................................................................................... 36 Communication and polyamory. ............................................................................... 38 Safer sex and polyamory. .......................................................................................... 39 AIDS Risk Reduction Model ........................................................................................ 40 ARRM applications in research. ............................................................................... 44 CHAPTER 3 METHODOLOGY ..................................................................................... 49 Narrative Inquiry ........................................................................................................... 49 Data Collection ............................................................................................................. 54 Participants. ............................................................................................................... 54 Interviews. ................................................................................................................. 55 Data Collection Tools. .............................................................................................. 58 Data Analysis ................................................................................................................ 59 Trustworthiness in Qualitative Research ...................................................................... 62 CHAPTER 4 FINDINGS .................................................................................................. 64 vi Narrative Profiles of Participants .................................................................................. 64 RQ1: What is the sexual risk profile of individuals who identify as polyamorous? .... 67 Actual Risk. ............................................................................................................... 67 Perceived Risk. ......................................................................................................... 73 RQ2: What are the most salient themes in the participants’ narratives about safer sex experiences among polyamorous partners? .................................................................. 78 The complexities of practicing safer sex. ................................................................. 78 Setting boundaries to ensure safer sex. ..................................................................... 85 Trust 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