"Complementary research conducted mostly with cisgender sexual minority men suggests that those who are high on anxious attachment-those most worried that people will not love them or find them good enough-are generally more likely to have anal sex without using a condom (Starks et al., 2017; Starks & Parsons, 2014). In other words, guys who are worried that a boyfriend or partner will think they are not good enough are more likely to agree to have sex "bareback.""
"The association between attachment anxiety and PrEP is less clear. At least one study suggests that sexual minority men who are worried that HIV prevention will interfere with intimacy are more interested in PrEP (Gamarel & Golub, 2015). Other studies suggest that some worry PrEP signals a lack of trust or commitment in a relationship (Bosco et al., 2021; Starks et al., 2019)."
Attachment anxiety involves worries about abandonment and feeling unworthy of love and acceptance. High attachment anxiety correlates with greater likelihood of condomless anal sex, particularly among cisgender sexual minority men. Some partners interpret stopping condom use or discontinuing PrEP as demonstrations of commitment, which can increase HIV transmission risk. Attachment-related concerns shape perceptions of sexual health precautions; some people worry that prevention interferes with intimacy while others worry that prevention signals mistrust. Attachment anxiety can also link drug use to sex within relationships. Minority stress may contribute to the development of attachment anxiety and amplify its impact on sexual health decisions.
Read at Psychology Today
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