Nearly two-thirds of new HIV infections are attributed to primary partners, necessitating a greater understanding of relationship context of HIV transmission among sexual minority men. Sexual agreements, which are the explicit decisions couples make about sexual behaviors allowed inside and outside of their relationship, have been primarily studied among adult sexual minority men. Little work has sought to understand how adolescent sexual minority men utilize and navigate sexual agreement conversations. In this qualitative study, we explored adolescent sexual minority men’s motivations for having these conversations, how they define different types of agreements (e.g., monogamous, non-monogamous), and the topics most commonly discussed in their conversations. We conducted thematic analysis of in-depth interviews with 30 partnered, HIV-negative, adolescent sexual minority men ages 15–19 years. Participants reported similar reasons, definitions, and desires for creating sexual agreements as those reported in the adult literature. Novel to this population was the influence of stigma and heterosexism on the participants' choice of sexual agreement type. Like adult sexual minority men, participants used sexual agreement conversations to respond to life events; however, the adolescents in our sample, when talking with their partners, led with the context of developmentally specific events such as leaving for college or attending a school dance. Those with more relationship experience often described having intentional, explicit sexual agreement conversations. Study findings suggest that content focused on sexual agreements is important for HIV prevention interventions designed with adolescent sexual minority men, especially young men who have less relationship experiences.

近三分之二的新艾滋病毒感染归因于主要伴侣，因此有必要更好地了解性少数男性中艾滋病毒传播的关系背景。性协议是夫妻对关系内外允许的性行为做出的明确决定，主要在成年性少数男性中进行研究。很少有人试图了解青少年性少数男性如何利用和引导性协议对话。在这项定性研究中，我们探讨了青少年性少数男性进行这些对话的动机、他们如何定义不同类型的协议（例如一夫一妻制、非一夫一妻制）以及他们谈话中最常讨论的主题。我们对 30 名 15-19 岁、有伴侣、艾滋病毒呈阴性的青少年性少数男性进行了深入访谈，进行了主题分析。参与者报告了与成人文献中报告的类似的达成性协议的原因、定义和愿望。对于这一群体来说，新奇的是耻辱和异性恋歧视对参与者选择性协议类型的影响。与成年性少数男性一样，参与者使用性协议对话来应对生活事件；然而，我们样本中的青少年在与伴侣交谈时，会以特定发展事件为背景，例如去上大学或参加学校舞会。那些拥有更多恋爱经验的人通常会描述进行有意识的、明确的性协议对话。研究结果表明，以性协议为重点的内容对于针对青少年性少数男性（尤其是恋爱经验较少的年轻男性）设计的艾滋病毒预防干预措施非常重要。