Noncohabiting Relationships Research Articles

Balancing risk, intimacy and (non)compliance: a qualitative study of sex across household during COVID-19 social restrictions

Government controls over intimate relationships, imposed to limit the spread of Sars-CoV-2, were unprecedented in modern times. This study draws on data from qualitative interviews with 18 participants in Natsal-COVID, a quasi-representative web-panel survey of the British population (n = 6,654 people), reporting that they had sex with someone from outside their household in the preceding four weeks; a period in which contact between households was restricted in the UK. Whilst only 10% of people reported sexual contact outside their household, among single people and those in non-cohabiting relationships, rates were much higher (Natsal-COVID). Our findings show that individuals did not take decisions to meet up with sexual partners lightly. Participants were motivated by needs—for connection, security, intimacy and a sense of normality. People balanced risks—of catching COVID-19, social judgement and punishment for rule-breaking—against other perceived risks, including to their mental health or relationships. We used situated rationality and social action theories of risk to demonstrate that people weighed up risk in socially situated ways and exhibited complex decision-making when deciding not to comply with restrictions. Understanding motivations for non-compliance is crucial to informing future public health messaging which accounts for the needs and circumstances of all population members.

Dissolution of Non-cohabiting Relationships and Changes in Life Satisfaction and Mental Health.

This study investigates how individuals’ life satisfaction and depression are affected by the dissolution of a steady non-cohabiting intimate relationship. Previous studies have focused more on the consequences of divorce and less on the influence of non-cohabiting relationships on the well-being of the individual. The data for this study were taken from pairfam, a large-scale German panel survey, and were used to estimate fixed-effects panel regression models and impact functions to identify the overall effect of dissolution and trajectories after separation. The study sample comprised 2,631 individuals who were observed over the course of 11,219 partnership years. Based on the results of this study, three main findings were reported. First, the dissolution of a non-cohabiting relationship led to a significant decline in mental health and life satisfaction. Second, the trajectories after dissolution suggest that the decline was only temporary, showing readjustment after 1 year. Third, gender differences were identified, suggesting worse consequences for men who experienced a significant decline in both dimensions and did not readjust in life satisfaction until several years after the dissolution. For women, decreases were only found for life satisfaction, but quick readjustments were observed.

Intimate physical contact between people from different households during the COVID-19 pandemic: a mixed-methods study from a large, quasi-representative survey (Natsal-COVID)

ObjectivesPhysical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households....

Menopausal status, age and management among women living with HIV in the UK.

There is currently little evidence exploring menopausal status, age at last menstrual period (LMP) and management of menopause among women living with HIV aged 45-60 years in England. Socio-demographic, lifestyle and clinical data were collected through a self-completed cross-sectional survey. Longitudinal CD4 count and viral load data were available from linkage to clinical records, if consent was provided. Women were categorised as pre-, peri- or post-menopausal. Factors associated with menopausal stage were examined using ordinal logistic regression adjusting for age. Age at LMP was estimated using Kaplan-Meier survival analysis. The 847 women had a median age of 49 [interquartile range (IQR): 47-52] years. Most were of black ethnicity (81.3%), were born outside the UK (85.0%) and had completed secondary education (88.7%); 177 (20.4%), 373 (43.0%) and 297 (34.2%) were pre-, peri- or post-menopausal, respectively. After adjusting for age, associations of menopausal status with non-cohabiting relationship [adjusted odds ratio = 0.63 (95% confidence interval: 0.43-0.91)], baseline viral load ≥100000 copies/mL [2.67 (1.20-5.94)] and unemployment [1.34 (0.97-1.84)] remained significant. Median (IQR) age at LMP was 54 (51-55) years in the group. In total, 27.9% (233/836) of women reported severe menopausal symptoms; 45.6% of those with somatic symptoms had heard of hormone replacement therapy and 8.7% had used it. Only 5.6% of women with urogenital symptoms had used topical oestrogen. Our findings highlight the importance of educating both women and their healthcare providers about menopausal symptoms and management options.

Intimate Physical Contact between People from Different Households During the COVID-19 Pandemic: A Mixed-Methods Study from a Large, Quasi-Representative Survey (Natsal-Covid)

Background: Physical distancing aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We explored whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020. Methods: The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimated IPCOH with a romantic/sexual partner in the four weeks prior to interview and identified associated factors. Qualitative interviews (n=18) were conducted to understand the context, reasons, and decision-making around IPCOH. Findings: Of 6,654 participants aged 18-59 years, 9.9% (95%CI:9.1-10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (e.g., condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54;0.32-0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34;1.10-1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks. Interpretation: Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures. Funding Information: Natsal (Wellcome/ESRC/NIHR), MRC/CSO, and UCL COVID-19 Rapid Response Fund. Declaration of Interests: The other authors declare that they have no conflicts of interest. Ethics Approval Statement: Ethical approval was obtained from the University of Glasgow MVLS College (reference 20019174) and LSHTM research ethics committees (reference 22565). An anonymised dataset will be deposited with the UK Data Archive.

Mental and Physical Health in Couple Relationships: Is It Better to Live Together?

AbstractThis study focuses on two main questions. First, do non-cohabiting relationships have an effect on mental and physical health? And second, do non-cohabiting relationships affect health in a similar way as cohabitation and marriage? To differentiate between the selection effects of healthier individuals into a couple relationship and the causal effects of couple relationships on health, we test hypotheses about the accumulation of health effects over time. We apply fixed-effects estimation techniques to data from the German Socio-economic Panel. For women, mental health improves after establishing a non-cohabiting relationship and remains similar after starting cohabitation and after getting married. For men, only marriage improves mental health status. The impacts of couple relationships on physical health primarily depend on the duration of the relationship and slowly accumulate over time. In addition, effects are stronger for younger adults.

Cohabitation and Romantic Relationship Quality Among Portuguese Lesbian, Gay, and Heterosexual Individuals

Lesbian and gay (LG) individuals are perceived as having poorer relationship functioning than heterosexual individuals, but this negative appraisal is not translated into actual relationship experiences. Indeed, relationship quality outcomes do not vary according to sexual orientation. Cohabitation status may play an important role, because it symbolizes relationship commitment and intimacy particularly for LG individuals. A cross-sectional study (N = 425, 52.9% women; Mage = 28.38, SD = 6.89) with romantically involved LG (38.4%) and heterosexual (61.6%) individuals examined the association between cohabitation and relationship quality outcomes. To isolate the role of cohabitation, cohabiting individuals were compared according to relationship legal status. Results showed that cohabiting (vs. non-cohabiting) LG individuals were more committed, invested, and satisfied, but those who legalized (vs. did not legalize) their union were only more committed. Among heterosexual individuals, no differences were observed. Furthermore, LG (vs. heterosexual) individuals were overall more committed, satisfied, and invested when cohabiting with their partner (especially in legalized unions), whereas heterosexual (vs. LG) individuals were more committed in non-cohabiting relationships. No other differences were found. This suggests that cohabitation may be used by LG individuals as a strategy to strengthen relationship quality and that legal recognition further increases relationship commitment.

Relationship Status and Drinking-Related Outcomes in a Community Sample of Lesbian and Bisexual Women.

Although marriage tends to be protective against hazardous drinking among women in the general population, few studies have compared drinking rates, levels, or problems based on relationship status among sexual minority women (SMW; lesbian, bisexual). We examined associations between relationship status (committed relationship/cohabiting; committed/not cohabiting; single) and past-year drinking outcomes using data from a diverse sample of 696 SMW interviewed in wave 3 of the 17-year longitudinal Chicago Health and Life Experiences of Women study. The mean age of SMW in the sample was 40.01 (SD = 14.15; range 18-82). A little more than one-third (37%) of the sample was white, 36% was African American, and 23% Latina; 4% reported another or multi- race/ethnicity. Compared to SMW in committed cohabiting relationships, single SMW were significantly more likely to be heavy drinkers. SMW in committed non-cohabiting relationships were more likely to report alcohol-related problem consequences, and both single SMW and those in committed non-cohabiting relationships were more likely to report one or more symptoms of potential alcohol dependence. Findings underscore the importance of exploring relationship factors that may influence drinking and drinking-related problems among SMW.

Partnership trajectories of people in stable non-cohabiting relationships in France

Background: In France, nearly one in ten people are in a stable non-cohabiting partnership. Many studies have pointed out the diversity of the phenomenon.

The prevalence of unplanned pregnancy ending in birth, associated factors, and health outcomes.

What are associated factors of unplanned pregnancies ending in birth? Pregnancies that were less planned were associated with women of lower socio-economic status (SES), an unhealthier lifestyle before and during the pregnancy, more stress, and less social support. In Europe, the prevalence of unplanned pregnancy leading to birth varies. Unplanned pregnancy is more common among socially disadvantaged women, and associated with adverse pregnancy outcomes. In a cross-sectional study, 517 women were recruited from May through September 2015. Women were recruited from six hospitals in Flanders, Belgium. Data from self-report and medical records were collected during the first 5 days postpartum. The validated London Measure of Unplanned Pregnancy was used to collect data regarding pregnancy planning. Data were analysed with Mann-Whitney U tests, Kruskal-Wallis tests, and multiple linear regression analysis. The majority of the pregnancies (83%) ending in birth were planned, 15% were ambivalent, and 2% unplanned. Women who are multigravida (95% CI -0.30 to -0.02), less well educated (95% CI 0.07-0.85), single or having a non-cohabiting relationship (95% CI 0.01-2.53), having history of drug abuse (95% CI -2.07 to -0.35), and experiencing intimate partner violence (95% CI -3.82 to -1.59) tended to have a significantly higher risk of a less planned pregnancy. Less planned pregnancies were significantly associated with initially unwanted pregnancies (P<0.001), no folic acid or vitamin use before pregnancy (P<0.001), lower number of prenatal visits (P=0.03), smoking during pregnancy (P<0.001), more stress (P=0.002), lower relationship satisfaction (P=0.001), and less social support (P<0.001). Less planned pregnancies were also significantly associated with hyperemesis (P<0.001) and shorter duration of delivery (P=0.03). No differences were found in neonatal outcomes. The prevalence of unplanned pregnancies is probably underestimated due to overrepresentation of women with higher SES in this study. Women's emotions may have influenced the answer to certain questions. Owing to the cross-sectional design, no causal relationships could be established. This study emphasizes the importance of targeting socially disadvantaged women in the prevention of unplanned pregnancies. This study was funded by the Research Foundation - Flanders (FWO). The authors have no conflict of interests. Not applicable.

Men's contraceptive practices in France: evidence of male involvement in family planning

ObjectiveTo describe contraceptive practices of men in a relationship in France, where use of female-controlled methods is predominant, and to explore their involvement in managing contraception within the couple. Study designData are drawn from a national probability cross-sectional survey on sexual and reproductive health conducted in France in 2010. The study sample comprised 3373 men aged 15–49, 1776 of whom were asked about their current contraceptive practices after they reported that they were fecund and sexually active and did not currently want a child. Analyses were performed with logistic regression models. ResultsFew men aged 15–49 with a partner did not use contraception (3.4%). Most reported using only a female method (71.7%), 20.4% only cooperative methods, such as condoms, withdrawal and the rhythm method and 4.5% both. Among contraceptive users, withdrawal (7.7%) was more likely to be used by men with low incomes or low educational levels. Condom use was reported as a contraceptive method by 18.9% of men. Its prevalence was higher for those in new and noncohabiting relationships (36.1%) and lower for those in cohabiting relationships (12.4%), in which STIs/HIV prevention is less of a concern. ConclusionMen's high awareness of contraceptive practices and their use of some cooperative methods reveal their involvement in contraceptive practices within the context of relationships. Condom use is associated with the prevention of STIs/HIV for noncohabiting men, but men who live with their female partner seem to use condoms mainly as a contraceptive method. Withdrawal appears to be associated with low level of education and financial difficulties. Finally, having engendered a pregnancy that was terminated appears to influence men's contraceptive practices. ImplicationsStudying men's contraceptive practices helps to understand their involvement in contraceptive management within relationships.

Before the Bride Really Wore Pink

Before the Bride Really Wore Pink

Emotional and Physical Satisfaction in Noncohabiting, Cohabiting, and Marital Relationships: The Importance of Jealous Conflict

This article examines whether associations between marital status and emotional and physical satisfaction depend on jealous conflict associated with expectations about sexual exclusivity. Using data from a representative sample of 681 women and men drawn from the city of Chicago and its inner suburbs, this study estimated logistic regression models of jealous conflict and ordered logistic regression models of adults' reported emotional and physical satisfaction of their relationships. The results show that marriages are less exposed to jealous conflict than cohabiting and noncohabiting relationships. Regarding emotional and physical satisfaction, their associations with marital status were contingent upon whether individuals reported jealous conflict in their relationships. Specifically, in relationships without jealous conflict, married couples were more emotionally satisfied than noncohabiting couples. Married couples, but not cohabiting and noncohabiting couples, had significantly lower emotional and physical satisfaction when jealous conflict occurred. Cohabitors were not less emotionally or physically satisfied than married respondents. Overall, this research supports the argument that sexual exclusivity expectations are important for understanding the link between marital status and relationship quality.

Neither single, nor in a couple. A study of living apart together in France

Among living arrangements, living apart together relationships arouse curiosity on the part of sociologists, demographers and even the media. From a scientific point of view, how have noncohabiting relationships evolved in recent decades? How can we re

Condom use with sex workers and abstinence behaviour among men in Nigeria

Non-regular, non-cohabiting relationships and condom neglect are known to fuel the HIV/AIDS epidemic in Africa. Reproductive health needs of the men, the major decision-makers in this community, have been grossly neglected in this regard. This exploratory, community-based study assessed condom use among married men when with commercial sex workers (CSWs) and abstinent behaviour when their wives were unavailable for sex. (A CSW is one known to receive payment for sex.) Out of the 3,178 married respondents, 1,755 (55.2%) had ever used condoms. Of this number, 1,296 (73.8%) resided in urban locations while 459 (26.2%) resided in rural areas. Of these men, 137 had used CSWs in the six months prior to the study. Only 63 (46%) of these had used a condom at the last visit. Young age (<30 years) was the only predictor of condom use when with CSWs (p=0.03). Predictors of abstinence behaviour when the wife was unavailable for sex included: primary and secondary education, young age of the wife, low occupational status and monogamy. National HIV/AIDS control programmes should address men's risk-taking behaviour, empowering women to negotiate condom use and reduce long abstinence periods. Continued efforts should be made to reach sex workers and to make condoms much more widely available, acceptable and affordable, especially in rural areas.

Domestic violence: prevalence in pregnant women and associations with physical and psychological health.

To examine the prevalence of domestic violence (DV) and its associations with obstetric complications and psychological health in women on antenatal and postnatal wards. A cross-sectional survey conducted in an inner-London teaching hospital. Two hundred English-speaking women aged 16 and over, were interviewed between July 2001 and April 2002. The Abuse Assessment Screen was used to assess for experiences of DV. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The analysis of predictors of obstetric complications grouped together those known to be associated with DV. 23.5% of women had lifetime experience of DV, 3% during the current pregnancy. Women with a history of DV were significantly more likely to be single, separated or in non-cohabiting relationship and to have smoked in the year prior to and/or during pregnancy. Higher EPDS scores were significantly associated with DV, single, separated or non-cohabiting status, and obstetric complications. Both a history of DV and increased EPDS scores were significantly associated with obstetric complications after controlling for other known risk factors. Domestic violence is regarded as an important risk marker for the development of obstetric complications and depressive symptomatology. This finding of itself justifies training and education of maternity health professionals to raise awareness.

Cohabiting, Dating, and Perceived Costs of Marriage: A Model of Marriage Entry

This paper investigates the decision to marry among individuals in cohabiting and steady noncohabiting relationships, with emphasis on the effects of cohabitation in the decision‐making process. A model is proposed wherein cohabitation influences the perceived costs and benefits of marriage, which influence intentions and expectations to marry, which influence actual marriage entry. The model is tested using data from the first and second waves of the National Survey of Families and Households. Cohabitation status is found to predict perceived costs and benefits of marriage, and also to predict marriage intentions and expectations. Cost perceptions further predict intentions and expectations among both cohabitors and daters, and perceived costs, intentions, and expectations to marry the partner predict actual marriage behavior. Cohabitation appears to significantly change the context in which decisions about marriage are made in romantic relationships and merits a greater place in the literature on dating and courtship.

Beyond Marital Status: Relationship Type and Duration and the Risk of Low Birth Weight

Unmarried women have higher rates of low birth weight than married women. However, assumptions that unmarried women are uniformly at a disadvantage may be unfounded. A woman's relationship characteristics may be more relevant for infant health than her formal marital status. Data from the 1995 National Survey of Family Growth were used to analyze associations between relationship characteristics and low birth weight among U.S. women aged 15-44 with a recent singleton live birth. Unadjusted odds ratios were generated to indicate the crude effects of independent variables, including relationship type and relationship duration at the time of conception. Multiple logistic regressions were performed to assess the impact of relationship variables on the likelihood of low birth weight, taking into account the effects of other covariates. In multivariate models of all women and non-Hispanic black women, relationship type and duration were not associated with low birth weight. However, low birth weight was almost six times as likely among Hispanic women in nonmarital, noncohabiting relationships as among those who were married. Surprisingly, among non-Hispanic white women, low birth weight was less likely among those in nonmarital, noncohabiting relationships than among those who were married. Unexpected associations also were found among low birth weight, race and ethnicity, and relationship duration: Low birth weight was more likely among non-Hispanic white women in relationships of from five to 10 years in length than among those in relationships of longer than 10 years and less likely among Hispanic women in relationships of one year or less than among those in a relationship for more than 10 years. Although unmarried women in the United States have higher rates of low birth weight than married women, many unmarried women are at no greater risk of low birth weight than their married counterparts. The findings confirm the need to consider the characteristics of relationships when examining the association of mother's "union status" and birth outcomes.