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Short report
Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men
  1. Clare Bellhouse1,2,
  2. Sandra Walker1,2,
  3. Christopher K Fairley1,2,
  4. Eric PF Chow1,2,
  5. Jade E Bilardi1,2,3
  1. 1 Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  2. 2 Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
  3. 3 Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Clare Bellhouse, Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, VIC 3053, Australia; clare.bellhouse{at}monash.edu

Abstract

Objective The aim of this report was to raise the issue of the definition and classification of partner terminology in men who have sex with men (MSM) research, particularly in regards to ‘fuck buddies’. If definitions in research differ from general consensus in the MSM population, it is possible that public health strategies will be ineffective as the target population may be inaccurate.

Methods Thirty semistructured interviews with MSM attending the Melbourne Sexual Health Centre were conducted, focusing on the willingness to change sexual practices to reduce the risk of pharyngeal gonorrhoea. As part of these interviews, men were also asked their views on the terminology they used to describe their relationships and sexual partners.

Results The degree of emotional attachment often defined the type or classification of relationships. There was a consensus among men that partners they engaged with for ‘sex only’ were classified as casual partners and partners with whom there was an emotional attachment or formalisation of the relationship were classified as ‘regular partners’. However, the classification of ‘fuck buddy’ as a regular or casual partner was less clear.

Conclusions Further research is needed to ascertain the ways in which men conceptualise sexual relationships and define or classify partner types, particularly ‘fuck buddy’ relationships. A third category for sexual relationships should be considered to encapsulate fuck buddy relationships.

  • GAY MEN
  • QUALITATIVE RESEARCH
  • SEXUAL BEHAVIOUR
  • HEALTH PROMOTION
  • CLINICAL STI CARE

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The terms ‘regular partner’ and ‘casual partner’ are commonly used in sexual health research to define or classify the type of relationship people have with a sexual partner. However, these terms are often poorly defined worldwide, highly subjective and vary between studies.1–3 In research focusing on men who have sex with men (MSM), regular partners are commonly assumed to refer to romantic relationships, such as ‘boyfriends’, ‘husbands’ or ‘life partners’;4 ,5 while casual partners are commonly thought to include relationships without emotional attachments, such as ‘one-night stands’ or anonymous sex.6 ,7 The term ‘fuck buddy’ is very commonly used to refer to sexual partners in the MSM population, but this term is not common in sexual health research. This may partly be due to an ethical issue, as the term ‘fuck’ is often considered inappropriate and vulgar. Different terminology for partner classification has been used in different countries; therefore, it is difficult to compare partner terminology research globally. Yet despite differing partner terminology dichotomies, the problem still remains in how to categorise ‘fuck buddies’.

In a recent study of 2057 MSM in Australia, it was found that of those who reported regular partners, the majority (68%) of men were referring to fuck buddies, and only 32% were referring to boyfriends.2 Another study conducted by Prestage et al,1 which recruited men online, as well as through gay community groups, found that MSM relationships are complex; all participants were sexually active, yet, only 11.8% of participants reported casual partners, and only 18.8% reported having a boyfriend only.1 They attributed this discrepancy to nearly half the sample reporting ‘fuck buddy’ relationships and concluded that in the absence of this category being available, some men reported fuck buddies as regular partners while others reported them as casual partners. It has been a challenge for both researchers and participants to reliably categorise ‘fuck buddy’ relationships into either ‘regular’ or ‘casual’ descriptions of sexual relationships.1

For these reasons, it is imperative that the definition and classification of partner terms in MSM research is consistent and appropriately categorises their sexual relationships, particularly where ‘fuck buddies’ are concerned. If meanings are inaccurate, it is possible that public health strategies will be ineffective as they are likely to incorrectly target the wrong groups.

Between March and September 2015, semistructured interviews were conducted with 30 MSM at the Melbourne Sexual Health Centre. The primary aim of the interview was to examine the willingness to change sexual practices to reduce the risk of pharyngeal gonorrhoea in MSM and the main findings and detailed sampling method are published elsewhere.5 As part of these interviews, men were also asked their views on the terminology they used to describe the type of relationships and sexual partners. A qualitative descriptive approach was used in this study, which is a pragmatic rather than theory-driven approach based on expert knowledge in the field.8 This approach is commonly used in healthcare research as it allows researchers to specifically address issues of clinical relevance, gain a preliminary insight into an issue and provide a straight description of experiences from the informant's point of view, as opposed to interpretative or theory-based analysis.8 SW, an experienced sexual health researcher and health psychologist, conducted the interviews. Written informed consent of participants was obtained before the interview. All interviews were digitally recorded, transcribed verbatim and analysed using content analysis, a commonly used approach in qualitative descriptive studies. Content analysis involves providing a descriptive summary of the content of the data. Themes were derived deductively from previous literature and the interview schedule, as well as inductively from the data.8 CB coded the data using NVivo, and a subset of transcripts was reviewed by JEB. No differences were evident in coding between researchers. Ethical approval for this study was obtained by the Alfred Hospital Ethics Committee (number 544/14).

Thirty men participated in the interview, with a median age of 32 years. The majority (83%) reported a current regular sexual partner and almost all (93%) reported at least one casual sexual partner (CSP) in the previous 3 months.

Interestingly, we found the level of emotional attachment often defined partner type; regular relationships often required formalisation through discussion and agreement, and there was a lack of consistency in the definition of ‘fuck buddy’.

Emotional attachment defines partner type

Most men reported they used the term ‘casual partner’ to refer to men they met with for sexual gratification only, with no emotional attachment or connection. Men commonly used terms such as ‘hook-ups’ or ‘randoms’ to refer to CSPs.Sam: It's a horrible description, but when I was talking to my friends back when I was single, it would be, have you hooked up with them before? Are they a regular or are they a random?

Similar agreement was found among men when labelling and defining regular partners. Men most commonly referred to regular partners as ‘boyfriends’ or ‘life partner’. Regular partners were regarded as relationships with an emotional attachment and some level of commitment.Tom: A partner would be someone that I have some level of commitment to … James: … when I hear regular partner I think of someone referring to like a boyfriend or someone that I do have that sort of deeper connection with or I was exclusive …

Discussion and clarification of regular relationship

Some men reported that for a relationship to evolve, or for a partner to become a regular partner or ‘boyfriend’, first there needed to be a discussion clarifying the nature of the relationship and an agreement around expectations of monogamy and/or commitment within the relationship.Chris: I ‘spose (suppose) when you agree on the terminology to use boyfriend then you start using boyfriend. But I would not use the term boyfriend until I have agreed on it.

Variation on definitions for ‘fuck buddy’

While there was a general consensus between MSM around the meaning of terms such as ‘hook-ups’, ‘randoms’ or ‘boyfriends’, the definition and classification of the term ‘fuck buddy’ varied among MSM. Some men regarded a ‘fuck buddy’ as more than just a casual ‘random’ or ‘hook-up’ as there was often some level of attachment or regular contact involved, however, not to the same degree or emotional level as a regular partner or ‘boyfriend’.Cameron: I definitely would not use fuck buddies for casual partners … Like fuck buddy has the sound [of] almost friends or someone that is at least an acquaintance whereas casual is somebody that I don't even get to introduce myself to, someone that is just a sexual, a one off.

Other men classified a fuck buddy in the category of casual partner:Steve: I guess fuck buddy is just like where you do not have any commitment to them, it's just for sex.

Yet again, other men classified fuck buddies in the regular partner category.Jack: I call casual partners ‘hook-ups’ … and probably any regular partners ‘fuck buddy’ or ‘fun buddy’.

This study shows that the degree of emotional attachment often defined the type or classification of relationships. There was a common consensus among men that partners they engaged with for ‘sex only’ were classified as casual partners and partners in whom there was an emotional attachment and often formalisation of the relationship were classified as ‘regular partners’. However, the classification of ‘fuck buddy’ as a regular or casual partner was less clear, reflecting the variability found in previous research.2 ,9 The term ‘fuck buddy’ seems to be quite subjective and also varies among participants, some categorised into ‘regular’ or ‘casual’ or may be viewed as somewhere in-between a casual and regular partner, depending on the degree of emotional attachment or regularity of contact.

As partner terminology was not the primary purpose of the study, time spent reflecting on this topic was limited and therefore, we acknowledge that there is some lack of depth and complexity in the data presented in this paper. However, this is the first study to examine from a MSM's perspective, how they define fuck buddies and how they categorise fuck buddies in casual or regular binary terms. Past studies have presented predetermined partner categories to MSM based on no scientific evidence. Participants were recruited from only one sexual health service in Melbourne, and men attending this service are more likely to be sexually active, which limits our generalisability beyond similar services. It is possible that a larger community-based sample of MSM may have differed in their views on sexual relationships. These findings do however provide an interesting insight into the subjective nature of partner terminology and provide evidence to support further exploration of the possible implications for risk reduction strategies within the MSM population.

The question remains of how can we more accurately define MSM's sexual partners, particularly ‘fuck buddy’ relationships, to appropriately target high-risk MSM in future prevention strategies. Past research has attempted to categorise the term ‘fuck buddy’ into either ‘regular’ or ‘casual’; however, conclusions from these studies may cause bias due to the vague and inconsistent definition and classification of ‘fuck buddy’. Another Australian study has shown that among newly diagnosed HIV-positive men, of those who attributed their infection to a ‘regular partner’, only one-third were referring to ‘boyfriends’, while two-thirds were referring to ‘fuck buddies’.10 As a substantial portion of newly acquired HIV infections were attributed to fuck buddy relationships, this study provides further evidence that future HIV prevention and educational campaigns should also target fuck buddy partnerships.2

MSM relationships are complex, and it is clear that fuck buddy relationships are unique. This qualitative paper is from a MSM's perspective, on how they define fuck buddy and how they categorise fuck buddy in casual or regular binary terms. It appears evident from our findings that a third category for fuck buddies is necessary in research to capture the nature of MSM relationships. Further research is needed to ascertain the ways in which men conceptualise sexual relationships in general and define or classify partner types, including whether classifications lie on a continuum of emotional attachment or whether they are considered discrete categories, and when and how partner status transition occurs. This is particularly important for ‘fuck buddy’ relationships to obtain accurate information to inform practice and risk reduction strategies, which target the correct groups.

References

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Footnotes

  • EPFC and JEB are joint last authors.

  • Handling editor Jackie A Cassell

  • Contributors SW, CKF, EPFC, CB and JEB designed the study. SW conducted the interviews. CB and JB performed data analyses. CB wrote the first draft of the manuscript. All authors contributed data interpretation and revised the manuscript critically for important intellectual content.

  • Funding This work was supported by the National Health and Medical Research Council (NHMRC) programme grant (number 568971). EPFC is supported by the Australian NHMRC Early Career Fellowship (number 1091226). JB is also supported by the Australian NHMRC Early Career Fellowship (number 1013135).

  • Competing interests None declared.

  • Ethics approval Alfred Hospital Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Further data from this study have been published elsewhere and can be found in ref. 5.

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