A Comparison of Sexual Health History and Practices among Monogamous and Consensually Nonmonogamous Sexual Partners

J Sex Med. 2015 Oct;12(10):2022-8. doi: 10.1111/jsm.12987. Epub 2015 Sep 22.


Introduction: Although consensually nonmonogamous (CNM) relationships are presumed to be far riskier for partners' sexual health compared with monogamous relationships, the disparity between them may be smaller than assumed. A growing body of research finds that many partners who have made monogamy agreements cheat, and when they do, they are less likely to practice safe sex than CNM partners.

Aim: Extant comparisons of monogamous and CNM relationships are rare and have yet to establish whether rates of sexually transmitted infections (STIs) and STI testing differ between these groups. The present research compared self-reported STI history, lifetime number of sex partners, and condom use practices among monogamous and CNM partners.

Methods: Participants (N = 556) were recruited for an online survey of "attitudes toward sexual relationships." Approximately two-thirds of the sample reported current involvement in a monogamous relationship, with the remainder indicating involvement in a CNM relationship.

Main outcome measures: All participants completed a questionnaire that included measures of condom use practices with primary and extra-pair partners, as well as their STI history.

Results: CNM partners reported more lifetime sexual partners than individuals in monogamous relationships. In addition, compared with monogamous partners, CNM partners were more likely to (i) report using condoms during intercourse with their primary partner; (ii) report using condoms during intercourse with extradyadic partners; and (iii) report having been tested for STIs. Approximately one-quarter of monogamous partners reported sex outside of their primary relationship, most of whom indicated that their primary partner did not know about their infidelity. The percentage of participants reporting previous STI diagnoses did not differ across relationship type.

Conclusions: CNM partners reported taking more precautions than those in monogamous relationships in terms of greater condom use during intercourse with all partners and a higher likelihood of STI testing. Thus, although persons in CNM relationships had more sexual partners, the precautions they took did not appear to elevate their rate of STIs above an imperfect implementation of monogamy. Lehmiller JJ. A comparison of sexual health history and practices among monogamous and consensually nonmonogamous sexual partners.

Keywords: Condom Use; Consensual NonMonogamy; Monogamy; Number of Sexual Partners; Sexual Health; Sexually Transmitted Infections.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Condoms / statistics & numerical data*
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Extramarital Relations / psychology*
  • Female
  • Humans
  • Male
  • Risk-Taking
  • Safe Sex
  • Sexual Behavior* / psychology
  • Sexual Behavior* / statistics & numerical data
  • Sexual Partners / psychology*
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / psychology
  • Surveys and Questionnaires