Sexual orientation disparities in history of intimate partner violence: results from the California health interview survey

Sexual Orientation Disparities in Mistimed and Unwanted Pregnancy Among Adult Women

CONTEXT

Many sexual minority women, regardless of sexual identity, engage in heterosexual behavior across the life course, which provides them opportunities to experience an unintended pregnancy. In addition, sexual minority women are more likely than others to report characteristics that may make them vulnerable to unintended pregnancy. Little research, however, has examined whether the risk of unintended pregnancy is elevated among these women.

METHODS

Using data from the 2006-2010 National Survey of Family Growth, logistic regression models were fitted to examine sexual orientation disparities in mistimed and unwanted pregnancies among 9,807 women aged 20-45; mixed-effects hazard models assessed disparities in the intention status of 5,238 pregnancies among these women by maternal sexual orientation.

RESULTS

Compared with heterosexual women reporting only male partners, heterosexual women who have sex with women had higher odds of reporting a mistimed pregnancy (odds ratio, 1.4), and bisexual women had higher odds of reporting an unwanted pregnancy (1.8). When compared with pregnancies reported by heterosexual women with only male partners, those reported by heterosexual women who have sex with women were more likely to be mistimed (hazard ratio, 1.7), and those reported by bisexual and lesbian women were more likely to be unwanted (1.7-4.4).

CONCLUSIONS

Compared with heterosexuals who have sex with men only, adult sexual minority women are at equal or greater risk of reporting an unintended pregnancy. More research addressing the reproductive health care needs of sexual minority women is needed to develop strategies to improve family planning for this population.

Partner Abuse Among HIV-Positive Sexual Minority Men: "That Was All I Deserved . . ."

Living with HIV can be both a precipitant and a consequence of partner abuse (PA) across populations, including male-male partnerships. However, overlapping experiences of living with HIV and experiencing PA are not well characterized. We conducted 24 qualitative interviews with urban HIV-positive sexual minority men (SMM) recruited from a public hospital HIV clinic in Seattle, Washington, who reported lifetime PA histories, and analyzed them using content analysis. Participants reported psychological, physical, and sexual victimization from partners, varying in severity. Themes included (a) how HIV and minority stress (e.g., through self-stigma, serosorting) and (b) familial and repeated exposure to violence (e.g., through normalization or acceptance of PA, partnering as strategy for increasing one's own safety, esteem, or social status), independently and in combination, provided a context for the men's victimization. Our findings suggest that PA-related interventions might focus on coping with stigma, expanding social networks, and educating SMM about dysfunctional relationship dynamics.

School Indicators of Violence Experienced and Feeling Unsafe of Dutch LGB Versus Non-LGB Secondary Students and Staff, 2006-2010

Gender and sexual orientation are expressed in heterosexual, lesbian (L), gay (G), bisexual (B), transgender (T), or queer (Q) interests and behavior. Compared with heterosexual persons, LGBTQ persons seem to experience more antisocial behavior, including negative discrimination and violence. To assess differences in LGBTQ-related discrimination in schools, the question for this research is "Do the degrees of violence experienced and feeling unsafe of LGBTQ students and staff in a school differ from those of non-LGBTQ students and staff in the same school?" Secondary analysis was carried out on data from a Dutch national digital monitor survey on safety in secondary schools. In 2006, 2008, and 2010, participation amounted to 570 schools, 18,300 teaching and support staff, and 216,000 students. Four indicators were constructed at the school level: two Mokken Scale means assessing severity of violence experienced and two Alpha Scale means assessing feeling unsafe. Analysis of mean differences showed that LGB students experienced more violence and felt less safe than non-LGB students; LGB staff felt less safe in school than non-LGB staff. When LGB students experienced more violence at school than non-LGB students, LGB students also felt less safe than non-LGB students for all 3 years. No such relationships existed for LGB staff, or between LGB staff and LGB students. No significant relationships were found between the four LGB school indicators and contextual school variables. The outcomes and uniqueness of the study are discussed. Recommendations are made to improve assessment and promote prosocial behavior of students and staff in schools.

Inter-personal violence and abuse in adolescent intimate relationships: mental health impact and implications for practice

This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.

Dating violence, quality of life and mental health in sexual minority populations: a path analysis

PURPOSE

Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health.

METHODS

The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression).

RESULTS

After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13-2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05-1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit.

CONCLUSION

Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.

Intimate Partner Violence in Self-Identified Lesbians: A Systematic Review of Its Prevalence and Correlates

This article presents the first systematic review on intimate partner violence (IPV) in self-identified lesbians in same-sex couples. Studies published from January 1990 to December 2013 were analyzed. Of the 687 studies reviewed, 59 were preselected, of which 14 studies were selected that met the inclusion and methodological quality criteria. A summary is presented of the characteristics of the studies, the participants, the prevalence of IPV victimization and perpetration, and its correlates. All the studies were carried out in the United States and used a nonprobabilistic sampling method. The majority of participants were White with a high educational level. The results indicate that all the forms of violence occur, but the most prevalent is emotional/psychological violence. The correlates positively associated with IPV are certain personality characteristics, fusion, previous IPV experience, a family history of violence, and alcohol consumption. This review finds significant limitations in the analyzed literature. Methodological recommendations are made for future studies.

Trajectories of dating violence: Differences by sexual minority status and gender

The purpose of this study was to examine how sexual minority status (as assessed using both identity and behavior) was associated with trajectories of dating violence. University students from a large Southwestern university completed questions on their sexual minority identity, the gender of their sexual partners, and about experiences of dating violence for six consecutive semesters (N = 1942). Latent growth curve modeling indicated that generally, trajectories of dating violence were stable across study participation. Sexual minority identity was associated with higher initial levels of dating violence at baseline, but also with greater decreases in dating violence across time. These differences were mediated by number of sexual partners. Having same and other-sex sexual partners was associated with higher levels of dating violence at baseline, and persisted in being associated with higher levels over time. No significant gender difference was observed regarding trajectories of dating violence.

Experiences of Intimate Partner Violence and Subsequent Police Reporting Among Lesbian, Gay, Bisexual, Transgender, and Queer Adults in Colorado: Comparing Rates of Cisgender and Transgender Victimization

Research indicates that lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at high risk of victimization by others and that transgender individuals may be at even higher risk than their cisgender LGBQ peers. In examining partner violence in particular, extant literature suggests that LGBTQ individuals are at equal or higher risk of partner violence victimization compared with their heterosexual peers. As opposed to sexual orientation, there is little research on gender identity and partner violence within the LGBTQ literature. In the current study, the authors investigated intimate partner violence (IPV) in a large sample of LGBTQ adults (N = 1,139) to determine lifetime prevalence and police reporting in both cisgender and transgender individuals. Results show that more than one fifth of all participants ever experienced partner violence, with transgender participants demonstrating significantly higher rates than their cisgender peers. Implications focus on the use of inclusive language as well as future research and practice with LGBTQ IPV victims.

Discrepant Alcohol Use, Intimate Partner Violence, and Relationship Adjustment among Lesbian Women and their Relationship Partners

This study examined the association between relationship adjustment and discrepant alcohol use among lesbian women and their same-sex intimate partners after controlling for verbal and physical aggression. Lesbian women (N = 819) who were members of online marketing research panels completed an online survey in which they reported both their own and same-sex intimate partner's alcohol use, their relationship adjustment, and their own and their partner's physical aggression and psychological aggression (i.e., verbal aggression and dominance/isolation). Partners' alcohol use was moderately correlated. Discrepancy in alcohol use was associated with poorer relationship adjustment after controlling for psychological aggression and physical aggression. Results are discussed in terms of the similarity and differences with previous literature primarily focused on heterosexual couples.

Emotional Distress, Alcohol Use, and Bidirectional Partner Violence Among Lesbian Women

This study examined the relationship between emotional distress (defined as depression, brooding, and negative affect), alcohol outcomes, and bidirectional intimate partner violence among lesbian women. Results lend support to the self-medication hypothesis, which predicts that lesbian women who experience more emotional distress are more likely to drink to cope, and in turn report more alcohol use, problem drinking, and alcohol-related problems. These alcohol outcomes were, in turn, associated with bidirectional partner violence (BPV). These results offer preliminary evidence that, similar to findings for heterosexual women, emotional distress, alcohol use, and particularly, alcohol-related problems are risk factors for BPV among lesbian women.

Young Men Who Have Sex With Men’s Experiences With Intimate Partner Violence

Research estimating the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) and other sexual minority populations is limited. However, existing research indicates rates similar to heterosexual women. This mixed-methods study was designed to inform intervention development and provides a description of the types of IPV experienced by young MSM (YMSM) within their dating and intimate relationships. Data collected include 101 surveys with YMSM aged 18 to 25 and 26 semi-structured qualitative interviews. YMSM experienced high levels of psychological aggression, physical assault, and sexual coercion both as victims and perpetrators. The study also found that there were high rates of mutual perpetration, young men reporting being both victim and perpetrator of partner violence. Qualitative data provide context and descriptions of these incidents to provide more information about the circumstances and perceptions of these incidents. The findings indicate that interventions should be multifaceted and include schools, communities, and families to address anger management, conflict resolution, and communication skills within young men’s relationships.

"Same-sex relationship in a straight world": individual and societal influences on power and control in young men's relationships

Young men who have sex with men (YMSM) continue to experience higher rates of HIV infection than other populations. Recently, there have been recommendations to consider HIV prevention at the dyadic or couple level. Using a dyadic approach to HIV prevention would also address an unaddressed concern related to intimate partner violence (IPV) among YMSM. Although research on IPV among YMSM is still in its infancy, great strides have been made in the past 10 years to describe the prevalence and related correlates of IPV within older adult same-sex relationships. These studies have found rates of IPV among MSM to be similar to rates among heterosexual women, and to be on the rise. The present study is designed to provide insight into how power is conceptualized within YMSM relationships and the role it may play in relationship challenges. This study draws from qualitative data collected from 11 focus groups with 86 YMSM and 26 individual semi-structured interviews to understand relationship challenges and the experiences of YMSM involved in partner violence. YMSM described relationship power as stemming from numerous sources including sexual positioning, gender roles, education, income, prior relationship experiences, and internalized homophobia. The findings have a number of implications for service providers and program design. Interventionists and other researchers need to consider power dynamics and other contextual elements of IPV before effective interventions can be developed for YMSM and other sexual minority populations.

Same-Sex Domestic Violence: Prevalence, Unique Aspects, and Clinical Implications

Domestic violence is a significant public health issue. Prevalence rates for same-sex domestic violence vary because of methodological issues related to recruitment and definitions of sexual orientation. However, such prevalence rates are currently considered to be similar to slightly greater than other-sex prevalence rates. Research has identified differences between same-sex domestic violence and other-sex domestic violence, including internalized and externalized stressors associated with being a sexual minority that interact with domestic violence to create or exacerbate vulnerabilities, higher risk for complex trauma experiences, and difficulties accessing services. This review provides a critical review of the literature, focusing upon empirical findings regarding same-sex domestic violence.

Associations between intimate partner violence and health among men who have sex with men: a systematic review and meta-analysis

BACKGROUND

Intimate partner violence (IPV) among men who have sex with men (MSM) is a significant problem. Little is known about the association between IPV and health for MSM. We aimed to estimate the association between experience and perpetration of IPV, and various health conditions and sexual risk behaviours among MSM.

METHODS AND FINDINGS

We searched 13 electronic databases up to 23 October 2013 to identify research studies reporting the odds of health conditions or sexual risk behaviours for MSM experiencing or perpetrating IPV. Nineteen studies with 13,797 participants were included in the review. Random effects meta-analyses were performed to estimate pooled odds ratios (ORs). Exposure to IPV as a victim was associated with increased odds of substance use (OR = 1.88, 95% CI(OR) 1.59-2.22, I² = 46.9%, 95% CI(I)² 0%-78%), being HIV positive (OR = 1.46, 95% CI(OR) 1.26-1.69, I² = 0.0%, 95% CI(I)² 0%-62%), reporting depressive symptoms (OR = 1.52, 95% CI(OR) 1.24-1.86, I² = 9.9%, 95% CI(I)² 0%-91%), and engagement in unprotected anal sex (OR = 1.72, 95% CI(OR) 1.44-2.05, I² = 0.0%, 95% CI(I)² 0%-68%). Perpetration of IPV was associated with increased odds of substance use (OR = 1.99, 95% CI(OR) 1.33-2.99, I² = 73.1%). These results should be interpreted with caution because of methodological weaknesses such as the lack of validated tools to measure IPV in this population and the diversity of recall periods and key outcomes in the identified studies.

CONCLUSIONS

MSM who are victims of IPV are more likely to engage in substance use, suffer from depressive symptoms, be HIV positive, and engage in unprotected anal sex. MSM who perpetrate IPV are more likely to engage in substance use. Our results highlight the need for research into effective interventions to prevent IPV in MSM, as well as the importance of providing health care professionals with training in how to address issues of IPV among MSM and the need to raise awareness of local and national support services.

Prevalence of dating violence among sexual minority youth: variation across gender, sexual minority identity and gender of sexual partners

Dating violence during adolescence negatively influences concurrent psychosocial functioning, and has been linked with an increased likelihood of later intimate partner violence. Identifying who is most vulnerable for this negative outcome can inform the development of intervention practices addressing this problem. The two goals of this study were to assess variations in the prevalence of dating violence across different measures of sexual minority status (e.g., sexual minority identity or same-sex sexual behavior), and to assess whether this association was mediated by bullying, the number of sexual partners, binge drinking or aggressive behaviors. These goals were assessed by employing the Massachusetts Youth Risk Behavior Survey (N = 12,984), a regionally representative sample of youth ages 14-18. In this sample, a total of 540 girls and 323 boys reported a non-heterosexual identity, and 429 girls and 230 boys reported having had one or more same-sex sexual partners. The results generally supported a higher prevalence of dating violence among sexual minority youth. This vulnerability varied considerably across gender, sexual minority identity and the gender of sexual partners, but generally persisted when accounting for the mediating variables. The findings support investigating dating violence as a mechanism in the disparities between sexual minority and heterosexual youth, and the importance of addressing sexual minority youth specifically in interventions targeting dating violence.