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Gamarel KE, Darbes LA, Kutsa O, Hightow-Weidman LB, Sullivan P, Stephenson R. Perspectives from Young Partnered Gay, Bisexual, and Other Men Who Have Sex with Men on the Adaptation of Couples HIV Testing and Counseling (CHTC). AIDS Behav 2021; 25:836-846. [PMID: 32975615 PMCID: PMC7886959 DOI: 10.1007/s10461-020-03037-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 01/05/2023]
Abstract
Young gay, bisexual, and other men who have sex with men (YGBMSM) are a priority population for HIV prevention efforts. Although there has been a growing focus on dyadic HIV prevention interventions for same-gender male couples, the unique needs of partnered YGBMSM have been largely overlooked. In this qualitative study, we explored partnered YGBMSM's perceptions of existing HIV prevention interventions to inform the design of a relationship-focused HIV prevention intervention. Between July and November 2018, we conducted in-depth interviews with 30 young partnered YGBMSM (mean age = 17.8, SD = 1.1). Participants described that interventions were needed to address skills regarding: (1) implicit versus explicit communication about sexual agreements; (2) boundary setting and identifying signs of abusive relationships; and (3) relationship dynamics (e.g., trust). Participants noted the absence of inclusive sexual education for them; thus, findings suggest that the provision of relationship skills training are requisites for HIV prevention interventions with YGBMSM in the US.
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Affiliation(s)
- Kristi E Gamarel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029d, USA.
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | - Lynae A Darbes
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Oksana Kutsa
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Lisa B Hightow-Weidman
- Institute for Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Population and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Brooks D, Wirtz A, Celentano D, Beyrer C, Arrington-Sanders R, Hailey-Fair K. Gaps in science and evidence-based interventions to respond to Intimate Partner Violence among Black gay and bisexual men in the U.S.: A Call for An Intersectional Social Justice Approach. SEXUALITY & CULTURE 2021; 25:306-317. [PMID: 33716496 PMCID: PMC7946129 DOI: 10.1007/s12119-020-09769-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intimate Partner Violence (IPV) is a prevalent, but underrecognized issue among sexual minorities (SM) broadly, but especially among Black Gay and Bisexual Men (BGBM). Over the last several years, acts of IPV among BGBM made national news, drawing attention to the unique ways that IPV plays out within this particular population. Yet, little research has examined the intersections between race and sexuality among BGBM, the lack of culturally responsive IPV services, their support needs, or the barriers that BGBM face when seeking IPV related services. When examined closely, the field of IPV has traditionally focused on cisgender heterosexual white woman as victims and cisgender white men as perpetrators, which has historically impacted the availability and quality of IPV services for other populations. This narrative critique of the IPV movement calls for an intersectional social justice and health equity approach to address the unique and intersectional needs of BGBM who experience IPV. By centering the intersectional needs of BGBM and the role that racism, homophobia, and heteronormative has played in shaping IPV-related services, this article challenges the IPV field to advance a social justice orientation in order to address the unmet needs of BGBM who experience IPV.
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Affiliation(s)
- Durryle Brooks
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrea Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Chris Beyrer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Renata Arrington-Sanders
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kimberly Hailey-Fair
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Stephenson R, Todd K, Gamarel KE, Bonar EE, Peitzmeier S. Development and Validation of a Scale to Measure Intimate Partner Violence Among Transgender and Gender Diverse Populations: Protocol for a Linear Three-Phase Study (Project Empower). JMIR Res Protoc 2020; 9:e23819. [PMID: 33242022 PMCID: PMC7728535 DOI: 10.2196/23819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is approximately twice as prevalent among transgender and gender diverse individuals (those whose current gender identity does not match their sex assigned at birth) than among cisgender individuals (those whose gender aligns with their sex assigned at birth). However, most existing scales measuring IPV are not validated among transgender and gender diverse populations and do not consider the unique forms of IPV experienced by transgender and gender diverse individuals. OBJECTIVE This paper describes the protocol for Project Empower, a study that seeks to develop and validate a new scale to measure IPV as experienced by transgender and gender diverse adults. A new scale is necessary to improve the accuracy of IPV measurement among transgender and gender diverse populations and may inform the current tools used to screen and link to services for transgender and gender diverse people who experience or perpetrate IPV. METHODS The proposed new scale will be developed by a linear three-phase process. In Phase I, we will recruit a maximum of 110 transgender and gender diverse participants to participate in in-depth interviews and focus groups. Phase I will collect qualitative data on the experiences of IPV among transgender and gender individuals. After generating scale items from the qualitative data in Phase I, Phase II will conduct up to 10 cognitive interviews to examine understanding of scale items and refine wording. Phase III will then conduct a survey with an online recruited sample of 700 transgender and gender diverse individuals to validate the scale using factor analysis and examine the prevalence, antecedents, and linked health outcomes of IPV. This study will generate the first comprehensive IPV scale including trans-specific IPV tactics that has undergone robust mixed-methods validation for use in transgender and gender diverse populations, regardless of sex assigned at birth. RESULTS Project Empower launched in August 2019, with Phases I and II expected to be complete by late 2020. Phase III (survey of 700 transgender individuals) is expected to be launched in January 2021. CONCLUSIONS A scale that more accurately captures the forms of IPV experienced by transgender and gender diverse people not only has the potential to lead to more accurate measurements of prevalence but also can identify unique forms of violence that may form the basis of IPV prevention interventions. Additionally, identifying the forms of IPV experienced by transgender and gender diverse people has the potential to lead to the refinement of clinical screening tools used to identify and refer those who experience and perpetrate violence in clinical settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23819.
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Affiliation(s)
- Rob Stephenson
- Center for Sexuality and Health Disparities and The School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Kieran Todd
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Kristi E Gamarel
- Center for Sexuality and Health Disparities and The School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Erin E Bonar
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
- The Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Sarah Peitzmeier
- Center for Sexuality and Health Disparities and The School of Nursing, University of Michigan, Ann Arbor, MI, United States
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Effects of emotion regulation and perpetrator-victim roles in intimate partner violence on mental health problems among men who have sex with men in China. Epidemiol Psychiatr Sci 2020; 29:e159. [PMID: 32792037 PMCID: PMC7443802 DOI: 10.1017/s2045796020000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China. METHODS From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China. RESULTS Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11-9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39-6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89,95% CI = 0.86-0.92), the correlation with victims of IPV was weaker than it was with non-victims. CONCLUSIONS This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims.
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Reback CJ, Rusow JA, Cain D, Benkeser D, Arayasirikul S, Hightow-Weidman L, Horvath KJ. Technology-Based Stepped Care to Stem Transgender Adolescent Risk Transmission: Protocol for a Randomized Controlled Trial (TechStep). JMIR Res Protoc 2020; 9:e18326. [PMID: 32788149 PMCID: PMC7458064 DOI: 10.2196/18326] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Transgender youth demonstrate significantly higher rates of engagement in sexual risk behaviors relative to their cisgender or gender-conforming counterparts, including high rates of condomless anal intercourse and engagement in sex work. In addition, transgender youth experience increased physical or sexual abuse, victimization, substance use, mental health disorders, incarceration, and homelessness. Owing to these syndemic health disparities, transgender youth are at substantially increased risk of HIV infection. OBJECTIVE This protocol aims to describe a randomized controlled trial (RCT), Adolescent Medicine Trials Network 160 TechStep (N=250), which assesses the differential immediate and sustained effects of each of 3 conditions (text messaging, WebApp, or information-only control) for reducing sexual risk behaviors and increasing pre-exposure prophylaxis (PrEP) uptake among high-risk, HIV-negative transgender youth and young adults (aged 15-24 years). METHODS Participants will be recruited through web-based (targeted social media sites and apps) and offline (print ads and flyers) advertisements, peer and clinic referrals, and street- and venue-based outreach, and by contacting potential participants who have requested contact for future studies. Participants will be randomized into 1 of the 3 conditions: (1) text messaging, (2) WebApp, or (3) information-only control for 6 months. Assessments will occur at baseline and at 3, 6, and 9 months. Participants who do not show improvements in sexual risk or PrEP uptake at the 3-month assessment will be rerandomized to receive weekly electronic coaching (eCoaching) sessions in addition to their assigned text messaging or WebApp intervention, or remain in the original text messaging or WebApp intervention using a 2:1 ratio. Participants originally assigned to the information-only condition are not eligible for rerandomization. RESULTS Funding for TechStep was awarded in June 2017. Phase 1 was approved by the Institutional Review Board (IRB) in April 2018. Recruitment began in November 2018 for phase 1, the formative phase. Initial phase 2 IRB approval came in June 2019. The data collection for phase 2, the RCT, is expected to be completed in April 2021. As of March 2020, 54 participants have been enrolled in TechStep. The final results are anticipated in May 2021. CONCLUSIONS By providing culturally responsive, technology-based interventions, TechStep aims to improve sexual health outcomes among HIV-negative transgender youth and young adults at high risk of HIV. TechStep will evaluate the efficacy of technology-based interventions for reducing HIV sexual risk behaviors and increasing PrEP initiation, adherence, and persistence. The suite of technology-based interventions developed in TechStep, and assessed for efficacy in a 3-condition RCT, represents an important advancement in intervention science toward developing tailored and scalable interventions for transgender youth and young adults. TRIAL REGISTRATION ClinicalTrials.gov NCT04000724; http://clinicaltrials.gov/ct2/show/NCT04000724. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/18326.
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Affiliation(s)
- Cathy J Reback
- Friends Research Institute, Inc, Los Angeles, CA, United States
- UCLA Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles, Los Angeles, CA, United States
| | - Joshua A Rusow
- Friends Research Institute, Inc, Los Angeles, CA, United States
| | - Demetria Cain
- PRIDE Health Research Consortium, Hunter College, City University of New York, New York, NY, United States
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sean Arayasirikul
- Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco, San Francisco, CA, United States
- Trans Research Unit for Equity, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, United States
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Abstract
Intimate partner violence (IPV) significantly increases HIV risk among MSM. Pre-exposure prophylaxis (PrEP) may provide MSM experiencing IPV an option for self-protection from HIV without requiring condom negotiation or compromising safety. This study examined relationships among various forms of IPV (physical, emotional, monitoring, controlling, and forced sex) and PrEP use among 863 MSM participating in a cross-sectional, internet-based survey. Participants reported IPV rates during the prior 6 months that were consistent with prior research (physical violence, 23.3%; emotional violence, 36.3%; monitoring, 45.1%; controlling, 25.3%; forced sex, 20.0%). Forced sex and emotional IPV were negatively associated with PrEP use in our sample; in contrast, controlling was positively associated with PrEP use. We suggest clinical IPV screenings among MSM seeking PrEP, as well as PrEP-focused interventions that explicitly address IPV.
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57
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Dickerson-Amaya N, Coston BM. Invisibility Is Not Invincibility: The Impact of Intimate Partner Violence on Gay, Bisexual, and Straight Men's Mental Health. Am J Mens Health 2020; 13:1557988319849734. [PMID: 31092110 PMCID: PMC6537270 DOI: 10.1177/1557988319849734] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Intimate partner violence (IPV) is a critical public health problem. However,
there is limited research conducted on and about men who are survivors. This
project extends previous research by examining the post-traumatic impact of
diverse forms of IPV (sexual, physical, emotional, control, and stalking) on the
internalized and externalized mental health of gay, bisexual, and straight men.
Using data from the National Intimate Partner and Sexual Violence Survey (2011;
N = 18,957), we find that all men are equally likely to
report emotional victimization and controlling tactics (with between 50% and 70%
doing so), while bisexual men are significantly more likely to report physical
and sexual violence and gay men are significantly more likely to report intimate
stalking. Due to these experiences, gay men are significantly more likely to
report missing school or work, but bisexual men are significantly more likely to
rate their current overall mental health as poor. Around 10% of all men,
regardless of sexual orientation, report post-traumatic stress disorder
symptomology and 30% of all men report difficulty sleeping. This research
suggests that sexual orientation is a critical area of focus in the study of
violence and mental health for men and that we can no longer ignore the voices
and needs of men survivors: Invisibility is not invincibility.
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Affiliation(s)
- Natasha Dickerson-Amaya
- 1 Department of Rehabilitation and Mental Health Counseling, School of Allied Health; Virginia Commonwealth University, Richmond, VA, USA
| | - Bethany M Coston
- 2 Gender, Sexuality and Women's Studies; Virginia Commonwealth University, Richmond, VA, USA
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Kahle EM, Sharma A, Sullivan S, Stephenson R. The Influence of Relationship Dynamics and Sexual Agreements on Perceived Partner Support and Benefit of PrEP Use Among Same-Sex Male Couples in the U.S. AIDS Behav 2020; 24:2169-2177. [PMID: 31950307 DOI: 10.1007/s10461-020-02782-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Use of Pre-exposure prophylaxis (PrEP) for HIV prevention by men who have sex with men (MSM) may be impacted by relationship dynamics. We assessed perceived partner support of PrEP use and benefit of PrEP by relationship characteristics among male couples. Baseline data from a randomized control trial of video-based HIV counseling and testing among male couples in the U.S. were used in adjusted multilevel regression models to assess individual and dyadic characteristics. Among 659 participants, 73.3% thought their partner would be supportive of their PrEP use; 26.7% reported their partner would not support PrEP use, which was significantly associated with intimate partner violence (IPV) (p = 0.008). Most (57.7%) did not believe PrEP would be beneficial to them or their partner. Couples with a sexual agreement allowing outside partners were significantly associated with higher perceived support of partners for PrEP (p < 0.001) and benefit of PrEP use (p < 0.001). Perceived partner support of PrEP was high but perceived benefit of PrEP was low, both shaped by relationship dynamics that highlight the need for tailored dyadic interventions. The association between perceived PrEP support and IPV points to the need to integrate relationship contexts in HIV prevention programs.
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59
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Hall CD, Ibragimov U, Luu MN, Wong FY. Actives, passives and power: heteronormative gender norms and their implications for intimate partner violence among men who have sex with men in Tajikistan. CULTURE, HEALTH & SEXUALITY 2020; 22:630-645. [PMID: 31184271 DOI: 10.1080/13691058.2019.1623913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
Global research reveals that gender-role norms have a profound effect on socio- and psycho-sexual expression (e.g. sexual positioning) among gay and bisexual men, which in turn may affect mental health and sexual risks. However, little is known about these factors among gay and bisexual men in Muslim-majority countries such as Tajikistan. Using a combination of in-depth individual interviews and focus-group assessments, this exploratory, qualitative study examined how gender roles might function as a social determinant for the practice of sexual positioning, which in turn may influence intimate partner violence (IPV), sexual risk and relational power. Results suggest that being the 'active' partner in sexual relationships closely aligns with the construct of hegemonic masculinity, affording actives more power in male-male relationships which may in some cases result in IPV directed against 'passives'. Despite this imbalance, passives also hold power in some cases, such as easier access to public resources such as the police and gay and bisexual focused services. Further research should examine gender norms and sexual positioning relative to IPV and sexual risks among Muslim men in Tajikistan.
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Affiliation(s)
- Casey D Hall
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Umedjon Ibragimov
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Minh N Luu
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Frank Y Wong
- Center for Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, FL, USA
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Stephenson R, Bratcher A, Mimiaga MJ, Garofalo R, Hidalgo MA, Hoehnle S, Sullivan PS. Brief Report: Accuracy in Self-Report of Viral Suppression Among HIV-Positive Men With HIV-Negative Male Partners. J Acquir Immune Defic Syndr 2020; 83:210-214. [PMID: 31917748 PMCID: PMC8754005 DOI: 10.1097/qai.0000000000002240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Among men who have sex with men, there is now clear evidence that the risk of HIV transmission through condomless sex when the HIV-positive partner is virally suppressed is effectively zero. However, an understanding of the accuracy of reporting of viral load among serodiscordant same-sex male couples is missing from the literature. SETTING This analysis uses data from the baseline sample of Stronger Together, a randomized controlled efficacy trial of an innovative dyadic intervention to enhance antiretroviral therapy adherence for HIV serodiscordant male couples in 3 US cities (Atlanta, Boston, and Chicago). METHODS Biomarker-confirmed and self-reported measures of viral load were used to assess the accuracy of self-report of viral suppression. In this descriptive analysis, the percentage of men who inaccurately reported being virally suppressed is compared across demographic, relationship, and HIV care characteristics. RESULTS Results confirm those of other recent studies that have shown relatively high levels of inaccuracy in reporting of viral suppression. Although 72.5% of men could accurately report their viral load status, 20% reported that they were virally suppressed when they did not have a biomarker-confirmed measure of viral suppression. CONCLUSION These results highlight the need to provide interventions to men who have sex with men living with HIV to support access to care and ensure current knowledge of viral load and to continue to support primary prevention of HIV through condom use and pre-exposure prophylaxis. For couples, particularly serodiscordant male couples, interventions that can teach the couple how to collaborate to achieve and maintain viral suppression for the positive partner are an urgent and pragmatic programmatic priority that can equip couples with the knowledge required to correctly implement U = U strategies.
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Affiliation(s)
- Rob Stephenson
- Department of Systems, Population and Leadership & The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Anna Bratcher
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Matthew J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Robert Garofalo
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Marco A Hidalgo
- Division of Adolescent and Young Adult Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Samuel Hoehnle
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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61
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Wei D, Cao W, Hou F, Hao C, Gu J, Peng L, Li J. Multilevel factors associated with perpetration of five types of intimate partner violence among men who have sex with men in China: an ecological model-informed study. AIDS Care 2020; 32:1544-1555. [PMID: 32093496 DOI: 10.1080/09540121.2020.1734523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In China, intimate partner violence (IPV) among men who have sex with men remains poorly investigated. Informed by the ecological model, this study explored multilevel factors associated with perpetration of IPV among men who have sex with men. The participants were recruited from 15 cities in mainland China. Univariate and multivariate regression analyses showed that the prevalence of committing physical, sexual, monitoring, controlling and emotional IPV was 8.6%, 7.1%, 15.2%, 7.6% and 17.1%, respectively. Committing physical IPV showed a positive association with perceived public discrimination and self-stigma towards homosexuality. Committing sexual IPV showed a positive association with involvement with a homosexual support agency and more sex partners. Monitoring IPV was positively associated with higher education and perceived stress, but negatively associated with instrumental and emotional support. Committing controlling IPV showed a positive association with drug use during sex and self-stigma but a negative association with self-esteem, self-efficacy and older age at first homosexual sex. Committing emotional IPV showed a positive association with commercial sex behaviour and perceived stress, but a negative association with resilience. Committing IPV was prevalent in this population. It is necessary to distinguish the various types of IPV in future studies, given their differences in associated factors.
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Affiliation(s)
- Dannuo Wei
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, United States
| | - Fengsu Hou
- Department of Public Mental Health, Kangning Hospital, Shenzhen, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Chun Hao
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Liping Peng
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
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62
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Peng L, She R, Gu J, Hao C, Hou F, Wei D, Li J. The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China. BMC Public Health 2020; 20:2. [PMID: 31900234 PMCID: PMC6942407 DOI: 10.1186/s12889-019-8125-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have shown that intimate partner violence (IPV) is prevalent in men who have sex with men (MSM). Mental health problems among MSM with IPV victimization have become a growing concern. The present study examined homosexual self-stigma and self-efficacy as potential mediators of the association between IPV victimization and depression. METHODS We recruited 578 MSM from 15 cities across China. Participants completed sociodemographic measures, the IPV-GBM (IPV among gay and bisexual men) scale, the Self-Stigma Scale-Short Form (SSS-S), the General Self-Efficacy (GSE) Scale and the Center for Epidemiologic Studies Depression 10 (CES-D-10). We calculated bias-corrected 95% confidence interval (CI) for total, direct and indirect effects using bootstrapping to conduct mediation analyses. RESULTS Findings showed that the prevalence of IPV victimization and depression were 32.7% (189/578) and 36.0% (208/578), respectively. Result from mediation analysis using structural equation modeling indicated that the association between level of IPV victimization and depression among MSM was fully mediated by higher homosexual self-stigma and lower self-efficacy. Homosexual self-stigma had a direct effect and an indirect effect via self-efficacy on depression. CONCLUSION The results provided evidence that integrated interventions that reduce self-stigma and foster self-efficacy could be promising approaches to decrease depression among MSM with IPV victimization.
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Affiliation(s)
- Liping Peng
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
| | - Rui She
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Chun Hao
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Fengsu Hou
- Department of Public Mental Health, Shenzhen Kangning Hospital, Shenzhen, Guangdong China
| | - Dannuo Wei
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
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Stephenson R, Sharma A, Mimiaga MJ, Garofalo R, Brown E, Bratcher A, Wimbly T, Hidalgo MA, Hoehnle S, Thai J, Sullivan PS, Suarez NA. Concordance in the reporting of intimate partner violence among male-male couples. JOURNAL OF FAMILY VIOLENCE 2019; 34:677-686. [PMID: 32773962 PMCID: PMC7413602 DOI: 10.1007/s10896-019-00076-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Intimate partner violence (IPV) among male couples is increasingly recognized as a public health concern. Research on IPV in opposite sex couples indicates frequent underreporting of IPV and high levels of discordance in reporting among dyads. Concordance studies inform refinement methods to measure the experience of IPV among dyads; however the lack of dyadic studies of male couples impedes our understanding of the extent to which IPV is differentially reported in male-male dyads. This study utilized baseline data from a randomized controlled trial of a behavioral intervention to optimize antiretroviral therapy (ART) adherence among 160 sero-discordant male couples in three US cities and provides the first analysis of concordance in reporting IPV among male couples. Low degrees of concordance in the reporting of IPV were identified among male dyads, with a greater proportion of men reporting violence perpetration than experiencing violence. The greater reporting of IPV perpetration may be linked to adherence to concepts of masculinity. The results underscore the unique experiences of IPV among male couples and the need to reexamine current IPV measurement and intervention strategies.
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Affiliation(s)
- R Stephenson
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - A Sharma
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - R Garofalo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - E Brown
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - A Bratcher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - T Wimbly
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - M A Hidalgo
- Center for Trans Youth Health and Development, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S Hoehnle
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - J Thai
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - P S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - N A Suarez
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
- The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Starks TJ, Dellucci TV, Gupta S, Robles G, Stephenson R, S Sullivan P, Parsons JT. A Pilot Randomized Trial of Intervention Components Addressing Drug Use in Couples HIV Testing and Counseling (CHTC) with Male Couples. AIDS Behav 2019; 23:2407-2420. [PMID: 30887190 PMCID: PMC6910720 DOI: 10.1007/s10461-019-02455-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Men who have sex with men (MSM) experience high rates of substance use and HIV infection. Main partners are the source of many (35-68%) of these new HIV infections. This study developed and examined the efficacy of two adjunct components to couples HIV testing and counseling (CHTC)-communication training (CT) videos and a substance use module (SUM)-to reduce drug use and sexual HIV transmission risk in MSM couples. Participants included 70 male couples randomized into one of four conditions: CHTC, CHTC + CT videos, CHTC + SUM, and CHTC + CT videos + SUM. Participants completed a survey pre-intervention and 1-, 3-, and 6-months later. Completion of the SUM in the absence of CT videos was associated with significant immediate decreases in drug use and related problems; however, at 3- and 6-month follow ups, the SUM was only associated with reductions in drug use and related problems among men who also viewed the CT videos. There were no between-condition differences in sexual behavior. CHTC may serve as a vehicle for the delivery of brief substance use intervention for MSM couples.ClinicalTrails.gov NCT # 03125915.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA.
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA.
| | - Trey V Dellucci
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
| | - Sugandha Gupta
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA
| | - Gabriel Robles
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
| | - Rob Stephenson
- Department of Systems, Population and Leadership, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
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Mimiaga MJ, Suarez N, Garofalo R, Frank J, Ogunbajo A, Brown E, Bratcher A, Pardee D, Hidalgo MA, Hoehnle S, Restar A, Wimbly T, Thai J, Sullivan PS, Stephenson R. Relationship Dynamics in the Context of Binge Drinking and Polydrug Use Among Same-Sex Male Couples in Atlanta, Boston, and Chicago. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1171-1184. [PMID: 30806868 PMCID: PMC6458086 DOI: 10.1007/s10508-018-1324-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 09/05/2018] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
An estimated one- to two-thirds of incident HIV infections among U.S. men who have sex with men (MSM) occur within the context of a primary relationship. The existing, yet limited, literature on sexual risk behavior among same-sex couples suggests that MSM with main partners are more often to report having lower perceived HIV risk, higher unrecognized HIV infection, and increased frequency of condomless anal intercourse with their primary partner. Furthermore, numerous studies document the strong relationship between polydrug use and binge drinking with HIV infection among MSM. However, more research is needed that identifies how individual- and relationship-level factors are related to polydrug use and binge drinking in the context of same-sex male relationships. We used baseline data collected as part of a prospective randomized controlled trial of 160 same-sex male couples (total N = 320 individuals). In 2015, recruitment commenced in three U.S. cities: Atlanta, GA, Boston, MA, and Chicago, IL. Participants completed a self-report assessment using an audio-computer-assisted self-interview system during their baseline enrollment visit. We collected information on participants' sociodemographic characteristics, drug and alcohol use, individual- and relationship-level variables of interest, as well as relationship quality. Multinomial logistic regression models were fit for three different categories of polydrug use and of binge drinking for which (1) both partners exhibited the behavior, (2) only the respondent exhibited the behavior, or (3) only the partner exhibited the behavior. Participants' age ranged from 18 to 69 (M = 35.9). The sample majority (77.5%) was White (248/320), with 12.2% Black (39/320) and 10.3% Multiracial (33/320); 68.4% had completed a college degree; and 9.6% were unemployed. A high proportion (62.2%) reported any drug use, including marijuana; 45% reported using drugs other than marijuana; and 18.1% reported polydrug use. Overall, 22.2% reported current binge drinking. Age discordance and being in a long-term relationship (6 or more years) were associated with a decreased odds of polydrug use among couples; being in an interracial dyad, recent history of arrest, living with HIV, and self-reported clinically significant depressive symptoms were associated with an increased odds of polydrug use. Additionally, being the older partner and reporting higher levels of internalized homophobia decreased odds for binge drinking, while recent history of arrest, living with HIV, and feeling more loved in their relationship were associated with an increased odds of binge drinking. Findings have implications for developing interventions to reduce substance use and promote health among same-sex male couples. Future research would benefit by using longitudinal study designs to understand the individual-, relationship-, and structural-level factors that potentiate polydrug use and binge drinking among same-sex male couples.
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Affiliation(s)
- Matthew J Mimiaga
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA.
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.
| | - Nicolas Suarez
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Robert Garofalo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - John Frank
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Adedotun Ogunbajo
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Emily Brown
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Anna Bratcher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana Pardee
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Marco A Hidalgo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sam Hoehnle
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Arjee Restar
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Taylor Wimbly
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennie Thai
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Gamarel KE, Darbes LA, Hightow-Weidman L, Sullivan P, Stephenson R. The Development and Testing of a Relationship Skills Intervention to Improve HIV Prevention Uptake Among Young Gay, Bisexual, and Other Men Who Have Sex With Men and Their Primary Partners (We Prevent): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e10370. [PMID: 30602433 PMCID: PMC6746068 DOI: 10.2196/10370] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/12/2018] [Accepted: 09/26/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Young gay, bisexual, and other men who have sex with men (YMSM) continue to be the group most heavily impacted by HIV in the United States. Substantial evidence indicates that up to two-thirds of new HIV infections occur in the context of a main partnership. Couples HIV testing and counseling (CHTC) has been shown to be a promising and effective strategy for increasing HIV prevention uptake among male couples; however, YMSM who are new to relationships may not have yet developed the efficacy, negotiation, and communication skills to navigate HIV testing in their relationship and communicate around developing a prevention plan. OBJECTIVE This study aims to develop and test a relationship skills-focused HIV prevention intervention for YMSM and their partners. The intervention consists of two telehealth-delivered sessions: the first focuses on relationship skills and the second consists of CHTC and prevention planning. Both sessions are attended by both members of the dyad. METHODS This protocol describes the development of the proposed intervention (We Prevent) and pilot test to examine its feasibility and preliminary efficacy. The intervention will include two motivational interviewing-based sessions: session one is a relationship skills-building session, focused on techniques to explore and build communication skills in a relationship, to help YMSM develop and enhance necessary skills for their current and future relationships; the second session is a CHTC session with YMSM and their partners, to help them develop an HIV prevention plan. Through qualitative data collection and a one-arm pilot with YMSM, we will develop and refine a developmentally appropriate relationship skills session as an addition to the current CHTC intervention. We will then conduct a pilot randomized controlled trial (RCT), comparing the acceptability, feasibility, and preliminary efficacy of the adapted two-session telehealth intervention for YMSM versus a control group receiving one session only-a CHTC session delivered via telehealth. RESULTS The We Prevent intervention is designed to increase uptake of HIV prevention, shown through self-reported reductions in condomless sex and increases in knowledge and uptake of pre-exposure prophylaxis. In addition, the intervention is designed to increase HIV and sexually transmitted infection (STI) testing. STI incidence is examined as a secondary outcome. A cost-input analysis will examine the costs associated with intervention delivery to inform future scale-up of the intervention. CONCLUSIONS Drawing on theory and existing CHTC protocols delivered with video-based counseling, this proposed intervention affords the opportunity to empower YMSM with the skills necessary to communicate with their partners and protect themselves from HIV in their current and future relationships. TRIAL REGISTRATION Clinicaltrials.gov NCT03551938; https://clinicaltrials.gov/ct2/show/NCT03551938 (Archived by WebCite at http://www.webcitation.org/73omJCz1a). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/10370.
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Affiliation(s)
- Kristi E Gamarel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Lynae A Darbes
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
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68
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Goldenberg T, Darbes LA, Stephenson R. Inter-partner and Temporal Variations in the Perception of Sexual Risk for HIV. AIDS Behav 2018; 22:1870-1884. [PMID: 28831758 DOI: 10.1007/s10461-017-1876-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study uses longitudinal qualitative methods to examine how gay and bisexual men perceive sexual risk across both a variety of partners and across time. Over ten weeks, participants completed three quantitative personal relationship diaries (PRD) describing sexual encounters during that time period. Participants then completed a timeline-based individual in-depth interview to unpack the PRD data. Participants used multiple factors to determine their own sexual risk (e.g., type of sex, partner concurrency, emotional connections), which often resulted in inconsistencies in defining sexual risk and determining the level of risk both within and across partners and across time. These findings can inform HIV prevention messages and programming.
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Relationship Characteristics and Dyadic Approaches to HIV Health-Enhancing Behaviours Among a Sample of Same-Sex Male Couples From Three U.S. Cities. ACTA ACUST UNITED AC 2018. [DOI: 10.1017/jrr.2018.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Recent modelling estimates up to two-thirds of new HIV infections among men who have sex with men occur within partnerships, indicating the importance of dyadic HIV prevention efforts. Although new interventions are available to promote dyadic health-enhancing behaviours, minimal research has examined what factors influence partners’ mutual engagement in these behaviours, a critical component of intervention success. Actor-partner interdependence modelling was used to examine associations between relationship characteristics and several dyadic outcomes theorised as antecedents to health-enhancing behaviours: planning and decision making, communication, and joint effort. Among 270 male-male partnerships, relationship satisfaction was significantly associated with all three outcomes for actors (p = .02, .02, .06 respectively). Latino men reported poorer planning and decision making (actor p = .032) and communication (partner p = .044). Alcohol use was significantly and negatively associated with all outcomes except actors’ planning and decision making (actors: p = .11, .038, .004 respectively; partners: p = .03, .056, .02 respectively). Having a sexual agreement was significantly associated with actors’ planning and decision making (p = .007) and communication (p = .008). Focusing on interactions between partners produces a more comprehensive understanding of male couples’ ability to engage in health-enhancing behaviours. This knowledge further identifies new and important foci for the tailoring of dyadic HIV prevention and care interventions.
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Suarez NA, Mimiaga MJ, Garofalo R, Brown E, Bratcher AM, Wimbly T, Hidalgo MA, Hoehnle S, Thai J, Kahle E, Sullivan PS, Stephenson R. Dyadic Reporting of Intimate Partner Violence Among Male Couples in Three U.S. Cities. Am J Mens Health 2018; 12:1039-1047. [PMID: 29749299 PMCID: PMC6131425 DOI: 10.1177/1557988318774243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Intimate partner violence (IPV) is a prevalent and pressing public health concern
that affects people of all gender and sexual identities. Though studies have
identified that male couples may experience IPV at rates as high as or higher
than women in heterosexual partnerships, the body of literature addressing this
population is still nascent. This study recruited 160 male–male couples in
Atlanta, Boston, and Chicago to independently complete individual surveys
measuring demographic information, partner violence experience and perpetration,
and individual and relationship characteristics that may shape the experience of
violence. Forty-six percent of respondents reported experiencing IPV in the past
year. Internalized homophobia significantly increased the risk for reporting
experiencing, perpetrating, or both for any type of IPV. This study is the first
to independently gather data on IPV from both members of male dyads and
indicates an association between internalized homophobia and risk for IPV among
male couples. The results highlight the unique experiences of IPV in male–male
couples and call for further research and programmatic attention to address the
exorbitant levels of IPV experienced within some of these partnerships.
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Affiliation(s)
- Nicolas A Suarez
- 1 Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Matthew J Mimiaga
- 3 Center for Health Equity Research, Brown University, Providence, RI, USA.,4 Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA.,5 Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.,6 The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Robert Garofalo
- 7 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,8 Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Emily Brown
- 6 The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Anna Marie Bratcher
- 9 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Taylor Wimbly
- 9 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Marco A Hidalgo
- 10 Center for Trans Youth Health and Development, Children's Hospital Los Angeles, Los Angeles, CA, USA.,11 Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Samuel Hoehnle
- 7 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,8 Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jennie Thai
- 7 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Erin Kahle
- 2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.,12 Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Patrick S Sullivan
- 9 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- 2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.,12 Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
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Martinez O, Isabel Fernandez M, Wu E, Carballo-Diéguez A, Prado G, Davey A, Levine E, Mattera B, Lopez N, Valentin O, Murray A, Sutton M. A couple-based HIV prevention intervention for Latino men who have sex with men: study protocol for a randomized controlled trial. Trials 2018; 19:218. [PMID: 29622045 PMCID: PMC5887179 DOI: 10.1186/s13063-018-2582-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/16/2018] [Indexed: 11/19/2022] Open
Abstract
Background Latino men who have sex with men (MSM) experienced a 13% increase in HIV diagnoses from 2010 to 2014, more than any other racial/ethnic subgroup of MSM in the United States. If current HIV diagnoses rates persist, about one in four Latino MSM in the United States will be diagnosed with HIV during their lifetime. Although some efficacious HIV prevention interventions for Latino MSM exist, none have focused on couples. This paper describes the protocol of a randomized controlled trial (RCT) to test the preliminary efficacy of a couple-based HIV prevention intervention that is culturally tailored for Latino men and their same-sex partners. Methods The RCT will determine the preliminary efficacy of Connecting Latinos en Pareja (CLP) to increase the proportion of anal sex acts that are HIV protected (i.e., anal sex acts in which condoms, pre-exposure prophylaxis (PrEP), treatment as prevention (TasP), or a combination thereof, are used to reduce risk of HIV transmission). CLP builds upon previous couple-based interventions with white and black MSM by incorporating biomedical prevention techniques, such as PrEP and TasP, implementing a framework responsive to the couple’s serostatus, and addressing the socio-cultural factors that influence HIV risk among Latino MSM. We also include input from community stakeholders, members of the target population, and a community advisory board as part of intervention development. Assessments will be conducted at baseline, and 3- and 6-months post-intervention to examine the intervention effects on outcomes (HIV-protected sex acts), and factors potentially mediating or moderating intervention effects. Discussion This paper describes an innovative RCT that incorporates multiple HIV prevention techniques for Latino MSM in couples, regardless of serostatus. The ongoing involvement of community stakeholders, members of the target population, and a community advisory board is emphasized, and plans for widespread dissemination and application of findings into practice are discussed. Trial registration Trial registration: NCT03048838. Registered on 3 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2582-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Omar Martinez
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA.
| | - M Isabel Fernandez
- Nova Southeastern University, 2000 South Dixie Highway, Miami, FL, 33133, USA
| | - Elwin Wu
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027-5927, USA
| | - Alex Carballo-Diéguez
- New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Guillermo Prado
- University of Miami, 1320 S Dixie Hwy, Coral Gables, Miami, FL, 33146, USA
| | - Adam Davey
- University of Delaware, 540 S College Ave, Newark, DE, 19713, USA
| | - Ethan Levine
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Brian Mattera
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Nikki Lopez
- GALAEI, 149 W Susquehanna Ave, Philadelphia, PA, 19122, USA
| | - Omar Valentin
- Temple University's School of Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA, 19122, USA
| | - Ashley Murray
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV/AIDS Prevention, TB, Hepatitis, Epidemiology Branch, 1600 Clifton Road, MS E-45, Atlanta, GA, 3029, USA
| | - Madeline Sutton
- Minority HIV/AIDS Research Initiative, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV/AIDS Prevention, TB, Hepatitis, Epidemiology Branch, 1600 Clifton Road, MS E-45, Atlanta, GA, 3029, USA
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Duncan DT, Goedel WC, Stults CB, Brady WJ, Brooks FA, Blakely JS, Hagen D. A Study of Intimate Partner Violence, Substance Abuse, and Sexual Risk Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in a Sample of Geosocial-Networking Smartphone Application Users. Am J Mens Health 2018; 12:292-301. [PMID: 26873342 PMCID: PMC5818104 DOI: 10.1177/1557988316631964] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Geosocial-networking smartphone applications ("apps") are widely used by gay, bisexual, and other men who have sex with men (MSM) and facilitate connections between users based on proximity and attraction. MSM have sexual encounters and relationships of varying degrees of emotional and physical intimacy with app-met individuals, potentially placing them at risk for intimate partner violence (IPV). The purpose of the current study was to utilize a geosocial-networking application to investigate relationships between experiences of IPV victimization as it relates to substance use and sexual risk behaviors in a sample of MSM. Participants ( n = 175) were recruited by means of broadcast advertisements on an application widely used by MSM (Grindr) to seek sexual partners. Multivariable regression models were fit to examine associations between IPV, substance abuse, and sexual risk behaviors. Lifetime experiences of IPV victimization were common, where 37.7% of respondents reported having experienced at least one form of IPV. While a marginally significant positive association between IPV and substance abuse was detected in multivariable models ( p = .095), individual forms of IPV were strongly associated with substance abuse. For example, sexual IPV victimization was associated with an increase in substance abuse in the preceding month ( p = .004). Experiences of IPV victimization were associated with higher numbers of partners for both condomless receptive and insertive anal intercourse ( p < .05). Given the relatively high prevalence of IPV victimization and its associations with substance abuse and sexual risk behaviors, these findings suggest that IPV screening and prevention programs may reduce substance abuse and sexual risk behaviors in this population.
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73
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Goldenberg T, Jadwin-Cakmak L, Harper GW. Intimate Partner Violence Among Transgender Youth: Associations with Intrapersonal and Structural Factors. VIOLENCE AND GENDER 2018; 5:19-25. [PMID: 29588911 PMCID: PMC5865252 DOI: 10.1089/vio.2017.0041] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Intimate partner violence (IPV) is a serious public health problem, linked with a number of poor health outcomes. Some research demonstrates that transgender and gender nonconforming (TGNC) youth may experience IPV at similar rates to heterosexual cisgender women; however, there is a dearth of data examining the experiences of IPV among this population. The exclusion of TGNC youth in IPV research and public health interventions is problematic because it contributes to a traditional gender-based heterosexual model of IPV that ignores the specific needs of TGNC populations. Given the pervasiveness of transphobic stigma in the United States and the complexities of the lives of TGNC youth, it is important to understand how both structural and individual factors are associated with IPV among TGNC youth. Using data from a cross-sectional survey of 131 TGNC youth from 14 different cities in the United States representing various regions of the country, this study explores the associations between a range of structural and intrapersonal factors and experiences of IPV victimization among TGNC youth. Separate logistic regression models were fit to examine the relationships between structural and intrapersonal factors and IPV. Structural results found that TGNC youth experiencing extreme victimization, a history of incarceration, and participation in sex work were much more likely to report IPV. The only intrapersonal variable that was associated with IPV was depressive symptomatology; however, this relationship was strong, with participants being nearly eight times more likely to report IPV if they experienced symptoms of depression. Gaining a better understanding of the complexity of both structural and intrapersonal factors among TGNC youth will greatly inform the development of IPV prevention and services for TGNC youth experiencing this type of violence.
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Affiliation(s)
- Tamar Goldenberg
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Laura Jadwin-Cakmak
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Gary W Harper
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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74
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Davis A, Kaighobadi F, Stephenson R, Rael C, Sandfort T. Associations Between Alcohol Use and Intimate Partner Violence Among Men Who Have Sex with Men. LGBT Health 2018; 3:400-406. [PMID: 27906642 DOI: 10.1089/lgbt.2016.0057] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Intimate partner violence (IPV) research among men who have sex with men (MSM) has primarily focused on the prevalence of IPV victimization and perpetration. Although alcohol use is a known trigger of IPV in opposite sex relationships, less is known about alcohol use and IPV perpetration and victimization in same-sex couples. The aim of this study was to examine associations between alcohol use and different types of IPV victimization and perpetration among MSM. METHODS MSM in New York City were recruited at gay-friendly venues and events to participate in an online survey assessing sociodemographics, alcohol use, and victimization/perpetration of IPV with both regular and casual sex partners. Logistic regression was used to examine associations between alcohol use and different types of IPV victimization and perpetration. RESULTS Among 189 participants, 103 (54.5%) reported experiencing at least one incidence of IPV perpetrated by a regular partner and 92 (48.7%) reported having perpetrated IPV against a regular partner in the past 12 months. Higher levels of alcohol use were significantly associated with (1) physical/sexual and HIV-related IPV victimization by a regular partner, (2) physical/sexual, monitoring, and controlling IPV victimization by a casual partner, (3) physical/sexual, emotional, controlling, and HIV-related IPV perpetration against a regular partner, and (4) physical/sexual and emotional IPV perpetration against a casual partner. CONCLUSIONS The association of high levels of alcohol use with different types of IPV perpetration and IPV victimization suggests a need for targeted services that address the co-occurring issues of alcohol use and IPV.
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Affiliation(s)
- Alissa Davis
- 1 Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University , New York, New York
| | - Farnaz Kaighobadi
- 1 Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University , New York, New York.,2 Department of Social Sciences, Bronx Community College, City University of New York , New York, New York
| | - Rob Stephenson
- 3 Department of Health Behavior and Biological Sciences, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan , Ann Arbor, Michigan
| | - Christine Rael
- 1 Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University , New York, New York
| | - Theodorus Sandfort
- 1 Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University , New York, New York
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75
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Hidalgo MA, Suarez NA, Garofalo R, Hoehnle S, Thai J, Mimiaga MJ, Brown E, Sullivan PS, Bratcher A, Wimbly T, Stephenson R. Clinically significant depressive symptoms among a diverse sample of same-sex male couples in Atlanta, Boston, and Chicago: An analysis of individual- and dyadic-level factors. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2018; 22:327-347. [PMID: 35847160 DOI: 10.1080/19359705.2018.1476278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Psychosocial and relationship factors are associated with depression outcomes in heterosexual couples. No known research has examined these relationships statistically among both partners within a same-sex male dyad. This study examined how socio-demographics, psychosocial and relationship factors influence depressive symptoms in a large sample of same-sex male couples in Atlanta, Boston, and Chicago. Linear and logistic regression models indicated that, at the individual level, age, polydrug use, relationship length, perceived love, and partner communication were associated with depression scores. Multinomial logistic regression models showed that couples with no sexual agreement or an agreement with restrictions were likely to exhibit depressive symptoms.
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Affiliation(s)
- Marco A Hidalgo
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Nicolas A Suarez
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Center for Sexual and Health Disparities, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert Garofalo
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Samuel Hoehnle
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Jennie Thai
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Matthew J Mimiaga
- Departments of Behavioral and Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Center for Health Equity Research, Brown University, Providence, Rhode Island, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Emily Brown
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Anna Bratcher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Taylor Wimbly
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Rob Stephenson
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behaviors and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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76
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Mgopa LR, Mbwambo J, Likindikoki S, Pallangyo P. Violence and depression among men who have sex with men in Tanzania. BMC Psychiatry 2017; 17:296. [PMID: 28810838 PMCID: PMC5558659 DOI: 10.1186/s12888-017-1456-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) continue to be at an increased risk of Violence, HIV transmission and Mental Disorders such as depression on top of many other bio-psycho-socio challenges they face as a result of their sexual orientation. METHODS We recruited 345 MSM using a respondent driven sampling technique. Revised Conflict Tactic Scale, PHQ-9 and questions adapted from the TDHS 2010 were used to assess for violence, depression and HIV-risk behaviors respectively. Continuous and categorical variables were analyzed with student's t-test and chi-square test respectively. Logistic regression analyses were performed to assess for predictors of depression and HIV-risk behaviors. All tests were two sided and p < 0.05 was taken as significance level. RESULTS Overall, 325 (94.2%) of participants experienced any form of violence, with emotional violence constituting the majority (90.1%), while physical and sexual violence were reported by 254 (73.6%) and 250 (72.5%) of participants respectively. Depressive symptoms were present in 245 (70.0%) and participants who experienced violence had a 3 times increased risk of depressive symptoms compared to their violence-free counterparts, p < 0.001. On the other hand, participants who experienced any form of violence displayed an over 11 times increased rate of depressive symptoms compared to their counterparts who were violence free, p < 0.001. Violence experience was found to be the strongest associated factor for depressive symptoms. CONCLUSIONS The rates of violence, depressive symptoms and HIV risk behaviors amongst MSM are astoundingly high thus necessitating extensive interventions. In view of this, deliberate measures to deal with the reported high rates necessitate joint intervention efforts from the policy makers, health providers and community at large.
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Affiliation(s)
- Lucy R. Mgopa
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Jessie Mbwambo
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Samuel Likindikoki
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Pedro Pallangyo
- The Jakaya Kikwete Cardiac Institute, Directorate of Research & Publications, P.O Box 65141, Dar es Salaam, Tanzania
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77
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Stephenson R, Finneran C. Receipt and Perpetration of Intimate Partner Violence and Condomless Anal Intercourse Among Gay and Bisexual Men in Atlanta. AIDS Behav 2017; 21:2253-2260. [PMID: 28176169 DOI: 10.1007/s10461-017-1709-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intimate partner violence (IPV) rates are disproportionately high among sexual minority populations, with increasing evident that gay men experience IPV at the same rates as heterosexual women. This study examines the relationship between self-reported condomless anal intercourse (CAI) and IPV among a sample of 750 gay and bisexual men. Participants answered questions regarding recent receipt and perpetration of IPV using the IPV-GBM Scale (Cronbach Alpha 0.90). Of the sample, 46.1% reported recent receipt of any type of IPV and 33.6% reported recent perpetration of any type of IPV. Overall, 55.1% of participants reported CAI at last sex. Significant associations were determined between several forms of IPV and increased odds of reporting CAI at last sex. These findings suggest that IPV may be a risk factor for CAI among men who have sex with men, and highlight the need to understand the IPV prevention and care needs of this population.
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78
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Hoff CC, Campbell CK, Chakravarty D, Darbes LA. Relationship-Based Predictors of Sexual Risk for HIV Among MSM Couples: A Systematic Review of the Literature. AIDS Behav 2016; 20:2873-2892. [PMID: 27048237 DOI: 10.1007/s10461-016-1350-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Behavioral and epidemiological studies report high risk for HIV among MSM couples. Over the last decade, studies have examined relationship dynamics associated with sexual risk for HIV. It is important to examine the impact this research has had on HIV prevention and what is still needed. We conducted a review of the literature focusing on relationship dynamics associated with sexual risk for HIV among MSM couples. Procedures used for this review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses established to provide a framework for collecting, reviewing and reporting studies systematically (Mohler et al. in Ann Intern Med 151(4):264-269, 2009). We found that positive relationship dynamics are associated with less risk with partners outside the relationship, but were associated with greater odds of unprotected anal intercourse with primary partners. We also discuss other factors including sexual agreements about outside partners and make recommendations for next steps in HIV prevention research among MSM couples.
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Affiliation(s)
- Colleen C Hoff
- Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Market Street Suite 523, San Francisco, CA, 94103, USA.
| | - Chadwick K Campbell
- Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Market Street Suite 523, San Francisco, CA, 94103, USA
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Deepalika Chakravarty
- Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Market Street Suite 523, San Francisco, CA, 94103, USA
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Lynae A Darbes
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
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79
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Abstract
Intimate partner violence (IPV) rates are disproportionately high among sexual minority populations. Few studies have examined the plausible relationship between minority stress and IPV among men who have sex with men. This study examines the associations between IPV and three indicators of minority stress: internalized homophobia, sexuality-based discrimination, and racism, in a large venue-based sample of gay and bisexual men from Atlanta, USA. Each of the minority stress measures was found to be significantly associated with increased odds of self-reporting any form of receipt of IPV. Significant associations were also identified between perpetration of IPV and minority stressors, with most types of IPV perpetration linked to internalized homophobia. This study confirms findings in a growing body of research supporting the relationship between minority stress and increased prevalence of IPV among men who have sex with men, and points to the need to address structural factors in IPV prevention programs for male-male couples.
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Affiliation(s)
- Rob Stephenson
- University of Michigan, Ann Arbor, MI, USA
- Rob Stephenson, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls, Room 2236, Ann Arbor, MI 48109, USA.
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80
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Woodyatt CR, Stephenson R. Emotional intimate partner violence experienced by men in same-sex relationships. CULTURE, HEALTH & SEXUALITY 2016; 18:1137-49. [PMID: 27109769 PMCID: PMC5036353 DOI: 10.1080/13691058.2016.1175027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Intimate partner violence research has focused almost exclusively on physical and sexual intimate partner violence in opposite-sex relationships, paying little attention to the intimate partner violence experienced by men in same-sex relationships. Emerging research focusing on intimate partner violence among male-male couples has focused largely on physical and sexual violence, with little consideration of the unique forms of emotional violence experienced by gay men. Ten focus-group discussions with gay and bisexual men were conducted to examine perceived typologies, antecedents and experiences of emotional violence that occur between male partners. Participants described emotional violence as the most threatening form of intimate partner violence, driven largely by factors including power differentials, gender roles and internalised homophobia. Results indicate that gay and bisexual men perceive emotional intimate partner violence to be commonplace. A better understanding of emotional violence within male-male relationships is vital to inform intimate partner violence prevention efforts and the more accurate measurement of intimate partner violence for gay men.
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Affiliation(s)
- Cory R. Woodyatt
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta Georgia, USA
| | - Rob Stephenson
- Health Behavior and Biological Science, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Michigan, USA
- Health Behavior and Biological Science, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Michigan, USA,
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81
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George PE, Bayer AM, Garcia PJ, Perez-Lu JE, Burke JG, Coates TJ, Gorbach PM. Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru? AIDS Behav 2016; 20:2078-89. [PMID: 26880321 PMCID: PMC4985504 DOI: 10.1007/s10461-016-1327-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Violence experience can increase HIV risk behaviors; however, literature is scarce on violence among male sex workers (MSWs) globally. In 2014, 210 Peruvian MSWs (median age 24.9) were interviewed about their experience of physical, emotional, and sexual violence and condom use with non-paying intimate partners and clients and were tested for HIV. Multivariable models examined relationships between violence in the past 6 months, condomless anal intercourse (CLAI) in the past 3 months and HIV infection. HIV infection (24 %), CLAI (43 %), being a violence victim (42 %) and perpetrator (39 %) were common. In separate multivariable models, being a violence victim [adjusted prevalence ratio aPR = 1.49 (95 % CI 1.09-2.03)] and perpetrator [aPR = 1.39 (1.03-1.87)] were associated with CLAI. Further, being a victim [aPR = 1.65 (1.04-2.62)] was associated with HIV infection. Violence, which was significantly associated with CLAI and HIV infection, is common among Peruvian MSWs, reinforcing the importance of violence awareness and prevention as HIV risk-reduction strategies.
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Affiliation(s)
- Paul E George
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA.
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
| | - Angela M Bayer
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J Garcia
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jose E Perez-Lu
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jessica G Burke
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thomas J Coates
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
| | - Pamina M Gorbach
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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82
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Goldenberg T, Stephenson R, Freeland R, Finneran C, Hadley C. 'Struggling to be the alpha': sources of tension and intimate partner violence in same-sex relationships between men. CULTURE, HEALTH & SEXUALITY 2016; 18:875-89. [PMID: 26966994 PMCID: PMC4914407 DOI: 10.1080/13691058.2016.1144791] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
In countries such as the USA, gay and bisexual men experience high rates of intimate partner violence. However, little is known about the factors that contribute to this form of violence. In this study, we examine gay and bisexual men's perceptions of sources of tension in same-sex male relationships and how these may contribute to intimate partner violence. We conducted seven focus-group discussions with 64 gay and bisexual men in Atlanta, GA. Focus groups examined men's reactions to the short-form revised Conflicts Tactics Scale to determine if each item was considered to be intimate partner violence if it were to occur among gay and bisexual men. Analysts completed a thematic analysis, using elements of grounded theory. The sources of tension that men identified included: gender role conflict, dyadic inequalities (e.g. differences in income, age, education), differences in 'outness' about sexual identity, substance use, jealousy and external homophobic violence. Results suggest that intimate partner violence interventions for gay and bisexual men should address behavioural factors, while also focusing on structural interventions. Interventions that aim to reduce homophobic stigma and redefine male gender roles may help to address some of the tension that contributes to intimate partner violence in same-sex male relationships.
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Affiliation(s)
- Tamar Goldenberg
- Department of Health, Behavior and Biological Sciences, School of Nursing, University of Michignm, Michigan, USA
| | - Rob Stephenson
- Department of Health, Behavior and Biological Sciences, School of Nursing, University of Michignm, Michigan, USA
| | - Ryan Freeland
- Center for Sexuality and Health Disparities, University of Michigan, Michigan, USA
| | - Catherine Finneran
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Craig Hadley
- Department of Anthropology, Emory College of Arts and Sciences, Atlanta, Georgia, USA
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83
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Costa D, Barros H. Instruments to Assess Intimate Partner Violence: A Scoping Review of the Literature. VIOLENCE AND VICTIMS 2016; 31:591-621. [PMID: 27302566 DOI: 10.1891/0886-6708.vv-d-14-00122] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A scoping review was conducted to map existing evidence on strategies to measure male and female intimate partner violence (IPV). PubMed, ISI Web of Knowledge, and Scopus databases were searched from inception to 2014. There were 1,098 studies analyzed. To assess IPV, the most commonly followed strategy was the creation of study-specific questions (30.3%). The Conflict Tactics Scales (CTS) were the most frequent choice among generic instruments, whereas for clinical samples, the preferred tool was the Abuse Assessment Screen. Prevalence estimates were generally higher when the original versions of the CTS were used. This review provides a guiding frame of what exists in the IPV measurement literature, showing trends in the choice for a particular instrument according to administration methods and settings.
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Affiliation(s)
- Diogo Costa
- EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal
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84
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Stephenson R, Freeland R, Finneran C. Intimate partner violence and condom negotiation efficacy among gay and bisexual men in Atlanta. Sex Health 2016; 13:SH15212. [PMID: 27120351 DOI: 10.1071/sh15212] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 03/08/2016] [Indexed: 11/23/2022]
Abstract
Background: The experience of intimate partner violence (IPV) has been shown to decrease condom negotiation efficacy among women; however, studies of this association among gay and bisexual men (GBM) are lacking. Methods: A venue-recruited sample of 745 GBM was recruited in Atlanta, GA, USA in 2012-13. Participants self-completed a survey including questions on recent (previous 12 month) experience and perpetration of IPV using the IPV-GBM Scale. Multivariate regression analysis examined the association between reporting low condom negotiation efficacy with the respondent's most recent sex partner (19.2% of respondents) and recent experience of IPV with the same or another partner. Results: Nearly half the sample (49.1%) reported recent receipt of IPV, although prevalence varied considerably across the forms of IPV. GBM who reported recent IPV experience were significantly less likely to report having felt able to negotiate condom use. Conclusions: These findings suggest that IPV may be a significant risk factor for HIV acquisition and transmission among GBM.
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85
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A Venue-Based Survey of Malaria, Anemia and Mobility Patterns among Migrant Farm Workers in Amhara Region, Ethiopia. PLoS One 2015; 10:e0143829. [PMID: 26619114 PMCID: PMC4664424 DOI: 10.1371/journal.pone.0143829] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 11/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mobile populations present unique challenges to malaria control and elimination efforts. Each year, a large number of individuals travel to northwest Amhara Region, Ethiopia to seek seasonal employment on large-scale farms. Agricultural areas typically report the heaviest malaria burden within Amhara thereby placing migrants at high risk of infection. Yet little is known about these seasonal migrants and their malaria-related risk factors. METHODS AND FINDINGS In July 2013, a venue-based survey of 605 migrant laborers 18 years or older was conducted in two districts of North Gondar zone, Amhara. The study population was predominantly male (97.7%) and young (mean age 22.8 years). Plasmodium prevalence by rapid diagnostic test (RDT) was 12.0%; One quarter (28.3%) of individuals were anemic (hemoglobin <13 g/dl). Nearly all participants (95.6%) originated from within Amhara Region, with half (51.6%) coming from within North Gondar zone. Around half (51.2%) slept in temporary shelters, while 20.5% regularly slept outside. Only 11.9% of participants had access to a long lasting insecticidal net (LLIN). Reported net use the previous night was 8.8% overall but 74.6% among those with LLIN access. Nearly one-third (30.1%) reported having fever within the past two weeks, of whom 31.3% sought care. Cost and distance were the main reported barriers to seeking care. LLIN access (odds ratio [OR] = 0.30, P = 0.04) and malaria knowledge (OR = 0.50, P = 0.02) were significantly associated with reduced Plasmodium infection among migrants, with a similar but non-significant trend observed for reported net use the previous night (OR = 0.16, P = 0.14). CONCLUSIONS High prevalence of malaria and anemia were observed among a young population that originated from relatively proximate areas. Low access to care and low IRS and LLIN coverage likely place migrant workers at significant risk of malaria in this area and their return home may facilitate parasite transport to other areas. Strategies specifically tailored to migrant farm workers are needed to support malaria control and elimination activities in Ethiopia.
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Buller AM, Devries KM, Howard LM, Bacchus LJ. Associations between intimate partner violence and health among men who have sex with men: a systematic review and meta-analysis. PLoS Med 2014; 11:e1001609. [PMID: 24594975 PMCID: PMC3942318 DOI: 10.1371/journal.pmed.1001609] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 01/17/2014] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Ana Maria Buller
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Karen M. Devries
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Louise M. Howard
- Section of Women's Mental Health and King's Health Partners Women's Health Academic Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Loraine J. Bacchus
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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"Working together to reach a goal": MSM's perceptions of dyadic HIV care for same-sex male couples. J Acquir Immune Defic Syndr 2013; 64 Suppl 1:S52-61. [PMID: 24126448 DOI: 10.1097/qai.0b013e3182a9014a] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Same-sex serodiscordant male dyads represent a high-priority risk group, with approximately one to two thirds of new HIV infections among men who have sex with men attributable to main partnerships. Early initiation and adherence to highly active antiretroviral therapy is a key factor in HIV prevention and treatment; however, adherence to highly active antiretroviral therapy in the United States is low, with poor retention throughout the continuum of care. This study examines the perceptions of dyadic HIV treatment of men who have sex with men across the continuum of care to understand the preferences for how care may be sought with a partner. METHODS We conducted 5 focus group discussions in Atlanta, GA, with 35 men who reported being in same-sex male partnerships. Participants discussed perceptions of care using scenarios of a hypothetical same-sex male couple who recently received serodiscordant or seroconcordant HIV-positive results. Verbatim transcripts were segmented thematically and systematically analyzed to examine patterns in responses within and between participants and focus group discussions. RESULTS Participants identified the need for comprehensive dyadic care and differences in care for seroconcordant HIV-positive versus serodiscordant couples. Participants described a reciprocal relationship between comprehensive dyadic care and positive relationship dynamics. This combination was described as reinforcing commitment, ultimately leading to increased accountability and treatment adherence. DISCUSSION Results indicate that the act of same-sex male couples "working together to reach a goal" may increase retention to HIV care across the continuum if care is comprehensive, focuses on both individual and dyadic needs, and promotes positive relationship dynamics.
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