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

Factors Shaping Gay Men's Experience of Intimate Partner Violence: An Ecological View

Gay men are particularly at risk for intimate partner violence (IPV). As regards the prevalence and unique consequences of IPV, many studies seek to understand the specific stressors faced by gay men, but few provide a more comprehensive perspective of IPV-related factors, including gay men-specific, general as well as protective factors. An ecological perspective was used to conduct a qualitative study aimed at identifying the different risk and protective factors related to IPV among gay men. We conducted individual semi-structured interviews with 23 gay men who acknowledge having experienced IPV by another man, as well as two focus groups with practitioners who provide services to this population. Our analysis led to a five-level ecological model, ranging from most proximal (e.g. prior victimization) to distal (e.g. conception of masculinity) factors, and including both general factors (e.g. power dynamics) and factors specific to gay men. Heterosexism emerged as an overarching contributing sociocultural factor. This study sheds new light on mechanisms whereby these factors affect the IPV experience, namely the risk of being victimized; the recognition of IPV victimization; and the response to the IPV experienced. These mechanisms are discussed along with heterosexism-related factors, and implications for research and practices are suggested.

Risk and Protective Factors Associated With Intimate Partner Violence with Gay Men: A Scoping Review

Intimate partner violence (IPV) is a complex, multidimensional phenomenon and may involve different risk and protective factors, as well as people of different sexual orientations, including gay men. Despite scientific evidence of the high prevalence of victimization and perpetration of this phenomenon, IPV in gay men is still largely invisible. The aim of this study was to map the risk and protective factors related to IPV among gay cis men based on a literature review. The Scopus, PsycNET, Pubmed, BVS-Psi, and SciELO databases were searched to retrieve articles published between 2018 and 2022. Thematic analysis was used to map the risk and protective factors of the 29 articles that met the inclusion criteria. Among the results, most studies investigated the risk factors for victimization of IPV, despite showing the high prevalence of bidirectionality in IPV among gay men. In addition, multiple risk and protective factors (individual, relational, and socio-community) have been shown to be associated with IPV among gay men. Mapping risk and protective factors for IPV at different ecological levels makes it possible to identify a more accurate profile of gay men's vulnerabilities, in addition to enabling the construction of more systemic interventions, which are multisectoral with specific prevention strategies, for IPV among gay men.

Family and Relationship Quality among Young Adults with Different Sexual Orientations in Urban China: The Mediating Effects of Life Satisfaction and Self-Esteem

This study explored the ambivalent effects of family on the close relationship quality of Chinese young adults. From a national estimate of the urban population across mainland China, 5,089 participants aged 20-39 were recruited for this study. A three-dimensional conceptualization was applied to identify three groups with different sexual orientations in this study. Group A comprised participants who identified as sexual minority people; Group B comprised participants who identified as heterosexuals but were not exclusively attracted to one sex and/or individuals who had had same-sex sexual experiences; Group C comprised participants who identified as heterosexuals. Groups A and B reported lower close relationship satisfaction and psychological well-being than Group C. Life satisfaction and self-esteem partially mediated the association between family and close relationship satisfaction for all groups. However, this relationship was weaker for Group B, and closeness to family benefitted Group B's life satisfaction to a lesser extent, indicating that the nuanced relationship with family influenced the sexual minority people with heterosexual identities. We recommend future directions and practices in local research and policy-making.

Intimate Partner Violence and Willingness to Use Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Chengdu, China

Intimate partner violence (IPV) is common in men who have sex with men (MSM). MSM also face increased risk of human immunodeficiency virus infection. However, it is not known whether IPV experience of MSM in China would affect their attitudes toward pre-exposure prophylaxis (PrEP) use. A cross-sectional study was conducted to explore the associations between different types of IPV and willingness to use PrEP in a sample of 608 MSM from November 2018 to May 2019 in Chengdu, China. Univariate and multivariate logistic regression analyses were used to explore the associations between different types of IPV and willingness to use PrEP. The average age of the participants was 31.8 ± 12.3 years, 48.9% of them were aware of PrEP before this study, and only 7.2% were aware of long-acting injectable PrEP (LAI-PrEP). The overall willingness to use any type of PrEP in the next 6 months was 82.2%. Approximately one third of the participants (n = 198) had experienced at least one type of IPV. We found that experience of sexual perpetration was negatively associated with the willingness to use on-demand PrEP (adjusted odds ratio [ORa] = 0.33, 95% CI = 0.16-0.67) and the overall willingness to use any type of PrEP (ORa = 0.31, 95% CI = 0.15-0.64). The willingness to use LAI-PrEP also had negative associations with any type of monitoring IPV (ORa = 0.58, 95% CI = 0.38-0.91), controlling victimization (ORa = 0.41, 95% CI = 0.21-0.82), and emotional victimization (ORa = 0.58, 95% CI = 0.35-0.97). The findings of this study demonstrate that IPV experiences are negatively associated with willingness to use PrEP among MSM, suggesting that PrEP promotion programs should consider IPV screening and develop explicit intervention strategies for both perpetrators and victims.

Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta-analysis

INTRODUCTION

Sexualized drug use (SDU), the use of psychoactive drugs in the context of sexual intercourse, has been identified as a risk factor for HIV among men who have sex with men (MSM) in Asia. Given the distinct social and cultural context of same-sex relationships and drug-using practice in Asia, we aimed to describe the prevalence of SDU in East and South Asian countries and its associations with condomless anal sex (CAI) and HIV status. Synthesizing SDU research in this region, including SDU definitions, prevalence and outcomes, provides insights to inform future research and improved programme planning, resourcing and advocacy.

METHODS

We systematically searched OVID Medline, OVID EMBASE, OVID Global Health, CINAHL, PsycINFO and SCOPUS publication databases for scientific articles published from 1990 to 2022 measuring SDU among MSM in East and South Asian countries. A narrative synthesis was utilized to describe key study attributes and findings, and meta-analyses using random pooled effect models were used to estimate SDU prevalence and its associations with CAI and HIV status. Subgroup meta-analyses, sensitivity analysis and assessment of publication bias examined potential sources of heterogeneity for the pooled SDU prevalence estimates.

RESULTS AND DISCUSSION

Of the 1788 publications screened, 49 publications met the selection criteria and 18 were suitable for meta-analyses. Findings highlight SDU definitions distinct from other regions but inconsistencies in the definition of SDU between studies that have been highlighted in research elsewhere. The pooled prevalence of recent SDU (past 12 months) was 13% (95% CI = 10-16%; I2 = 97.6) but higher when studies utilized self-administered surveys (15%; 95% CI = 12-19%; p<0.05). SDU was associated with greater odds of CAI (pooled odds ratio [OR] = 3.21; 95% CI = 1.82-5.66) and living with diagnosed HIV (OR = 4.73; 95% CI = 2.27-8.21).

CONCLUSIONS

SDU is common among MSM in East and South Asian countries, but varying SDU definitions limit between-study comparisons. Responses to SDU-related harms should consider local contexts, including specific drug types used and their relative risks.

Intimate Partner Violence Perpetration Among Sexual Minority People and Associated Factors: A Systematic Review of Quantitative Studies

Introduction

Intimate partner violence (IPV) among sexual minority people has been underestimated since few decades ago despite its spreading. The current systematic review aims to review and systematize studies on factors associated with IPV perpetration within this population.

Methods

Data search was conducted on EBSCO and PubMed considering articles published until July 2022, and 78 papers were included.

Results

Although methodological limitations can affect the results found, the data demonstrated an association between IPV perpetration and psychological, relational, family of origin-related and sexual minority-specific factors, substance use, and sexual behaviors.

Conclusion

The findings emerged highlight the importance of a multidimensional approach to tackle IPV perpetration among sexual minority people and limit relapses, while increasing individual and relational wellbeing.

Policy Implications

The empirical evidence emerged can contribute to the development of policies and services tailored for sexual minority people victims of IPV, to date still scarce and often ineffective.

Intimate Partner Violence Perpetration Among Sexual Minority People and Associated Factors: A Systematic Review of Quantitative Studies

INTRODUCTION

Intimate partner violence (IPV) among sexual minority people has been underestimated since few decades ago despite its spreading. The current systematic review aims to review and systematize studies on factors associated with IPV perpetration within this population.

METHODS

Data search was conducted on EBSCO and PubMed considering articles published until July 2022, and 78 papers were included.

RESULTS

Although methodological limitations can affect the results found, the data demonstrated an association between IPV perpetration and psychological, relational, family of origin-related and sexual minority-specific factors, substance use, and sexual behaviors.

CONCLUSION

The findings emerged highlight the importance of a multidimensional approach to tackle IPV perpetration among sexual minority people and limit relapses, while increasing individual and relational wellbeing.

POLICY IMPLICATIONS

The empirical evidence emerged can contribute to the development of policies and services tailored for sexual minority people victims of IPV, to date still scarce and often ineffective.

Romantic Attachment, Internalized Homonegativity, and Same-Sex Intimate Partner Violence Perpetration Among Lesbian Women in Italy

Same-Sex Intimate Partner Violence (SSIPV) among lesbian women has been underestimated until few decades ago. While the association between romantic attachment and SSIPV has been widely demonstrated, mechanisms that mediate this association and the complex relationships between romantic attachment, SSIPV, and SSIPV-specific risk factors have not been adequately investigated to date. The current study assessed the influence of romantic attachment on SSIPV perpetration among lesbian women, exploring the mediating role of internalized homonegativity within this association. Three hundred and twenty-five Italian lesbian women with a mean age of 30 years were recruited and completed the following self-report measures: the Experiences in Close Relationships-Revised (ECR-R), the Measure of Internalized Sexual Stigma, and the Revised Conflict Tactics Scale Short Form. The results showed a positive association between attachment anxiety, and general and psychological SSIPV perpetration. Similarly, attachment avoidance was positively related with general, psychological, and physical SSIPV perpetration. The association between romantic attachment, and general and psychological SSIPV was partially mediated by internalized homonegativity. These findings have theoretical implications and provide valuable information to implement services and interventions tailored for SSIPV, to date scarce and not effective.