Prevalence of Substance Use and Intimate Partner Violence in a Sample of A/PI MSM

Domestic Violence in Asian Communities: A Scoping Review of Quantitative Literature

Domestic violence (DV) is a prevalent social problems that threaten individuals' health and well-being, and the issue of DV in Asian communities requires extensive and comprehensive investigation. Following the steps by Arksey and O'Malley, a scoping review was conducted to (a) summarize and synthesize existing quantitative evidence on the topic of DV in Asian immigrant communities in North America, and (b) identify research gaps in the literature to guide future work. Inclusion criteria were that (a) the studies must comprise a sample of Asian immigrants in North America, (b) the focus of the article was specifically on individuals' experiences of DV in the past year or lifetime, (c) DV was measured as either independent or dependent variable, (d) full-text publications written in English, (e) articles must be peer-reviewed, quantitative studies. On completion of the review process, 35 full-text articles were identified for review. Across studies, five main topics emerged: factors related to DV victimization, prevalence and forms of DV, individuals' attitudes and/or perceptions about DV, DV-related consequences, and intervention evaluation. Some less common topics include help-seeking behaviors and sources and culturally responsive scales. The findings of this review suggest that future research will benefit from using a nationally representative Asian sample and culturally sensitive tools, examining potential protective factors against DV victimization, and employing an experimental design to evaluate the effectiveness of culturally sensitive interventions. Policies should provide stronger support to agencies and practitioners to deliver culturally sensitive services.

Prevalence, Determinants, and Trends in the Experience and Perpetration of Intimate Partner Violence Among a Cohort of Gay, Bisexual, and Other Men Who Have Sex with Men in Montréal, Toronto, and Vancouver, Canada (2017-2022)

Purpose: Longitudinal data on the experience and perpetration of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBM) are limited. We estimated the prevalence of past 6-month (P6M) physical and/or sexual IPV (hereafter IPV) experience and perpetration, identified their determinants, and assessed temporal trends, including the impact of the coronavirus disease (COVID)-19 pandemic. Methods: We used data from the Engage Cohort Study (2017-2022) of GBM recruited using respondent-driven sampling in Montréal, Toronto, and Vancouver. Adjusted prevalence ratios (aPRs) for determinants and self-reported P6M IPV were estimated using generalized estimating equations, accounting for attrition (inverse probability of censoring weights) and relevant covariates. Longitudinal trends of IPV were also assessed. Results: Between 2017 and 2022, 1455 partnered GBM (median age 32 years, 82% gay, and 71% White) had at least one follow-up visit. At baseline, 31% of participants experienced IPV in their lifetime and 17% reported ever perpetrating IPV. During follow-up, IPV experience was more common (6%, 95% confidence interval [CI]: 5%-7%) than perpetration (4%, 95% CI: 3%-5%). Factors associated with P6M IPV experience included prior IPV experience (aPR: 2.68, 95% CI: 1.76-4.08), lower education (aPR: 2.31, 95% CI: 1.32-4.04), and substance use (injection aPR: 5.05, 95% CI: 2.54-10.05, non-injection aPR: 1.68, 95% CI: 1.00-2.82). Similar factors were associated with IPV perpetration. IPV was stable over time; periods of COVID-19 restrictions were not associated with IPV changes in this cohort. Conclusion: Prevalence of IPV was high among GBM. Determinants related to marginalization were associated with an increased risk of IPV. Interventions should address these determinants to reduce IPV and improve health.

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 Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis

Introduction

Intimate partner violence (IPV) among men who have sex with men (MSM) has become a serious and widespread public health issue, which might result in low quality of life and increase the global burden of diseases.

Aim

To quantitatively estimate the pooled prevalence of IPV and its specific forms (physical violence, sexual violence and emotional violence) among MSM.

Methods

Databases of PubMed, Cochrane Library, CINAHL, MEDLINE, PsycINFO, CNKI, WANFANG Data, and Weipu (CQVIP) Data were searched for identified studies published between January 1990 and August 2020. Random effect meta-analyses were used to synthesize the pooled prevalence and 95% CIs of IPV.

Main Outcome Measures

The pooled prevalence of IPV in victimization and in perpetration among MSM.

Results

A total of 52 studies with 32,048 participants were included for final analysis. The pooled prevalence of IPV was 33% (6,342 of 19,873; 95%CI, 28–39%) in victimization and 29% (1,491 of 5,983; 95%CI, 17 –40%) in perpetration across all recall periods among MSM population. Furthermore, the pooled prevalence of physical violence was 17% (3,979 of 22,928; 95%CI, 14 –20%) and 12% (942 of 9,236; 95%CI, 10 –15%), of sexual violence was 9% (1,527 of 19,511; 95%CI, 8 –11%) and 4% (324 of 8,044; 95%CI, 3 –5%), of emotional violence was 33% (5,147 of 17,994; 95%CI, 25 –40%) and 41% (1,317 of 3,811; 95%CI, 17 –65%) in victimization and perpetration, respectively. Out of all the IPV identified, emotional violence was estimated at the highest level.

Conclusion

This study demonstrated a high prevalence of IPV both in victimization and perpetration among MSM, and emotional violence was estimated at the highest level out of all IPV forms. Efforts are needed to develop corresponding prevention programs for victims with an intent to increase the accessible availability of health services, and ultimately improve their life quality.

Liu M., Cai X., Hao G. et al., Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021;9:100433.

Moderating effect of self-efficacy on the association of intimate partner violence with risky sexual behaviors among men who have sex with men in China

Background

In China, men who have sex with men (MSM) face a high risk of HIV infection. Intimate partner violence (IPV) is common in this population and leads to various adverse consequences, including risky sexual behaviors, substance abuse, and poor mental health, which pose huge challenges to HIV prevention and control.

Methods

An anonymous cross-sectional study was conducted to investigate the lifetime prevalence of IPV and prevalence of risky sexual behaviors during the previous 6 months in a convenience sample of 578 MSM from 15 cities covering seven geographical divisions in mainland China. The associations between IPV and risky sexual behaviors and the moderating effect of self-efficacy on these associations were explored through univariate and multivariate regression analyses.

Results

The prevalence rates of IPV perpetration and victimization were 32.5% and 32.7%, respectively. The proportions of participants who reported inconsistent condom use with regular or casual partners and multiple regular or casual sexual partners were 25.8%, 8.3%, 22.2%, and 37.4%, respectively. Multiple IPV experiences were positively associated with risky sexual behaviors; for example, any IPV victimization was positively associated with multiple regular partners, adjusted odds ratio (ORa) = 1.54, 95% CI [1.02,2.32], and multiple casual partners, ORa = 1.93, 95% CI [1.33, 2.80]. Any IPV perpetration was positively associated with inconsistent condom use with regular partners, ORa = 1.58, 95% CI [1.04, 2.40], and multiple casual partners, ORa = 2.11, 95% CI [1.45, 3.06]. Self-efficacy was identified as a significant moderator of the association between multiple casual sexual partnership and emotional IPV.

Conclusions

In conclusion, given the high prevalence of both IPV and risky sexual behaviors among Chinese MSM in this study, the inclusion of self-efficacy in interventions targeting IPV and risky sexual behaviors should be considered.

Bidirectional IPV Among Adolescent Sexual Minorities

Research repeatedly concludes that lesbian, gay, and bisexual individuals (i.e., sexual minorities) are at increased risk of experiencing abuse in a romantic or sexual relationship. For service providers, a vital but largely unanswered question is how common it is for victims of sexual minority intimate partner violence (SM-IPV) to also have perpetrated IPV, particularly in regard to adolescent relationships. To our knowledge, the present article is only the second in the literature to examine adolescent SM-IPV directionality, and it is the first to compare adolescent SM-IPV directionality and heterosexual IPV (H-IPV) directionality within the same sample. In 25 high schools across three northern New England states, sexual minority (n = 398) and heterosexual (n = 2,687) high school-aged adolescents aged 13 years to 19 years (where sexual orientation is defined indirectly via sexual attraction) completed a questionnaire as part of a broader evaluation study of a bystander-focused violence prevention curriculum (we utilized baseline data in this article). Chi-square tests revealed that experiencing victimization was significantly associated with engaging in perpetration for all forms of IPV assessed for both sexual minority and heterosexual youths. The sole exception was threatening IPV, for which a significant association was found among heterosexual but not sexual minority individuals. Bidirectional IPV rates did not differ substantially by sexual attraction: Verbal abuse was most likely to be bidirectional for both sexual attraction groups and all other assessed IPV forms occurring overwhelmingly in unidirectional patterns. Although replication is needed, study results suggest that adolescent IPV is not generally bidirectional. Directions for future research are discussed, including the need for sampling plans that enable further disaggregation by age and sexual orientations.

Tobacco, Alcohol, Drug Use, and Intimate Partner Violence Among MSM Living With HIV

Men who have sex with men (MSM) and are living with HIV have reported high rates of intimate partner violence (IPV) and substance use. We examined relationships between accumulative IPV, incidents of IPV, and numbers of substances used. One hundred twenty Taiwanese MSM living with HIV completed a cross-sectional survey. Accumulative IPV was assessed by summing the number of 15 types of IPV experienced in the previous year; substance use was measured by any use of alcohol, tobacco, or other drugs during the previous week. In multivariate analysis, IPV was not associated with tobacco use but was positively associated with alcohol and other drug use and significantly associated with the probability of using multiple substances. MSM living with HIV who experienced greater IPV were more likely to use alcohol and other drugs and were more likely to use more than one substance. Health care providers screening for IPV should also screen for substance use.

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

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.

MSM HIV testing following an online testing intervention in China

BACKGROUND

Scaling up HIV testing is the first step in the HIV treatment continuum which is important for controlling the HIV epidemic among men who have sex with men (MSM). Following an online HIV testing intervention among MSM, we aim to examine sociodemographic and spatial factors associated with HIV testing.

METHODS

We conducted a secondary analysis on data from an online HIV testing intervention among MSM who had never-tested for HIV. The survey was distributed through online networks connected to all provinces and regions of China. Univariate and multivariable analyses were performed to examine factors associated with testing three weeks post-intervention.

RESULTS

At three weeks after the intervention, 36% of 624 followed-up MSM underwent HIV testing, 69 men reported positive HIV test results. Having money for sex, ever tested for sexually transmitted infections and intimate partner violence experience were significant factors of post-intervention HIV testing. Students were less likely to undergo HIV testing at follow-up compared to others (adjusted odds ratio=0.69, 95% C.I.=0.47-0.99), adjusted by age and type of intervention. Moderate provincial spatial variation of testing was observed.

CONCLUSIONS

While high risk men generally had higher HIV testing rates, some MSM like students had lower testing rates, suggesting the need for further ways to enhance HIV testing in specific MSM communities.

HIV risk behaviours among immigrant and ethnic minority gay and bisexual men in North America and Europe: A systematic review

HIV surveillance systems show that gay, bisexual, and other men who have sex with men (MSM) bear a disproportionate burden of HIV in North American and European countries. Within the MSM category, HIV prevalence is often elevated among ethnic minority (i.e., Latino, Asian, and Black) MSM, many of whom are also foreign-born immigrants. Little research has focused specifically on foreign-born populations, though studies that provide data on the nativity of their samples offer an opportunity to investigate the potential role of transnational migration in informing HIV risk among ethnic minority MSM. This systematic review of ethnic minority MSM studies where the nativity of the sample is known provides a robust alternative to single studies measuring individual-level predictors of HIV risk behaviour. In this review, HIV prevalence, unprotected sex, drug use, and HIV testing are analysed in relation to the ethnicity, nativity, and location of the samples included. The results, which include high rates of HIV, unprotected sex, and stimulant use in foreign-born Latino samples and high rates of alcohol and club drug use in majority foreign-born Asian Pacific Islander (API) samples, provide baseline evidence for the theory of migration and HIV risk as syndemics within ethnic minority populations in North American and European countries. The findings also suggest that further research on the contextual factors influencing HIV risk among ethnic minority MSM groups and especially immigrants within these groups is needed. These factors include ethnic networks, individual post-migration transitions, and the gay communities and substance use cultures in specific destination cities. Further comparative work may also reveal how risk pathways differ across ethnic groups.

Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?

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.

Depressive Symptoms, Substance Use and Partner Violence Victimization Associated with HIV Disclosure Among Men Who have Sex with Men

HIV continues to disproportionately affect men who have sex with men (MSM). Depression and substance use have been shown to be risk factors of partner violence among male same-sex couples. However, research exploring the risk factors for partner violence victimization after HIV disclosure among MSM is limited. The aim of this study was to determine the association between depressive symptoms, substance use, and disclosure-associated verbal and/or physical violence from a partner among MSM. Data were obtained from 340 HIV-positive MSM. Multivariable logistic regression was used to determine the associations between Center for Epidemiologic Studies-Depression and substance use scores, and disclosure-associated partner violence. After adjusting for age and income, every one-unit increase in substance use scores resulted in a 9 % (OR 1.09; 95 % CI 1.01-1.16) increase in the odds of disclosure-associated partner violence. HIV disclosure interventions for MSM populations should address substance use and potential violence from partners after disclosure.

Annual Review of Asian American Psychology, 2014

This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.

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

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