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

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.

Substance Use and Associated Experiences of Intimate Partner Violence Among MSM in Los Angeles, California

This study examined the prevalence and correlates of intimate partner violence (IPV) among a cohort of racial/ethnically diverse men who have sex with men (MSM) in Los Angeles. An ongoing longitudinal cohort study of MSM in Los Angeles, constructed by design so half of the participants use substances (SU) and half are persons living with HIV, provided data. Data collection occured between 2014 and 2020. At semiannual study visits, participants completed a computer-assisted self-interview which included questions on substance use (past 6 months) and experiences of IPV (past 12 months). The criterion variable was reported physical and sexual IPV. Multivariable models generalized estimating equations (GEE) estimated associations between reported SU and physical and sexual IPV, adjusting for repeated measurement and confounders. In total, 557 persons (2,962 visits) contributed to the analysis; the median baseline age was 30 years (interquartile range: 28.0-39.0). The prevalence of IPV in the past 12 months was 22.3%, with 18.3% reporting physical and 10.2% reporting sexual IPV across study visits. Stimulant use prevalence was higher among those who reported IPV compared to those who did not (68% vs. 42.1%; p < .001); cannabis use prevalence was lower among those reporting IPV (42.3% vs. 49% respectively; p < .001). Adjusted analysis showed reported stimulant use associated with greater odds of physical IPV (adjusted odds ratio [aOR] = 2.0; 95% confidence interval [CI] [1.4, 2.8], p < .001) but not sexual IPV (aOR = 1.3; 95% CI [0.8, 2.0], p = .332). Models stratified by HIV status yielded similar results. Findings showed a high prevalence of past-year IPV experiences among MSM in Los Angeles. Findings highlight links between SU and IPV and underscore a significantly increased likelihood of IPV for MSM in Los Angeles who report current methamphetamine use. This study provides evidence to support universal IPV screening and to make available safety resources at all points where MSM seek healthcare.

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.

Descriptive study on substance uses and risk of sexually transmitted infections in the practice of Chemsex in Spain

Background

In recent years, there has been an increasing use of sex-related substances (known as "Chemsex") to facilitate, intensify, and prolong the sexual experience of men who have sex with men. This phenomenon poses a public health problem, increasing the risk of sexually transmitted infections (STIs) and mental disorders.

Objective

The primary aim of this study was to delve into the correlation between substance use and sexual health, specifically examining the association between different substances used and the risk of sexually transmitted infections (STIs) in the context of Chemsex in Spain.

Methods

An observational, descriptive, cross-sectional study was conducted among 563 Spanish participants between January and April 2023. Non-probabilistic purposive sampling was used by the investigators. The researchers administered a questionnaire to men who have sex with men who use substances, especially in the sexual sphere, in all the autonomous communities of Spain.

Results

14.7% reported having practiced slamsex in the last year, and 17.94% were diagnosed with a Sexually Transmitted Infection in the previous 6 months. Of these, 21% were on PREP treatment, with the main STIs being gonorrhea (p < 0.001), chlamydia (p < 0.001), genital herpes (p = 0.020), and syphilis (p < 0.001). The 63.7% used methamphetamines as the main drug in the practice of chemsex.

Discussion

Chemsex in Spain is linked to a high prevalence of STIs, especially gonorrhea and chlamydia, even among those on PrEP treatment. The use of various drugs during chemsex, such as amyl nitrite, GHB, ecstasy, and others, correlates with higher rates of STIs, highlighting the need for interventions to reduce risk and harm. The drugs most associated with slamsex include ketamine, mephedrone, and methamphetamine, underscoring the importance of addressing the risk behaviors associated with this activity.

Conclusion

This study shows that chemsex appears to be associated with a high prevalence among men who have sex with men. Who use multiple substances in a sexual context, and are particularly exposed to sexually transmitted infections (STIs), indicating a particular need for STI prevention and care in this group.

How Intimate Partner Violence Is Influenced by Social Identity Among Sexual Minority Men

Purpose: Sexual minority men (SMM) experience intimate partner violence (IPV) at disproportionately high rates. The objective of this article was to identify the experiences of SMM and health care providers on how social identity impacts IPV. Methods: SMM participants (N = 23) were recruited from online community settings and a lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) organization in Los Angeles; providers (N = 10) were recruited from LGBTQ+ organizations. Semistructured interviews were audio recorded and transcribed verbatim. An applied thematic analysis approach was implemented to create memos, inductively generate a codebook, apply codes to the transcripts, and identify key themes in data. Results: Three main themes were identified. The first theme was weaponizing social identity to control a partner, which had three subthemes: (1) immigration status, race/ethnicity, and skin color, (2) threatening to "out" the partner's sexual orientation, and (3) abusing power inequity. Men who perpetrated IPV often used minority identities or undisclosed sexuality to leverage power over their partner. The second theme was use of IPV to establish masculinity, by exerting power over the more "feminine" partner. The third theme was internalized homophobia as a root cause of IPV, which details how internalized homophobia was often expressed in violent outbursts toward partners. Conclusion: These findings highlight how IPV among SMM can be influenced by social and sexual identity. Future research must consider socially constructed power structures and the multiple identities of SMM when developing interventions to address IPV in this population.

Negative Associations between Minority Stressors and Self-Reported Health Status among Sexual Minority Adults Living in Colombia

Colombia has extensive laws prohibiting discrimination against sexual minority people. However, violence and discrimination toward sexual minorities are still frequent. While a growing body of research shows that sexual minority people experience elevated rates of discrimination and domestic abuse globally, little research has been conducted on these issues affecting sexual minorities in Colombia specifically. Using minority stress theory as a conceptual framework, this paper aims to fill this gap by examining the prevalence of experiencing intimate partner violence (IPV) and witnessed discrimination and the relationship of these stressors to self-reported health among a national sample of sexual minority Colombians. We found that bisexual individuals experienced higher rates of physical and sexual IPV, compared to lesbian and gay individuals. Additionally, sexual minority Colombians who experienced IPV and witnessed discrimination were more likely to report having poorer health, compared to those who had not. We discuss the implications of our findings for future research and clinicians working with sexual minority clients.

Interventions, Barriers, and Facilitators to Address the Sexual Problems of Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV: A Rapid Scoping Review

Sexual problems are common among gay, bisexual, and other men who have sex with men (GBM) after diagnosis with HIV. However, these are often overlooked in care and research, where sexual risk reduction and biomedical aspects of sexual health tend to dominate. We conducted a rapid scoping review to investigate which sexual problems of GBM living with HIV are addressed by interventions, and the barriers and facilitators to their implementation. Literature from high-income countries published in English since 2010 was reviewed. Medline, Embase, PsycInfo, and Scopus databases were searched on July 4, 2022. Targeted sexual problems were categorized according to the ten dimensions of Robinson's Sexual Health Model, and barriers and facilitators, according to the five domains of the Consolidated Framework for Implementation Research (CFIR). Interventions focused solely on the dimension of Sexual Health Care/Safer Sex were excluded. Relevant information was extracted from the qualifying documents with NVivo 12 software for content analysis. Fifty-two documents were included, referring to 37 interventions which mainly took place in the United States (n = 29/37; 78%), were group-based (n = 16; 41%), and used counselling techniques (n = 23; 62%; e.g., motivational interviewing, cognitive-behavioral therapy). Their settings were mostly primary care (n = 15; 40%) or community-based (n = 16; 43%). On average, interventions addressed three sexual health dimensions (SD = 2; range: 1-10). The most targeted dimension was Sexual Health Care/Safer Sex (n = 26; 70%), which concerned sexual risk reduction. Next, Challenges (n = 23; 62%), included substance use (n = 7; 19%), sexual compulsivity (n = 6; 16%), sexual abuse (n = 6; 16%), and intimate partner violence (n = 4; 11%). Third was Talking About Sex (n = 22; 59%) which mostly concerned HIV disclosure. About a third of interventions addressed Culture/Sexual identity (n = 14; 38%), Intimacy/Relationships (n = 12; 33%), and Positive sexuality (n = 11; 30%). Finally, few targeted Body Image (n = 4; 11%), Spirituality (n = 3; 8%), Sexual Anatomy Functioning (n = 2; 5%) or Masturbation/Fantasy (n = 1; 3%). Forty-one documents (79%) mentioned implementation barriers or facilitators, particularly about the characteristics of the interventions (41% and 78%, respectively; e.g., cost, excessive duration, acceptability, feasibility) and of the individuals involved (37% and 46%; e.g., perceived stigmatization, provider expertise). The other three CFIR dimensions were less common (5%-17%). The search strategy of this review may not have captured all eligible documents, due to its limit to English-language publications. Overall, most interventions incorporated a focus on Sexual Health Care/Safer Sex, at the expenses of other prevalent sexual problems among GBM living with HIV, such as intimate partner violence (Challenges), erectile dysfunction (Sexual Anatomy Functioning), and Body Image dissatisfaction. These findings suggest they could receive more attention within clinical care and at the community level. They also highlight the importance of cost-effective and acceptable interventions conducted in non-stigmatizing environments, where patients' needs can be met by providers who are adequately trained on sexuality-related topics.

Self-reported intimate partner violence among men who have sex with men at an urban Australian sexual health clinic

BACKGROUND

In Australia, 17% of women and 6% of men have experienced intimate partner violence (IPV). Although most IPV research has focused on heterosexual partnerships, studies suggest that men who have sex with men (MSM) may experience IPV at similar or higher rates than those documented among women. IPV may also take different forms among MSM and have different health and social impacts. This study aims to assess the utility of a screening tool for identifying and responding to IPV among MSM attending a sexual health clinic in Sydney, Australia.

METHODS

Between 1 June 2020 and 30 June 2022, MSM clients were screened using standardised questions to identify IPV experienced within the preceding 12months. Answers to the screening questions were correlated with data collected routinely at the initial clinic visit, including age, employment, country of birth, drug and alcohol use, sexual partner numbers, and any history of sex work, pre-exposure prophylaxis use and HIV status, as well as any bacterial STI diagnosed at the initial visit.

RESULTS

There were 2410 eligible clients and of these, 2167 (89.9%) were screened during the study period. A total of 64 men (3.0%) (95% CI 2.3-3.8%) reported experiencing physical violence or intimidation in the past 12months. Controlling for age, men who were born in Australia were 2.03 (95% CI: 1.04-3.01) times more likely to report IPV, and men who had Medicare were 2.43 (95% CI: 0.95-3.90) times more likely to report IPV than those who did not. Those who had ever injected drugs were 5.8 (95% CI: 1.87-9.73) times more likely to report IPV, and men with sexualised drug use were 4.11 (95% CI: 2.03-6.19) times more likely. Those that were employed or studying were 72% (95%CI: 0.13-0.42) less likely to report IPV.

CONCLUSIONS

The prevalence of reported IPV in our study was lower than that reported by others, which may be due to differences in recruitment methods and questions asked. Associations between IPV in MSM and injecting drug use and sexualised drug use highlight that clinicians should be aware of the impact and potential for IPV particularly in those with risk factors.

Mental and Physical Health Correlates for Emotional Intimate Partner Violence Perpetration and Victimization: A Meta-Analysis

Approximately 50% of both men and women will experience emotional intimate partner violence (IPV) in their lifetime-a form of violence highly associated with other forms of IPV-making it important to develop further understanding of for assessment and treatment purposes. The bio-psycho-social model was used to guide the study. Utilizing data from 181 studies, yielding 348 effect sizes, we conducted a meta-analysis examining mental and physical health correlates with emotional IPV perpetration and victimization. We also examined if mental and physical health correlates were significantly stronger for emotional IPV perpetration or victimization, as well as if correlates were stronger for men or women. Suicidal ideation, post-traumatic stress, anxiety, depressive symptoms, borderline personality disorder (PD), psychological distress, physical pain, trauma, anger, shame, poor physical health, antisocial PD, and somatic symptoms were significantly associated with emotional IPV victimization. Borderline PD, narcissism, emotional dysregulation, anger, post-traumatic stress, antisocial PD, psychopathy, depressive symptoms, anxiety symptoms, and trauma were significantly associated with emotional IPV perpetration. Anger, emotional dysregulation, and psychopathology were stronger correlates for emotional IPV perpetration compared to victimization, and post-traumatic stress disorder (PTSD) and psychological distress were stronger correlates for victimization. PTSD and suicidal ideation were stronger correlates of IPV victimization for women than men, and anger was a significantly stronger correlate of IPV perpetration for women than men. This study highlights the importance of a holistic approach when working with victims and perpetrators of IPV, focusing on the importance of taking all aspects of the bio-psycho-social model into account.

Intimate partner violence and its associations among HIV-infected MSM with new drug abuse in Jinan, China

BACKGROUND

Intimate Partner Violence (IPV) is prevalent among HIV-infected men who have sex with men (MSM), with well-established risk factors and adverse outcomes. However, there is a lack of comprehensive investigation of both upstream risk factors and downstream adverse outcomes among HIV-infected MSM in a Chinese context. This study aimed to examine IPV and its associations among a Chinese sample of HIV-infected MSM.

METHODS

A cross-sectional study was conducted among 294 HIV-infected MSM in Jinan City from June to December 2020. All data were collected through an online questionnaire, which included IPV, sexual risk behavior, antiretroviral therapy (ART) adherence, depression, anxiety, and suicidal ideation. Chi-square tests and multivariate logistic regressions were performed to examine risk factors and adverse outcomes of IPV.

RESULTS

Of the 294 HIV-infected MSM, 71.1% experienced any IPV, including control (37.1%), threat of public identity (30.6%), emotional violence (25.2%), security threat (18.4%), and physical violence (13.9%). The prevalence of sexual risk behavior, good ART adherence, depression, anxiety, and suicidal ideation was 55.1%, 53.4%, 48.3%, 32.3%, and 65.0%, respectively. Abuse of methamphetamine (METH) (aOR:2.79; 95%CI:1.43 ~ 5.45), capsule 0 or stimulating liquid (aOR:2.68; 95%CI:1.31 ~ 5.47), Magu (aOR:3.16; 95%CI:1.51 ~ 6.60), and other new drugs (aOR:2.87; 95%CI:1.52 ~ 5.43), disclosing HIV infection to partners (aOR:2.03; 95%CI:1.10 ~ 3.78), and gay sexual orientation (aOR = 3.32; 95%CI: 1.82 ~ 6.05) were significantly correlated with the experience of IPV. In addition, IPV was significantly associated with sexual risk behavior (aOR = 2.02; 95%CI:1.16 ~ 3.53), ART adherence (aOR = 2.63; 95%CI:1.46 ~ 4.74), depression (aOR = 3.83; 95%CI:2.09 ~ 7.02), anxiety (aOR = 2.27; 95%CI:1.19 ~ 4.35), and suicidal ideation (aOR = 3.78; 95%CI:2.11 ~ 6.80).

CONCLUSIONS

IPV is prevalent among HIV-infected MSM and is associated with poor behavioral and mental health, highlighting more efforts are needed to address this issue. The finding that new drug abuse, HIV disclosure, and gay sexual orientation are associated with increased risk of IPV provides essential insights for the development of comprehensive and targeted IPV prevention and intervention programs in the future.

Cumulative violence exposures among men who have sex with men living with HIV in India: Psychosocial correlates of HIV care continuum outcomes

Lifetime exposures to violence among men who have sex with men (MSM) are associated with multiple psychosocial health risks and can affect engagement and outcomes of HIV treatment. This study a) explored relationships between levels of exposures to violence and HIV care continuum outcomes among MSM living with HIV in India, and b) identified psychosocial correlates of HIV care continuum outcomes among MSM living with HIV and those with lifetime cumulative exposures to violence (CVE). CVE referred to exposures to violence in both childhood and adulthood. This cross-sectional analysis used survey data collected between August 2016 and May 2017 from 1763 men who have sex with men living with HIV across 10 cities in India, using respondent-driven sampling. We found that higher levels of violence exposure were significantly associated with lower awareness of HIV positive status, and lower likelihood of initiating antiretroviral therapy. Compared with MSM living with HIV that had no CVE, those with CVE were more likely to report perpetration of interpersonal violence, alcohol misuse, depressive symptoms, and HIV transmission risk behaviors and to have two to four co-occurring psychosocial problems. In multivariable analysis with the subset of MSM with CVE, psychosocial correlates significantly associated with at least one HIV care continuum outcome were HIV transmission risk behaviors, perpetration of interpersonal violence, depression, and alcohol misuse. The findings highlight the need for integrating care for lifetime violence exposures and associated behavioral problems in HIV care settings for men who have sex with men living with HIV in India.

Intimate Partner Violence Polyvictimization and Health Outcomes

This study examines how gender interacts with polyvictimization patterns in survivors' health problems using 8,587 survivors of intimate partner violence from the National Intimate Partner and Sexual Violence Survey, a nationally representative sample collected in 2010. Polyvictimization included six categories that were created in our previous work: sexual violence, physical and psychological violence, coercive control, multiple violence, stalking, and psychological aggression. Multiple violence was associated with chronic pain, headache, difficulty sleeping, and poor health perception. Females experiencing coercive control were more likely to have chronic pain than males. The appropriate assessment of gendered patterns of polyvictimization, and relevant subsequent services and support will better address health problems among survivors.

Negative Sexual Experiences Among Gay, Bisexual, and Other Men Who Have Sex with Men Using GPS-Enabled Hook-Up Apps and Websites

Gay, bisexual, and other men who have sex with men (GBMSM) often use GPS-enabled dating apps and websites to facilitate in-person sexual encounters. Many of these encounters are positive and enjoyable. However, there is limited research on GBMSM's negative experiences with partners from hookup and dating apps/websites, especially those characterized by threats to GBMSM's sexual, physical, and/or psychological safety. In this report, we investigated this matter. We analyzed data from interviews with GBMSM (N = 60) and identified four categories of negative sexual experiences, each of which were comprised by sub-categories: 1) sexual violence (physical sexual assault, verbal sexual coercion, intoxicated assault/coercion), 2) sexual health risk behaviors (condom use resistance and coercion, deception related to HIV/STI status), 3) non-negotiated behaviors (undiscussed/unexpected sex acts, rough sex, sexualized racism, undesired substance use by the partner), and 4) threats to physical safety beyond sexual violence (being blocked from leaving, stalked, robbed, drugged). These results can inform future research and interventions that aim to promote safety on dating apps/websites within the GBMSM community.

Power and poverty: A participatory study on the complexities of HIV and intimate partner violence in an informal urban settlement in Nairobi, Kenya

People in informal urban settlements in Kenya face multiple inequalities, yet researchers investigate issues such as HIV or intimate partner violence (IPV) in isolation, targeting single populations and focusing on individual behaviour, without involving informal settlement dwellers. We formed a study team of researchers (n = 4) and lay investigators (n = 11) from an informal settlement in Nairobi, Kenya to understand the power dynamics in the informal urban settlement that influence vulnerability to IPV and HIV among women and men from key populations in this context. We facilitated participatory workshops with 56 women and 32 men from different marginalised groups and interviewed 10 key informants. We used a participatory data analysis approach. Our findings suggest the IPV and HIV nexus is rooted in the daily struggle for cash and survival in the informal urban settlement where lucrative livelihoods are scarce and a few gatekeepers regulate access to opportunities. Power is gendered and used to exercise control over people and resources. Common coping strategies applied to mitigate against the effects of poverty and powerlessness amplify vulnerabilities to HIV and IPV. These complex power relations create and sustain an environment conducive to IPV and HIV. Prevention interventions thus need to address underlying structural drivers, uphold human rights, create safe environments, and promote participation to maximise and sustain the positive effects of biomedical, behavioural, and empowerment strategies.

Depression as a mediator between intimate partner violence (IPV) and CD4 cell count among men who have sex with men (MSM) living with HIV in China

Intimate partner violence (IPV) is associated with adverse mental and physical outcomes among men who have sex with men (MSM) living with HIV. Few studies focus on psychological IPV, such as verbal threats. This study examined the associations between different forms of IPV and depression and CD4+ cell count, with depression as a mediator for the association between IPV and CD4+ cell count. Data for these analyses were derived from a larger cross-sectional study on HIV-HCV co-infection among MSM in Shanghai, China (N = 1623). We estimated the average causal mediation effects (ACME) and average direct effects (ADE) through three steps. About 16% of participants experienced IPV, with forced sex (7%), verbal threats (5%), and thrown objects (4%) being most common. Verbal threats showed the strongest link with depression and low CD4+ cell count. Depression fully mediated the relationship between verbal abuse and low CD4+ cell count, suggesting it as a potential pathway between psychological IPV and poorer HIV-related health outcomes. More research on psychological IPV is warranted to examine its health impacts. Mental health could be a potential focus of intervention to enhance HIV-related health outcomes among MSM with IPV experience.

Violence Victimization, Homelessness, and Severe Mental Illness Among People Who Use Opioids in Three U.S. Cities

This study examined the associations between violence victimization, homelessness, and severe mental illness (SMI) among people who use opioids (PWUOs) in three U.S. cities. We analyzed data from a cross-sectional survey conducted from May 2019 to February 2020 across three study sites: Los Angeles, CA; Las Vegas, NV; and Atlanta, GA. We used multivariable regressions to examine how multiple victimizations and housing situation are associated with SMI. Based on K-6 scale, nearly half (44.2%) were screened positive for SMI. Meanwhile, 69.7% of the participants reported experiencing some kind of violence in their lifetime, and more than half (51.9%) reported experiencing recent violence (in the past 6 months). The most common form of lifetime violence was emotional (59.5%), followed by physical and intimate partner violence (IPV) (56.1 and 34.9%, respectively), and 34.9% of all participants reported experiencing multiple forms of victimization in the past 6 months. Participants who reported homelessness were more likely to report having experienced recent violence victimization (p < .001). In multivariable models, experiencing recent victimization was significantly associated with SMI (adjusted odds ratio (AOR) = 1.85, 95% confidence interval [CI] [1.46, 2.38]), as was homelessness (AOR = 1.57, 95% CI [1.15, 2.14]), after adjusting for study covariates. Among those with moderate and SMI (n = 927), only 22% were currently receiving mental health services, and those who reported having experienced any forms of violence in the past 6 months were more likely to utilize mental health services than those who had not experienced any recent violence victimization (25 vs. 17.9%, p < .05). To improve mental health and wellness among this high priority population, mental health facilities and syringe service programs may consider screening for experiences of violence and using trauma-informed mental health approaches. Harm reduction interventions must be responsive to the diverse individual and structural-level needs of PWUOs, especially those experiencing homelessness and housing insecurity. Holistic strategies and services are needed to meet the social and structural needs of this population.

Systematic screening of gender violence and domestic violence among HIV-positive patients: the VIHOLETA study

We conducted a multicentre observational study in people living with HIV (PLHIV) on antiretroviral therapy in Alicante (Spain) from 2019 to 2020 aiming to analyse the prevalence of abuse and assess treatment adherence according to this variable. We used the Abuse Assessment Screen tool, the simplified medication adherence questionnaire and the medication possession ratio to assess outcomes.. Of the 161 included PLHIV, 53 (32.9%) had suffered abuse (27 emotional abuse, 6 physical abuse, 3 sexual abuse, 13 emotional and physical abuse, 4 unknown type). Seven (4.3%) had suffered abuse in the last year (5 emotional, 2 physical). Abuse had lasted a median of 48 months (interquartile range 12-81). HIV status was considered as a cause of violence by 9.4% of victims. In the multivariable analysis, only abuse was independently associated with non-adherence [adjusted odds ratio (aOR) 3.92; 95% confidence interval (CI) 1.80-8.84; p = 0.0007]. Abuse (aOR 6.14; 95% CI 1.63-27.70; p = 0.001) and previous incarceration (aOR 15.08 95% CI 2.71-104.71; p = 0.003) were associated with detectable viral load. In conclusion, the prevalence of abuse is high in PLHIV, hampering adherence and virological success. Abuse screening tools should be incorporated into routine HIV care.

Syndemic Factors and Lifetime Bidirectional Intimate Partner Violence Among Gay, Bisexual, and Other Sexual Minority Men

Purpose: Bidirectional intimate partner violence (IPV), the reporting of both IPV victimization and perpetration, is likely the most common form of violence among gay, bisexual, and other sexual minority men (GBM) and is thought to be part of a larger syndemic of stressors. This purpose of this study was to examine associations between syndemic factors and lifetime bidirectional IPV among GBM in three Canadian cities to inform future interventions. Methods: Data from GBM (N = 2449) were used to fit three logistic regression models with lifetime bidirectional IPV as the outcome and four syndemic factors (i.e., depressive symptomatology, childhood sexual abuse [CSA], illegal drug use, and alcohol misuse) as independent variables. Model 1 examined syndemic factors individually. Model 2 employed a summative scale of syndemic exposure. Model 3 used marginal analysis to examine the relative excess risk of each potential iteration of the syndemic. Results: Thirty-one percent (N = 762) of respondents reported lifetime bidirectional IPV. Each of the syndemic factors were significantly associated with greater odds of reporting bidirectional IPV (Model 1). Model 2 exhibited a dose-response relationship between the number of syndemic factors reported and bidirectional IPV. Model 3 suggested that the specific combination of depressive symptomatology, CSA, and alcohol misuse resulted in the highest risk of lifetime bidirectional IPV. Conclusion: Bidirectional IPV was common in this sample and was associated with a complex interplay of stressors. However, there may be opportunities to target interventions to the specific syndemic issues in an effort to prevent and mitigate this form of IPV in GBM.

Intimate Partner Violence and the Sexual Health of Sexual Minority Men

Purpose: This qualitative study explores the pathways by which various forms of intimate partner violence (IPV) impact the sexual health behaviors of cisgender identified sexual minority men (SMM). Methods: Semi-structured interviews were conducted with 23 racially and ethnically diverse SMM who recently experienced IPV and 10 clinical and social service providers focused on how experiences of IPV directly or indirectly influences sexual risk as well as engagement in HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use). Applied thematic analysis, including cycles of analytic memo writing and coding, aided the identification of patterns across the data. Results: Analyses yielded three overarching themes: use of condoms, use of PrEP, and HIV and sexually transmitted infections (STIs). Participants described different ways condom use or nonuse was a mechanism by which power and/or control might be asserted by one partner over the other partner. A range of responses to questions about PrEP were identified, including partners encouraging PrEP use, as well as avoidance of conversations about PrEP or actual PrEP use, to prevent experiencing aggression or IPV from partners. Responses regarding HIV/STIs included those ranging from a new diagnosis being a potential trigger for violence to the exploitation of status to control partners. Conclusion: These findings suggest that in relationships with IPV, HIV prevention strategies can be sources of relationship control and trigger abuse. Addressing IPV may help to prevent HIV/STI transmission and promote the health of SMM. In addition, long-acting formulations of PrEP may be a promising strategy for SMM experiencing IPV when oral PrEP medications may be a risk factor for violence.

Spiraling Risk: Visualizing the multilevel factors that socially pattern HIV risk among gay, bisexual & other men who have sex with men using Complex Systems Theory

PURPOSE OF REVIEW

Global disparities in HIV infection, particularly among gay, bisexual, and other men who have sex with men (GBMSM), indicate the importance of exploring the multi-level processes that shape HIV's spread. We used Complex Systems Theory and the PRISMA guidelines to conduct a systematic review of 63 global reviews to understand how HIV is socially patterned among GBMSM. The purpose was to conduct a thematic analysis of the reviews to (1) synthesize the multi-level risk factors of HIV risk, (2) categorize risk across the socioecological model, and (3) develop a conceptual model that visualizes the interrelated factors that shape GBMSMS's HIV "risk."

RECENT FINDINGS

We included 49 studies of high and moderate quality studies. Results indicated that GBMSM's HIV risk stems from the individual, interpersonal, and structural levels of the socioecological model. We identified a few themes that shape GBMSM's risk of HIV infection related to biomedical prevention methods; sexual and sex-seeking behaviors; behavioral prevention methods; individual-level characteristics and syndemic infections; lived experiences and interpersonal relationships; country-level income; country-level HIV prevalence; and structural stigma. The multi-level factors, in tandem, serve to perpetuate GBMSM's risk of HIV infection globally. The amalgamation of our thematic analyses from our systematic reviews of reviews suggests that the risk of HIV infection operates in an emergent, dynamic, and complex nature across multiple levels of the socioecological model. Applying complex systems theory indicates how multilevel factors create a dynamic and reinforcing system of HIV risk among GBMSM.

Non-Consensual Sex and Help-Seeking Behavior Among PrEP Users in Belgium: Findings from an Online Survey

Non-consensual sex poses a threat not only to sexual health but also to mental and physical health in general. HIV pre-exposure prophylaxis (PrEP) users might be particularly vulnerable to non-consensual sex because of interplaying factors such as mental health disorders, a high number of sex partners, engagement in chemsex, and the widespread use of dating apps. The objectives of this study were to assess the occurrence of non-consensual sex, its associated factors, and related help-seeking behavior among PrEP users. We analyzed data from an online survey among PrEP users in Belgium (09/2020-02/2022). Almost one in five participants (34/187, 18.2%) reported having ever experienced non-consensual sex. The most reported form was having sex against one's will, followed by having been given drugs against one's will, and having had sex without a condom against one's will. The vast majority of those who had experienced non-consensual sex (29/34, 85.3%) did not seek help afterward, mostly due to a lack of perceived need (21/29, 72.4%). Reported barriers to seeking help were shame (6/29, 20.7%) and lack of awareness of help services (3/29, 10.3%). Having experienced non-consensual sex in the past five years was associated with younger age and suicidal ideation in a multivariable logistic regression model. We conclude that addressing barriers to non-consensual sex help services is crucial to maximize their use and minimize the consequences of non-consensual sex experiences. PrEP consultations also represent an opportunity to offer such help given PrEP users are already familiar with these PrEP services and engaged in care.

Prevalence of and Factors Associated With Intimate Partner Violence Victimhood Among Men Who Have Sex With Men in Guangzhou, China

BACKGROUND

Intimate partner violence (IPV) has been a concern among men who have sex with men (MSM), but less attention has been paid to the factors associated with this population in China.

AIMS

We investigated the prevalence of and factors associated with IPV victimhood among MSM in Guangzhou, China.

METHODS

Men who have sex with men were recruited from May to November 2017, and data were collected using an anonymous electronic questionnaire. χ2 Tests and nonconditional logistic regressions were used to explore the factors associated with IPV victimhood.

RESULTS

A total of 129 in 976 MSM (13.22%) reported experiencing IPV victimhood. Multivariable logistic regression analysis showed that individuals who had condomless anal intercourse (CAI; adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.00-2.17) or had sex with a female partner (aOR, 1.81; 95% CI, 1.15-2.83) in the past 6 months were at a higher risk of IPV victimhood. Participants who had ever experienced child sexual abuse (CSA) were more likely to experience IPV (aOR, 1.97; 95% CI, 1.32-2.94). Individuals who used rush poppers before sex had a higher risk of IPV (aOR, 1.79; 95% CI, 1.21-2.63). In addition, ever having sex with a female sex partner (aOR, 1.65; 95% CI, 1.04-2.60), ever having used rush poppers before sex (aOR, 1.79; 95% CI, 1.22-2.64) in the past 6 months, and ever having experienced CSA (aOR, 2.01; 95% CI, 1.35-3.01) were associated with experiencing more types of IPV.

CONCLUSIONS

Intimate partner violence victimhood was relatively common among MSM in Guangzhou, particularly among those who had CAI, experienced CSA, had sex with a female partner, used rush poppers before sex, and with less education.

Sexual Relationship Violence Among Young, Partnered Sexual Minority Men in the United States

While there has been a growth in studies examining sexual violence among sexual minority men, little research attention has been paid to the experience of sexual violence among young sexual minority men (YSMM). In this article we analyze secondary data from the baseline of a pilot randomized control trial with 318 YSMM aged 15 to 24 years in the United States who were in relationships with other males to examine the associations between sexual minority-specific stigma and sociodemographic and relationship characteristics and experiences of intimate partner violence (IPV) and sexual IPV in their relationships. Approximately one-in-five participants reported experiencing any form of IPV and 6% reported sexual IPV in their current relationship. Participants who reported sexual minority-specific familial rejection (Adjusted Odds Rato (aOR) = 2.33, 95% confidence interval [CI] [1.03, 5.26], p < .05), internalized heterosexism (aOR = 3.17, 95% CI [1.45, 6.95], p < .01), and housing insecurity (aOR = 7.22, 95% CI [1.66, 31.34], p < .01) reported higher odds of sexual IPV in their relationship. Study findings point to the role of multiple sexual minority-specific forms of stigma in creating vulnerabilities for the experience of sexual IPV among YSMM, and highlight the need for continued research and interventions that address sexual minority-specific stigma and structural vulnerabilities to guide violence prevention efforts with YSMM.

An ecological approach to understanding the impact of sexual violence: a systematic meta-review

Aim

A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence.

Methods

Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted.

Results

Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however.

Conclusion

Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.

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.

Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries

BACKGROUND

Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to limit COVID-19 transmission. Most studies have only included heterosexual women.

METHODS

Data from the Global Drug Survey (an annual, anonymous, online survey collecting data on drug use) Special Edition were analysed to explore the impact of COVID-19 on people's lives, including their intimate relationships. Five relationship groupings were created using respondents' lived gender identity: women partnered with men (46.9%), women partnered with women (2.1%), men partnered with men (2.9%), men partnered with women (47.2%), and partnerships where one or both partners were non-binary (1%). Self-reported experience and perpetration of IPVA in the past 30 days before (February) and during COVID-19 restrictions (May or June) in 2020 (N = 35,854) was described and compared for different relationship groupings using Fishers Exact Tests. Changes in IPVA during restrictions were assessed using multivariable logistic regression.

RESULTS

During restrictions, 17.8 and 16.6% of respondents had experienced or perpetrated IPVA respectively; 38.2% of survivors and 37.6% of perpetrators reported this had increased during restrictions. Greater proportions of non-binary respondents or respondents with a non-binary partner reported experiencing or perpetrating IPVA (p < .001) than other relationship groupings. 22.0% of respondents who were non-binary or had a non-binary partner, 19.5% of men partnered with men, 18.9% of men partnered with women, 17.1% of women partnered with women and 16.6% of women partnered with men reported experiencing IPVA. Respondents with higher psychological distress, poor coping with pandemic-related changes, relationship tension and changes (increases or increases and decreases) in alcohol consumption reported increased experience of IPVA during restrictions.

CONCLUSIONS

This study confirmed that IPVA can occur in all intimate relationships, regardless of gender of the perpetrator or survivor. Non-binary respondents or respondents with non-binary partners reported the highest use and experience of IPVA. Most IPVA victim support services have been designed for heterosexual, cisgender women. IPVA support services and perpetrator programmes must be tailored to support all perpetrators and survivors during the pandemic and beyond, regardless of their sexual or gender identity.

Physical and Sexual Violence and Sexual Behaviors Among Men Who Have Sex with Men in 22 U.S. Cities-National HIV Behavioral Surveillance, 2017

National prevalence of physical and sexual violence and its relationship to sexual behaviors are unknown among men who have sex with men (MSM). We estimated 12-month prevalence of physical and sexual violence and assessed relationships between violence and sexual behaviors among MSM. Data were obtained from National HIV Behavioral Surveillance 2017 that used time-space sampling methods to recruit and interview MSM in 22 U.S. cities. Weighted percentages with 95% confidence intervals (CI) were reported. Adjusted prevalence ratios (aPR) and 95% CIs were calculated using logistic regression with predicted marginal means. Overall, 10.2% (95% CI: 9.3%-11.2%) of MSM experienced physical violence only, 3.2% (95% CI: 2.7%-3.7%) experienced sexual violence only, and 2.3% (95% CI: 1.9%-2.7%) experienced both types of violence, in the past 12 months. Compared to MSM who did not experience violence, those who did reported higher percentages of unemployment, poverty, homelessness, same-sex discrimination, non-injection drug use, and binge drinking. Violence was not independently associated with condomless anal sex among MSM. MSM who experienced both types of violence were more likely than those who did not experience violence to have had four or more male sex partners (aPR=1.18, 95% CI: 1.02-1.37). MSM who experienced both types of violence (aPR=2.49, 95% CI: 1.52-4.09), sexual violence (aPR=2.27, 95% CI: 1.47-3.52), or physical violence (aPR=1.76, 95% CI: 1.27-2.44) were more likely than those who did not experience violence to have had exchange sex. Recent physical violence and sexual violence are common among MSM. Findings highlight the importance of violence screening and suggest the need for tailored interventions that improve the safety and economic security of MSM who experience violence, including those who exchange sex.

L’approche syndémique appliquée à la santé des minorités sexuelles et de genre : étude de la portée

INTRODUCTION

Sexual and gender minorities (SGM) represent a vulnerable population, disproportionately affected by mental health issues, a higher exposure to violence and a higher prevalence of sexually transmitted infections, including HIV, for some subgroups. Derived from medical anthropology, the concept of a syndemic consists in the clustering and interaction between multiple health conditions through adverse social conditions such as discrimination or precarity. Confronted to the multitude of adverse conditions affecting SGM, this framework is pertinent to study their health and to propose interventions.

PURPOSE OF RESEARCH

The purpose of this scoping review is to synthetize the knowledge regarding syndemic theory applied to sexual and gender minorities in order to propose concrete suggestions for scholarly research and field intervention.

RESULTS

126 papers were included. European data as well as data concerning sexual minority women and transgender men are scarce. A co-occurrence of psychosocial conditions fostered by stigmatization is well-established. Furthermore, the presence of a syndemic was associated to sexual higher odds of acquiring HIV, suicidal behavior and healthcare utilization.

CONCLUSIONS

The syndemic framework is important to the health of SGM, both for academic and interventional purposes. Current priorities should be to act against structural disadvantages leading to a syndemic, to improve our knowledge on SGM health in European context and to develop local programs based on peer-support.

Intimate partner violence and HIV treatment adherence in urban South Africa: Mediating role of perinatal common mental disorders

Background

Antiretroviral therapy (ART) has potential to eliminate perinatal HIV infections, but adherence to ART in late pregnancy and postpartum is often suboptimal. Intimate partner violence (IPV) may influence non-adherence among perinatal women living with HIV (WWH), but few quantitative studies have examined this over time or explored mechanisms for this association.

Methods

We used secondary data from a parent trial in Johannesburg comprising WWH from the control arm (n=63) and WWH ineligible for the trial (n=133). Trained nurse researchers administered questionnaires at first antenatal visit on past-year psychological, physical, and/or sexual IPV (WHO instrument), socio-demographics (age, food security, education), and perinatal common mental symptoms of depression (Hospital Anxiety and Depression Screener-d); anxiety (HADS-a); post-traumatic stress disorder (PTSD; Harvard Trauma Questionnaire). At endline visit 2-4 months postpartum, nurse researchers assessed self-reported ART adherence using a visual analog scale (with ≥95% considered "good"). We fitted structural equation models (SEM) in MPlus to explore direct and indirect effects of IPV on ART adherence.

Results

Of 196 perinatal WWH, 53.1% reported IPV exposure at baseline. The majority of participants (85.7%) had good perinatal ART adherence. In adjusted models, IPV at baseline was associated with halved odds of good adherence (aOR=0.51, 95%CI=0.20-0.96). IPV was associated with higher adjusted odds of probable depression (aOR=4.64), anxiety (aOR=2.85), and PTSD (aOR=3.42). In SEM, IPV had a direct (standardized coef=-0.22) and indirect effect (coef=-0.05) on ART via common mental disorders. The total effect of IPV on perinatal adherence was of moderate size (coef= -0.27) and the model had good fit (CFI=0.972; TLI=0.969; RMSEA=0.045; SRMR=0.076).

Conclusion

IPV was longitudinally associated with perinatal ART non-adherence in part due to its relationship with mental health symptomology. Addressing IPV within clinical care has potential to improve perinatal mental health, maternal HIV outcomes, and HIV-free infant survival.

Psychosocial and Culturally-Specific Factors Related to Intimate Partner Violence Victimization among a Sample of Latino Sexual Minority Cis Men in the U.S

A growing body of research illustrates that sexual minority men (SMM) experience elevated rates of intimate partner violence (IPV) compared to heterosexual individuals. Researchers have examined the relationship between minority stress and IPV victimization among sexual minority men. A majority of the IPV research identifying risk factors associated with IPV victimization among SMM have sampled predominately non-Hispanic White SMM, while Latino SMM are consistently under-represented in IPV research. This study examines the associations between (1) co-occurring psychosocial factors (e.g., depression, anxiety, childhood sexual abuse, drug use, and problematic drinking) and (2) Latino-specific minority stress factors (e.g., U.S.-born, language, race/ethnic identities, and discrimination) on IPV victimization in a nationwide sample of Latino SMM. Data were collected from Latino SMM aged 18 or older, identified as cis-male, and in a romantic relationship with a cis-male partner (N = 530). The participants were recruited through social media and geo-location-based dating mobile applications. A majority (72%) of the sample reported IPV victimization in their lifetime. Specific to forms of IPV, more than half (51.9%) of the sample reported monitoring behaviors, while 49.6% reported emotional IPV, 45.1% reported physical IPV, 31.5% reported controlling behaviors, and 22.3% reported HIV-related IPV. In multivariable models, psychosocial and Latino-specific factors were associated with the increased likelihood of IPV victimization. Regarding Latino-specific factors, being born in the U.S. and race-based discrimination predicted IPV victimization. These findings highlight the extent to which minority stress elevates the risk of IPV for Latino SMM and point to the need to address social factors in IPV prevention services. Further, work on SMM IPV victimization tends to focus on the potential role of sexual orientation-related discrimination, whereas the current study points to the importance of race-based discrimination.

Intimate Partner Violence and HIV Prevention Among Sexual Minority Men: Protocol for a Prospective Mixed Methods Cohort Study

BACKGROUND

Sexual minority men experience intimate partner violence (IPV) at rates similar to those reported by heterosexual women in the United States. Previous studies linked both IPV victimization and perpetration to HIV risk and seroconversion; however, less is known about the impact of IPV on HIV testing, sexually transmitted infection (STI) testing, pre-exposure prophylaxis (PrEP) uptake, and the persistence of PrEP use among sexual minority men experiencing IPV. Although prior work suggests that IPV may influence HIV prevention behavior, experiences of IPV are so highly varied among sexual minority men (eg, forms, frequency, and severity; steady vs casual partnerships; perpetration vs receipt; and sexual vs physical vs psychological violence) that additional research is needed to better understand the impact that IPV has on HIV risk and protective behaviors to develop more effective interventions for sexual minority men.

OBJECTIVE

This study aims to contribute to our understanding of the antecedents of IPV and the direct and indirect pathways between perpetration and receipt of IPV and HIV or STI risk behavior, STIs, and use of PrEP among sexual minority men experiencing IPV.

METHODS

This mixed methods study has 2 phases: phase 1 involved formative qualitative interviews with 23 sexual minority men experiencing IPV and 10 key stakeholders or providers of services to sexual minority men experiencing IPV to inform the content of a subsequent web-based cohort study, and phase 2 involves the recruitment of a web-based cohort study of 500 currently partnered HIV-negative sexual minority men who reside in Centers for Disease Control and Prevention-identified Ending the HIV Epidemic priority jurisdictions across the United States. Participants will be followed for 24 months. They will be assessed through a full survey and asked to self-collect and return biospecimen kits assessing HIV, STIs, and PrEP use at 0, 6, 12, 18, and 24 months. They will also be asked to complete abbreviated surveys to assess for self-reported changes in key study variables at 3, 9, 15, and 21 months.

RESULTS

Phase 1 was launched in May 2021, and the phase 1 qualitative interviews began in December 2021 and were concluded in March 2022 after a diversity of experiences and perceptions were gathered and no new ideas emerged in the interviews. Rapid analysis of the qualitative interviews took place between March 2022 and June 2022. Phase 2 recruitment of the full cohort began in August 2022 and is planned to continue through February 2024.

CONCLUSIONS

This mixed methods study will contribute valuable insights into the association that IPV has with HIV risk and protective behaviors among sexual minority men. The findings from this study will be used to inform the development or adaptation of HIV and IPV prevention interventions for sexual minority men experiencing IPV.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41453.

Intimate Partner Violence Victimization During the COVID-19 Pandemic Among a Global Online Sample of Sexual Minority Men

Purpose

We aimed to describe the prevalence of IPV victimization, changes of experiencing IPV victimization, and examined factors associated with more severe or frequent IPV victimization since the COVID-19 crisis among a global sample of sexual minority men (SMM).

Methods

Data were collected between October and November 2020 through a gay social networking (GSN) application. We used multinominal logistic regression to examine correlates of experiencing any IPV during the pandemic and experiencing more severe or frequent IPV since the pandemic began.

Results

Of all participants (n = 9420), IPV victimization prevalence in the past 6 months was 17.0%, 19.5% of whom reported experiencing more severe or frequent IPV and 55.7% reported experiencing IPV that stayed the same since the COVID-19 started. Experiencing more severe or frequent IPV victimization since the pandemic began was associated with having engaged in sex work, having an income reduction by more than 20% and cutting meals since the COVID-19 crisis began. Increased tobacco use and psychological distress were also associated with increased IPV victimization. Lastly, SMM who reported having met a sexual partner through GSN apps were more likely to say that their experience of IPV had been more severe or frequently.

Conclusion

Our results demonstrate relatively high levels of reporting IPV victimization during the COVID-19 pandemic among a global sample of SMM. The findings illustrate an increasing need for IPV resources and programs as the pandemic continues to evolve. New technologies such as GSN apps have the potential to deliver confidential and safe IPV screening, services, and resources.

Abuse in the Continua: HIV Prevention and Care Outcomes and Syndemic Conditions Associated with Intimate Partner Violence Among Black Gay and Bisexual Men in the Southern United States

Intimate partner violence (IPV) has been implicated in HIV acquisition and worse HIV outcomes. Limited research focuses on the experiences of Black gay and bisexual men. Using data from cross-sectional surveys in Baltimore, Maryland, and Jackson, Mississippi, we analyzed the association between IPV victimization and HIV-related outcomes among 629 adult Black gay and bisexual men, among whom 53% self-reported a negative result at last HIV test. 40% of participants reported lifetime physical, sexual, and/or psychological IPV victimization, and 24% past-year victimization. Recent and lifetime IPV were associated with recent clinical diagnosis of STI (adjPrR: 1.44; 95%CI: 1.08-1.92) and ART medication interruptions (adjPrR: 1.59; 95%CI: 1.25-2.01), respectively. Physical IPV was inversely associated with current PrEP use (adjPrR: 0.35; 95%CI: 0.13-0.90). Recent IPV was independently correlated with depression symptomatology (adjPrR: 2.36; 95%CI: 1.61-3.47) and hazardous alcohol use (adjPrR: 1.93; 95%CI: 1.42-2.61), with evidence of interactions. IPV-HIV relationships were intersected by internalized stigma, housing instability, poverty, and lack of insurance. Tailored IPV services are urgently needed for comprehensive HIV services for Black gay and bisexual men in the U.S.

Interpersonal and self-directed violence among sexual and gender minority populations: Moving research from prevalence to prevention

Purpose of review

This scoping review of reviews aimed to detail the breadth of violence research about sexual and gender minorities (SGM) in terms of the three generations of health disparities research (i.e., documenting, understanding, and reducing disparities).

Recent findings

Seventy-three reviews met inclusion criteria. Nearly 70% of the reviews for interpersonal violence and for self-directed violence were classified as first-generation studies. Critical third-generation studies were considerably scant (7% for interpersonal violence and 6% for self-directed violence).

Summary

Third-generation research to reduce or prevent violence against SGM populations must account for larger scale social environmental dynamics. Sexual orientation and gender identity (SOGI) data collection has increased in population-based health surveys, but administrative datasets (e.g., health care, social services, coroner and medical examiner offices, law enforcement) must begin including SOGI to meet the needs of scaled public health interventions to curb violence among SGM communities.

Prevalence of violence towards men living with HIV/AIDS in rural communities of SouthWestern Uganda

Background

Violence towards HIV positive men is one of the silent barriers to utilization of HIV care services. HIV positive men are potential victims of violence from other people including women, and violence may interfere with treatment outcomes. This study determined the prevalence of violence towards HIV positive men in rural communities of southwestern Uganda.

Methods

A cross-sectional study was conducted among 307 HIV positive men at selected health centers using an interviewer administered questionnaire. Data were analyzed in SPSS version 23 using chi-square and multivariate regression at 95% level of significance and a precision of 0.05.

Results

Of the 307 participants, 45.3% had experienced violence. Of these, 23.8% (n=73) had experienced kicking or slapping while 12.7% (39) reported sexual violence. Factors associated with violence were; using alcohol and drugs (aOR 0.26, 95% CI 0.09-0.76, p=0.014), knowledge of support structures (OR 2.25, 95% CI 1.33-3.78, p=0.002) and owning land for farming (aOR 0.26, 95% CI 0.10-0.70, p=0.011).

Conclusion

The prevalence of violence at 45.3% is quite high especially since violence against men is rarely talked about. This should not be ignored there should be strategies to support this vulnerable group.

Intimate Partner Violence Experiences During COVID-19 Among Male Couples

In addition to the growing morbidity and mortality related to the 2019 novel coronavirus (SAR-CoV-2) pandemic, social distancing measures during the pandemic may result in increased intimate partner violence (IPV). However, it is yet unknown if gay, bisexual, and other men who have sex with men (GBMSM)'s IPV risk has increased during this time. This article describes and analyzes IPV experiences during the COVID-19 pandemic in a sample of coupled-GBMSM in the United States. We hypothesized that pandemic-driven stressors would be associated with increased IPV prevalence and severity. A sample of 214 coupled men living in the US who had previously participated in HIV-related couple studies was surveyed in July-September 2020. Respondents reported demographic, sexual and substance use behaviors, and relationship characteristics. Surveys also collected data on pandemic-related life-changes (employment, substance use, COVID-19 illness). IPV victimization and perpetration were measured with the Gay and Bisexual Men Intimate Partner Violence scale and measured individually experienced or perpetrated violence, sexual, emotional, monitoring, or controlling behaviors, and if a given behavior was new and/or had changed in frequency during the pandemic. Reported prevalence and pandemic-related changes in victimization and perpetration were described. New or more frequent IPV victimization was modeled against employment, substance use changes, COVID-19 illness, and outside sexual partners (modified by a couple's sexual agreement). IPV perpetration prevalence was 15.17%, 34.44% of which was new or more frequent. Victimization prevalence was 14.95%, of which 46.88% was new or more frequent. After adjustment, outside sexual partners were associated with IPV among those with nonmonogamous sexual agreements; each outside sexual partner increased the odds of new or more frequent victimization by 70% (OR = 1.70; 95% CI [1.16, 2.51]). Given this study's documented rise in IPV among a sample of coupled men, additional research into IPV predictors, interventions, and support strategies in GBMSM populations are warranted.

Perceptions of Contexts of Intimate Partner Violence Among Young, Partnered Gay, Bisexual and Other Men Who Have Sex With Men in the United States

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15-19 (n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners' acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.

Performer Roles and Behaviors in Dyadic Sexually Explicit Media Featuring Men Who Have Sex with Men

Heterosexual gender roles are not directly relevant to gay romantic relationships, but gay men often take on different relationship roles depending on their sexual roles. In the present paper, we argue that gay men might draw on sexually explicit media (SEM) featuring men who have sex with men (MSM) to get information about how insertive sexual partners ("tops") and receptive sexual partners ("bottoms") typically behave. For this to be the case, however, we would have to reliably observe different behavior in SEM performers acting as tops vs. bottoms. We examined 220 of the most viewed online dyadic MSM SEM videos to determine whether performed verbal and physical intimacy, victimization, and sexual behaviors depended on the sexual role taken. We found that tops and bottoms engaged in similar amounts of intimacy behaviors, but that bottoms were depicted as initiating sexual activity more than tops. Tops enacted physical and psychological victimization more than bottoms, although these behaviors were rare. Tops were shown taking the insertive role across all sexual acts and versatile performers (i.e., those taking both insertive and receptive roles) were rarely depicted. The present study adds to the literature about the complexity of sexual-self-labels, and suggests that MSM SEM depictions of intimacy and sexual decision-making depend on the sexual role taken.

Intimate Partner Violence and Preferences for Pre-exposure Prophylaxis (PrEP) Modes of Delivery Among A Sample of Gay, Bisexual, and Other Men Who Have Sex with Men

While there is strong evidence that the experience of intimate partner violence (IPV) shapes PrEP use among heterosexual women, evidence for similar relationships among gay, bisexual and other men who have sex with men (GBMSM) is scant. In this paper we analyze baseline data from a large randomized controlled trial (RCT) of an HIV prevention intervention for GBMSM recruited from three cities (Atlanta, Detroit and New York City) to examine how the recent experience of IPV shapes their rankings of PrEP delivery options. Men were asked to rank from 1 to 8 PrEP taken by daily pill, event-based pill, injection, anal suppository (before sex), suppository (after sex), gel (penile or rectal) (before sex), and gel (after sex) and condoms. The analysis sample is 694 HIV-negative, sexually active GBMSM. Analysis considers an ordinal outcome measuring participant's ranked preferences for their future use of eight HIV prevention options. Men who experienced physical IPV preferred PrEP in pill form, while men who experienced partners monitoring their behaviors (monitoring IPV) preferred PrEP by injection. Men who experienced emotional IPV ranked PrEP by pill lower than other methods. Sexual and controlling IPV were not significantly associated with PrEP modality ranking. As more modes of PrEP delivery become available, providers should be encouraged to screen GBMSM seeking PrEP for IPV, and to provide men with the necessary information to facilitate an informed choice when deciding on a PrEP modality that will work for them and their relationship context.

Experiencing Intimate Partner Violence (IPV) Is Associated with Psychosocial Health Problems Among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Nigeria, Africa

Previous research has shown high rates of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBMSM). Experiencing IPV may predispose GBMSM to psychosocial health problems. A vast majority of the research on IPV among GBMSM have been conducted in North America and Europe. To date, no published studies that we are aware of have investigated the prevalence and correlates of IPV among GBMSM in West Africa. To fill this gap in research, the present study investigated the prevalence of IPV and its' association with psychosocial health problems in a large multicity sample of community-recruited GBMSM in Nigeria. Bivariate and multivariable logistic regression analyses were utilized to examine associations between sociodemographic characteristics, psychosocial health problems, sexual risk, and experiences of IPV (N = 389). The prevalence of experiencing emotional, physical, sexual, monitoring behaviors, and controlling behavior were 45%, 31%, 20%, 55%, and 22% respectively. Experiencing all types of IPV, except physical violence, was significantly associated with increased odds of having depressive symptoms (Adjusted OR [AOR] 1.79-2.63; 95% confidence interval [CI]: 1.08-4.60) and anxiety (AOR 1.63-2.63; 95% CI: 1.01-4.18). Experiencing emotional violence (standardized beta [β] = 0.21; standard error [SE] SE = 0.44), physical violence (β = 0.14; SE = 0.48), and controlling behaviors (β = 0.11; SE = 0.54) was associated with increased odds of loneliness. Experiencing all types of IPV was associated with history of suicide thoughts (AOR 2.20-3.68; 95% CI: 1.28-6.32) and suicide attempt (AOR 2.36-3.42; 95% CI: 1.20-6.75). Additionally, we observed a dose-response relationship, whereby increasing number of IPV was associated with a higher likelihood of reporting psychosocial health problems. Lastly, after adjusting for other psychosocial health problems and demographic characteristics, there remained a significant association between experiencing IPV and reporting a history of suicide thoughts and suicide attempt. Consequently, it is imperative that health interventions aimed at improving psychosocial health of GBMSM explore experience and perpetration of IPV.

Examining the impact of social distancing and methamphetamine use on sexual risk and intimate partner violence in sexual and gender minority young adults during the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic in 2020, concerns were raised about the potential impact of pandemic-related social distancing measures on existing health disparities among sexual and gender minority (SGM) young adults, including HIV transmission risk and intimate partner violence (IPV). Another concern was the potential for increased methamphetamine use during the pandemic, which is a known risk factor for HIV transmission and IPV.

METHODS

The present analysis examines the impact of COVID-19 social distancing (social distancing and quarantining) and methamphetamine use on HIV risk and IPV in a combined dataset from 3 cohort studies of SGM young adults (two in Los Angeles and one in Chicago) from May 2020 to April 2021 (n = 1142). Bivariate analyses and multivariable logistic regressions were estimated.

RESULTS

The median age was 26. All participants were assigned male at birth and most participants were men (93.8%). The largest racial groups were Hispanic/Latinx (44.6%) and Black (29.0%). In adjusted models methamphetamine use was consistently associated with having a new sex partner, higher numbers of sex partners, and experience of IPV, during the pandemic. Reporting no social distancing and reporting one social distancing behavior, were associated with experience of IPV relative to reporting 2 social distancing behaviors. Social distancing was not associated with sexual risk behavior or Pre-exposure Prophylaxis use.

CONCLUSIONS

SGM young adults live at the intersection of multiple vulnerabilities during the COVID-19 pandemic. Addiction services, HIV prevention services, and violence support services should be prepared to support young adult SGM needs, particularly those who use methamphetamine.

Patterns of polyvictimization predict stimulant use, alcohol and marijuana problems in a large cohort of sexual minority and gender minority youth assigned male at birth

OBJECTIVE

Men who have sex with men (MSM) and gender minorities (GM) are more likely to have substance problems and experience various forms of victimization compared to their heterosexual and cisgender counterparts. Polyvictimization allows for the assessment of the combined impact of multiple forms of victimization on health. This study examines the effects of polyvictimization patterns on stimulant use, alcohol and marijuana problems among a large cohort study.

METHOD

The sample was collected between 2015 and 2019 (n = 1,202). Mean age was 22. The sample was racially diverse (34.4% Black, 29.0% Hispanic/Latinx, 25.8% white, 5.9% other racial identity), 92.4% of the sample were MSM and 7.6% of the sample were GM. Using latent class analysis five qualitatively different polyvictimization classes were identified. Associations between these classes and stimulant use, alcohol and marijuana problems were examined using negative binomial and logistic regressions.

RESULTS

Polyvictimization class significantly predicted alcohol problems and cannabis problems, at baseline as well as methamphetamine, and cocaine use at both time points. The polyvictimization profiles that were characterized by intimate partner violence (IPV), childhood sexual abuse (CSA), and high victimization across types were associated with substance outcomes at baseline. The polyvictimization class that was characterized by report of IPV was associated with cocaine use at 6 month follow-up. The polyvictimization class that was characterized by CSA was associated with methamphetamine use at 6 month follow-up.

CONCLUSIONS

Researchers should examine the effects of victimization experiences more holistically and develop substance interventions that take multiple forms of victimization experiences into account. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Intimate Partner Violence Victimization and Mental Health Among Men Who Have Sex With Men Living With HIV in Guatemala

Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by poor mental health compared to their heterosexual counterparts. One factor that may increase mental health problems among MSM is intimate partner violence (IPV) victimization. The objectives of this study are to (a) describe the prevalence of different forms of IPV victimization experienced by MSM living with HIV in Guatemala City and (b) examine the relationship between IPV victimization and mental health. We analyzed cross-sectional survey data from a cohort of MSM living with HIV in Guatemala City (n = 374) to describe the burden of IPV, including physical, sexual, and emotional IPV. We then examined relationships between lifetime IPV and each form of recent IPV (past 12 months) with self-reported anxiety and depression using multivariable logistic regression. Over a quarter (27.3%) of the participants screened positive for anxiety and nearly one fifth (17.9%) screened positive for depression. Over a quarter of the participants (28.6%) reported ever having experienced any IPV victimization and 8.8% reported having experienced any form of recent IPV. In multivariable analyses, participants who experienced any form of lifetime IPV had roughly twice the odds of experiencing anxiety (OR: 1.86; 95% CI = [1.03, 3.38]) and depression (OR: 2.02; 95% CI = [1.02, 3.99]) compared to those who had not. Participants who experienced recent emotional IPV had over seven times the odds of experiencing anxiety (OR: 7.23; 95% CI = [1.46, 38.85]) compared to those who had not. MSM living with HIV in Guatemala experience a high burden of anxiety, depression, and IPV victimization. Those participants who had experienced lifetime IPV and recent emotional IPV were significantly more likely to screen for anxiety and depression. To improve their mental health, HIV clinics and other health services should provide support for MSM who have experienced IPV victimization.

Exploring the causal role of intimate partner violence and abuse on depressive symptoms in young adults: a population-based cohort study

BACKGROUND

Previous studies have shown an association between experience of intimate partner violence and abuse (IPVA) and depression. Whether this is a causal relationship or explained by prior vulnerability that influences the risk of both IPVA and depression is not known.

METHODS

We analysed data from the Avon Longitudinal Study of Parents and Children prospective cohort (N = 1764 women, 1028 men). To assess the causal association between IPVA at 18-21 years old and logged depressive symptom scores at age 23, we used (i) multivariable linear regression, (ii) inverse probability of treatment weighting (IPTW), and (iii) difference-in-difference (DiD) analysis, which compared the mean change in logged depressive symptom scores between ages 16 and 23 between those who experienced IPVA and those who did not.

RESULTS

Women who experienced IPVA had on average 26% higher depressive symptom scores after adjustment for measured confounders (ratio of geometric means 1.26, 95% CI 1.13 to 1.40). In men, the difference was 5% (ratio of geometric means 1.05, 95% CI 0.92 to 1.21). Results from IPTW analysis were similar. In the DiD analysis, there was no evidence that being exposed to IPVA affected the change in depressive symptom scores over time compared to being in the non-exposed group for either women (difference-in-differences 1%, -12 to 16%) or men (-1%, -19 to 20%).

CONCLUSIONS

Multivariable linear regression and IPTW suggested an association between IPVA and higher depressive symptom score in women but not men, but DiD analysis indicated a null effect in both women and men. This suggests the causal origins of higher depressive symptoms in this young adult population are likely to reflect prior vulnerability that leads to both higher depressive symptoms and increased risk of IPVA exposure.

Relationship Power and Intimate Partner Violence in Sexual Minority Male Couples

Objective: The objective of the present study was to test pathways implied by Disempowerment Theory to predict intimate partner violence (IPV) among men in a same-sex relationship. Background: Sexual minority men in relationships experience rates of IPV comparable with heterosexual women, yet most research on IPV focuses on heterosexual couples. Disempowerment Theory suggests that a range of individual, family-of-origin, and intimate relationship risk factors predict the use of violence to re-establish power in a relationship. Method: Data for the present study were gathered from an online survey completed by sexual minority men currently in a same-sex relationship (n = 339). Analysis of data included two steps: (a) we tested the direct effect of individual, family, and relational predictors on the odds of IPV and (b) we calculated a path model that included relationship power as a link between the predictors (individual, family, and relational) and IPV. Results: In line with Disempowerment Theory, relationship power was negatively associated with IPV. Bivariate analysis indicated an association between childhood sexual abuse and IPV, but childhood sexual abuse was not predictive of IPV through relationship power. Other individual (depression) and relationship-specific (sexual communication and relationship satisfaction) risk factors were associated with IPV indirectly through relationship power. Conclusion: Disempowerment Theory may provide a useful framework for understanding the occurrence of IPV in sexual minority male couples. It may also provide a starting point for the development of multi-component interventions to reduce violence in these couples.

Interpersonal Trauma Among Women and Men Receiving Buprenorphine in Outpatient Treatment for Opioid Use Disorder

People with opioid use disorder (OUD) are vulnerable to negative health outcomes related to substance use and psychosocial issues, such as interpersonal trauma (IPT). Participants receiving buprenorphine completed a cross-sectional survey (July-September 2019). OUD outcomes were prospectively abstracted over a 28-week timeframe. More than a third reported recent IPT (40% women, 36% men). Sexual violence was more common among women than men (p = .02). For women only, IPT was associated with substance use during follow-up (β = 20.72, 95% CI: 4.24, 37.21). It is important for public health strategies in the opioid crisis to address IPT using sex- and gender-informed approaches.

Gay, Bisexual, and Queer Men's Attitudes and Understandings of Intimate Partner Violence and Sexual Assault

Gay, bisexual, and queer (GBQ) men experience significant rates of intimate partner violence (IPV) and sexual assault (SA); however, there is limited research into their attitudes and understandings of IPV and SA. This article presents the findings of a 2018 survey of 895 GBQ men currently residing in Australia, focused on their views and experiences of healthy and unhealthy relationships. The survey included quantitative and open-ended qualitative questions. The findings presented in this article are primarily descriptive, with cross-tabulations and t tests to demonstrate significant differences between groups and correlational statistics to outline associations between variables. Qualitative data were coded under broad themes. The study found a considerable proportion of men (three in five) identified that they had experienced an unhealthy or abusive relationship in the past, with minimal disclosure to police or health services. Men with a history of partner abuse or violence were more likely to report binge drinking or drug use and more likely to know a friend who had abused his partner. 40% of the sample had witnessed an incident of relationship violence between GBQ men, and two-thirds intervened in the violence in some way. The findings of this study underscore the need to engage GBQ men in discussions about respectful relationships, address the role of alcohol and drugs in GBQ socialization and relationships, and provide bystander skills for men to intervene in situations of aggression or violence between men in relationships.

Prevalence of Intimate Partner Violence and Associated Factors Among Men Who Have Sex with Men in China

Intimate partner violence (IPV) in the heterosexual population has gained increasing public concern in China, but little is known about it among men who have sex with men (MSM).¹ This study aimed to investigate the prevalence of IPV and associated factors among MSM in Chengdu, China. Participants were recruited from a local MSM-friendly health consulting center. This study used the adjusted Intimate Partner Violence Scale among Gay and Bisexual Men (IPV-GBM scale) to capture lifetime IPV experiences including physical, sexual and emotional violence, monitoring, and controlling behaviors. Among 431 participants, 153 (35.5%) reported any IPV experiences, and 119 (27.6%) reported themselves as being the perpetrator. Adjusted logistic regression models revealed that having been engaged in transactional sex was positively associated with victimization through monitoring behaviors (adjusted odds ratio [ORa] = 2.7, 95% confidence interval CI = [1.7, 7.4]) and perpetration of monitoring behaviors (ORa = 3.9, 95% CI = [1.5, 13.3]); drug use was positively associated with victimization through controlling behaviors (unadjusted odds ratio [ORu] = 2.5, 95% CI = [1.2, 5.0]) and emotional violence (ORa = 1.9, 95% CI = [1.0, 3.5]); older age (≥18 years) of first homosexual intercourse was negatively associated with perpetration of physical violence (ORu = 0.3, 95% CI = [0.2, 0.7]) and sexual violence (ORu = 0.4, 95% CI = [0.2, 1.0]); higher self-esteem was negatively associated with both victimization and perpetration of sexual and emotional violence. We found that victimization and perpetration experiences were correlated in all dimensions of IPV. Violence was prevalent among MSM and merits public attention. This study provides more evidence about IPV among Chinese MSM and identifies two significant factors contributing to IPV (self-esteem and age of first homosexual intercourse), which have been overlooked in previous studies. Researchers should take these factors into consideration for interventions developments.

Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV

Retention in care and sustained viral suppression are integral outcomes in the care continuum for people living with HIV (PLWH) and HIV prevention; however, less is known about how substance use predicts sustained viral suppression over time. This study seeks to examine the predictive effects of substance use on sustained viral suppression in a sample of cisgender sexual minority men and gender minority PLWH (n = 163) drawn from a longitudinal sample in the Chicago area collected 2015-2019. Using data from 3 visits separated by 6 months, participants were coded persistently detectable, inconsistently virally suppressed, and consistently virally suppressed (< 40 copies/mL at all visits). Multinomial logistic regressions were utilized. About 40% of participants had sustained viral suppression. In multinomial logistic regressions, CUDIT-R predicted persistent detectable status and stimulant use was associated with inconsistent viral suppression. Substance use may create challenges in achieving sustained viral suppression, which has important implications for care and prevention.

Sexual Violence in Childhood and Post-Childhood: The Experiences of Young Men Who Have Sex With Men in Beirut

Sexual violence has been found to have psychosocial and sexual ramifications for men who have sex with men (MSM) but has not been studied in the Middle East. We assessed the prevalence and correlates of experiences of child and post-child sexual violence among young MSM residing in Beirut, Lebanon. In total, 226 MSM, aged 18 to 29, were recruited with long-chain peer referrals and administered a survey that included questions on history of being pressured to have sex, as well as specific forms of sexual harassment and abuse, in addition to measures of psychosocial functioning and sexual behavior. Logistic regression analysis was used to examine correlates of child sex abuse and experiences of sexual violence post-childhood; 17.3% experienced sexual abuse as a child (below age 13), while 63.3% experienced any form of sexual violence post-childhood-furthermore, 48.7% had experienced being forced or pressured to have sex during their lifetime, including 32.3% prior to age 18. Participants who experienced child sex abuse were more likely to experience abusive relationships in adulthood, as well as at least one type of sexual harassment/abuse post-childhood. Experience of any sexual violence post-childhood was correlated with greater recent sexuality-related discrimination and more recent male sex partners. These findings reveal a high prevalence of sexual violence among MSM in Beirut, both in childhood and post-childhood. More research within the Middle East is needed to better understand the drivers of sexual violence in this population, and how to best provide prevention and coping services.