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Partner Violence: A Significant Part of a Syndemic Among Black Men Who Have Sex With Men
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Download the PDF here
Reported by Jules Levin
22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018
Elwin Wu, Nabila El-Bassel, and Louisa Gilbert Social Intervention Group Columbia University School of Social Work, New York, NY USA
"HIV, substance misuse, and partner violence (PV) have long been characterized as a syndemic-interacting and reinforcing epidemics-among key populations such as drug-involved women and female sex workers.1,2 There is a nascent recognition of PV as part of the syndemic among MSM.3-8"
"Among 1043 study participants, 612 (59%) had HIV infection, 381 (37%) did not, and 50 (5%) had an unknown HIV status. Age averaged 35.7 years. Participants had an average of 4.7 male sex partners in the past 90 days and an average of 14.7 condomless anal sex acts in the past 90 days. Three quarters of these men reported any illicit substance use, 65% used marijuana, 40% reported binge drinking, 32% used powdered cocaine, and 24% used any party drug.
More than one third of participants, 36%, ever experienced some form of partner violence, and 23% experienced some form of partner violence in the last 30 days. About one quarter of men (27%) ever experienced psychological partner violence, and 22% ever experienced physical partner violence. Lifetime rates of other types of partner violence were 13% for injurious violence, 10% for sexual violence, 9% for gay-related violence, and 5% for HIV-related violence. While 16% of men experienced psychological violence in the past 30 days, 10% experienced physical violence in the past 30 days.
see tables, 1, 2 and 3 below
Multivariate linear or logistic regression analysis identified several factors that independently raised odds of currently experiencing partner violence: not knowing one's HIV status (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 2.1 to 11.7), greater number of male sex partners (beta 3.6, 95% CI 2.6 to 4.6), greater number of condomless anal sex acts (beta 6.4, 95% CI 2.9 to 9.8), binge drinking (aOR 2.1, 95% CI 1.6 to 2.9), and illicit substance use (aOR 2.5, 95% CI 1.6 to 4.1). The same factors were independently associated with higher odds of currently perpetrating partner violence.
The Columbia University investigators believe their findings show that "relationship health and violence deserve as much attention and vigor" in black MSM as in other populations who endure partner violence. They proposed that addressing partner violence in black MSM may help prevent HIV transmission in this high-risk population." Mark Mascolini report excerpt.
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