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One third of black MSM in NYC group experience partner violence
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22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018
Mark Mascolini
A New York City study of more than 1000 black men who have sex with men (MSM) found that one third ever experienced partner violence and one quarter endured partner violence in the past 30 days [1]. Not knowing one's HIV status, binge drinking, illicit drug use, and other variables independently predicted currently experiencing or perpetrating partner violence.
Columbia University researchers who conducted this study noted that HIV infection, partner violence, and substance misuse constitute a syndemic (interacting and reinforcing epidemics) in key female populations such as drug-using women and sex workers. But much less is known about partner violence and its impact among MSM. Because black MSM account for a high proportion of new HIV infections in the United States and partner violence may affect HIV transmission risk, the Columbia team conducted this study. They aimed to determine the prevalence of partner violence in black MSM and to explore factors contributing to partner violence.
The study group came from screening for a randomized trial to test a sexual and drug risk reduction protocol in black MSM couples in New York City. At least 1 partner had to be engaged in illicit drug use, and at least 1 had to have an elevated risk of acquiring HIV or another sexually transmitted infection. Participants had to identify themselves as black men who had noncoerced sex with another man in the past 3 months.
Researchers assessed personal violence with the Revised Conflict Tactics Scale, excluding items related to minor psychological violence and adding 2 items: gay-related personal violence (threatening to or actually disclosing MSM status) and HIV-related personal violence (threatening to or actually disclosing HIV status).
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.
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.
Reference
1. Wu E, El-Bassel N, Gilbert L. Partner violence: a significant part of a syndemic among black men who have sex with men. AIDS 2018: 22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018. Abstract TUPDD0102.
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