Intimate Partner Violence and HIV Prevention among Sexual Minority Men

性少数男性的亲密伴侣暴力和艾滋病毒预防

• 批准号: 10254507
• 负责人: Erik D. Storholm
• 金额: $ 65.82万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10254507
• 关键词: AIDS prevention; Address; Adult; Alcohol consumption; Behavior; Buffers; Characteristics; Child Abuse; Chronic; Cohort Studies; Coping Skills; Cross-Sectional Studies; Data; Development; Diagnosis; Emotional; Etiology; Frequencies; HIV; HIV Seronegativity; HIV Seropositivity; HIV risk; Human immunodeficiency virus test; Individual; Interruption; Intervention; Knowledge; Life Experience; Link; Los Angeles; Measures; Mediating; Mental Health; Methodology; Methods; Minority; Outcome; Participant; Pathway interactions; Prevalence; Recommendation; Recording of previous events; Research; Research Activity; Risk; Risk Behaviors; Risk Factors; Severities; Sexual Partners; Sexually Transmitted Diseases; Shapes; Social support; Stress; Structure; Substance abuse problem; Testing; Time; Victimization; Violence; Woman; Work; base; cis-male; cohort; condomless anal sex; design; effective intervention; experience; follow-up; inattention; innovation; intimate partner violence; men; pre-exposure prophylaxis; prevent; primary outcome; prospective; protective behavior; psychologic; psychosocial; recruit; resilience; secondary outcome; self esteem; sexual minority; sexual risk behavior; sexual risk taking; social stigma; social structure; stressor; substance use; theories; uptake; violence perpetration; violence prevention

SUMMARY/ABSTRACT Sexual minority men (SMM) experience intimate partner violence (IPV) at alarming rates. Prior work has linked IPV to sexual risk-taking behavior and increased risk for HIV seroconversion among SMM, but less is known about the impact of IPV on HIV and sexually transmitted infection (STI) testing/acquisition, pre-exposure prophylaxis (PrEP) uptake, and the persistence of PrEP use among SMM. While these findings reveal the potential for IPV to have a strong deleterious effect on HIV prevention, experiences of IPV are so varied among SMM (e.g., frequency, severity; steady vs. casual partnerships; mutual perpetration vs. only perpetrating or receiving violence; sexual vs. physical vs. psychological violence) that additional research is needed to unpack the overall association between IPV and HIV risk before effective interventions can be developed. Guided by a framework that combines the Syndemics and Minority Stress theories, the proposed innovative observational cohort study will examine how perpetration and/or receipt of various forms of IPV (e.g., physical, sexual, and psychological; in the context of steady or casual intimate relationships) contribute to HIV risk and protective behaviors among HIV-negative SMM over a 24-month timeframe in order to: 1. Examine the longitudinal associations of IPV with HIV testing, PrEP uptake, PrEP persistence, STI diagnosis, condomless anal sex, and HIV seroconversion. 2. Determine the structural- and individual-level and resilience and risk factors that may buffer or amplify associations between IPV and these HIV risk and protective behaviors. 3. Identify the characteristics of SMM, their intimate partners, and the relationship dynamics that serve to mediate or moderate the impact of IPV on HIV risk and protective behaviors. 4. Make recommendations for interventions that interrupt the pathways between IPV and HIV risk based on quantitative data from the cohort, and qualitative data guided by technical experts. We will assess sexual risk behavior, conduct HIV and STI testing, and assess PrEP uptake and persistence over the 24 months of follow-up. We hypothesize that greater frequency of IPV will be associated with history of childhood abuse, mental health problems, substance use, sexual risk taking and lower levels of HIV testing, PrEP uptake, and PrEP persistence. We anticipate that alcohol and substance use among participants and their partners will be highly associated with episodes of IPV (both victimization and perpetration) and with HIV risk behavior. We also hypothesize that coping skills and social support will moderate the effects of IPV on risk behavior, HIV testing, PrEP uptake, and PrEP persistence. The proposed study will advance our understanding of both the risk and resiliency factors relevant to preventing and reducing IPV, reducing IPV-associated risk behaviors, and increasing HIV protective behaviors among SMM. This research will inform the development and adaptation of IPV, HIV, and substance abuse interventions for SMM.

摘要/摘要 性少数男性 (SMM) 遭遇亲密伴侣暴力 (IPV) 的比例惊人。之前的工作已链接 IPV 性冒险行为和 SMM 中 HIV 血清转化的风险增加，但人们对此知之甚少 IPV 对 HIV 和性传播感染 (STI) 检测/获取、暴露前预防 (PrEP) 的影响 SMM 中 PrEP 的吸收率以及持续使用情况。虽然这些发现揭示了 IPV 的潜力 IPV 对 HIV 预防具有强烈的有害影响，SMM 之间的 IPV 经历差异很大（例如频率、 严重程度；稳定与随意的伙伴关系；相互实施暴力与仅实施或接受暴力；性 vs. 性 身体暴力与心理暴力），需要进行额外的研究来揭示两者之间的总体关联 在制定有效干预措施之前先了解 IPV 和 HIV 风险。以一个框架为指导，该框架结合了 流行病和少数族裔压力理论，拟议的创新观察队列研究将探讨如何 实施和/或接受各种形式的 IPV（例如，身体的、性的和心理的；在以下情况下） 稳定或随意的亲密关系）会增加 HIV 阴性 SMM 的 HIV 风险和保护行为 在 24 个月的时间范围内，以便： 1. 检查 IPV 与 HIV 检测、PrEP 的纵向关联 摄取、PrEP 持续性、STI 诊断、无套肛交和 HIV 血清转化。 2. 确定 可能缓冲或放大 IPV 之间关联的结构和个人层面以及复原力和风险因素 以及这些艾滋病毒风险和保护行为。 3. 识别SMM的特征、他们的亲密伙伴以及他们的目标 关系动态有助于调节或缓和 IPV 对 HIV 风险和保护行为的影响。 4. 根据以下情况提出中断 IPV 和 HIV 风险之间途径的干预措施建议 来自队列的定量数据以及技术专家指导的定性数据。我们将评估性风险 行为，进行 HIV 和 STI 检测，并评估 PrEP 在 24 个月随访期间的吸收和持续性。 我们假设 IPV 的较高频率与儿童虐待史、心理健康状况有关 问题、物质使用、性冒险和较低水平的 HIV 检测、PrEP 摄取和 PrEP 持续性。 我们预计参与者及其伴侣的酒精和药物使用与 IPV 事件（受害和犯罪）以及 HIV 危险行为。我们还假设应对 技能和社会支持将减轻 IPV 对危险行为、HIV 检测、PrEP 吸收和 PrEP 的影响 坚持。拟议的研究将增进我们对与相关风险和弹性因素的理解 预防和减少 IPV、减少 IPV 相关危险行为并增加 HIV 保护行为 SMM之中。这项研究将为 IPV、HIV 和药物滥用的发展和适应提供信息 SMM 的干预措施。