Intimate partner violence, minority stress, and sexual risk-taking among U.S. MSM Open Access

Finneran, Catherine Anne (2011)

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Title: Intimate partner violence, minority stress, and sexual risk-taking among U.S. MSM
Author: Catherine Finneran

Background: Recent research suggests that intimate partner violence (IPV) may increase sexual risk for HIV among MSM. However, little research has examined how experiences of minority stress, particularly homophobia and racism and including IPV, are associated with sexual risk-taking among MSM.

Objective: To examine the relationships between intimate partner violence, homophobia, racism, and sexual risk-taking among a population of self-identified gay and bisexual men in the U.S.

Methods: A national, internet-based survey of U.S. MSM (N = 2,086) recruited from social networking sites was conducted in 2010. From a subset of these data (n = 1,575), five outcomes were modeled using logistic regression: experiences of physical violence, experiences of sexual violence, perpetration of physical violence, perpetration of sexual violence, and unprotected anal intercourse (UAI) at last sex. Models controlled for age, race/ethnicity, homosexual identity, education, employment, HIV status, homophobic discrimination, racism, internalized homophobia, UAI, and IPV.

Results: Approximately 48% of MSM respondents reported UAI at last sex. MSM reported prevalence rates of 8.8% for experiences of physical IPV, 3.6% for experiences of sexual IPV, 4.3% for physical IPV perpetration, and 0.8% for sexual IPV perpetration. MSM who reported experiencing more homophobic discrimination were more likely to report experiences of sexual IPV (OR: 1.28, 95% CI: 1.11, 1.47) and perpetration of sexual IPV (OR: 1.70, 95% CI: 1.25, 2.31), as were MSM who reported more internalized homophobia (OR: 1.08, 95% CI: 1.03, 1.13). MSM who reported engaging in UAI were more likely to report perpetrating physical IPV (OR: 2.21, 95% CI: 1.29, 3.79); accordingly, MSM who reported perpetrating physical IPV were more likely to report UAI (OR: 2.08, 95% CI: 1.12, 3.85). Experiencing racism was associated with increased odds of experiencing sexual IPV (OR: 1.19 95% CI: 1.06, 1.34).

Conclusions/Implications: The high prevalences of IPV and UAI among MSM reported here suggest critical need for MSM-specific IPV. IPV screening should be incorporated into routine HIV/STI counseling and testing. The associations identified between racism, homophobia and both IPV and UAI point to the need for prevention messages to address the social, cultural, and attitudinal contexts in which MSM take sexual risks.

Table of Contents


Chapter I: Introduction. 1 Objectives & Aims. 2 HIV among MSM in the U.S.2 Racial disparities. 4 Age disparities. 5 Chapter II: Literature Review.. 8 Minority Stress. 8

Intimate Partner Violence among MSM... 11

Sexual Risk-Taking. 25 Homophobia and Gay Pride. 28 Race and Racism.. 33 Gaps in the Literature. 35 Chapter III: Manuscript. 39 Introduction. 43 Background. 44 Data & Methods. 48 Measurements. 48 Results. 52 Discussion. 55 References. 60 Appendix A: Tables. 63 Chapter IV: Recommendations. 69 Public Health Implications. 69 References. 77

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