Intimate Partner Violence and Correlates With Risk Behaviors and HIV/STI Diagnoses Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in China

Abstract

Background Intimate partner violence (IPV) research has primarily focused on heterosexual couples, but has largely ignored IPV among men who have sex with men (MSM). We examined IPV prevalence among MSM and men who have sex with men and women (MSMW) in China. Methods MSM over the age of 16 were recruited through three MSM-focused websites in China. An online survey containing items on sociodemographics, risk behaviors, IPV, and self-reported HIV or STI diagnosis was completed. Multivariate regression was used to examine associations between IPV and risk behaviors and an HIV or STI diagnosis. Results Among 610 participants, 182 (29.8%) reported experiencing at least one type of IPV. MSMW were at significantly greater risk for IPV (adjusted odds ratio (AOR) 1.65, 95% CI [1.08–2.53]) compared to MSM. Men who had experienced IPV were more likely to have participated in group sex (AOR 1.86, 95% CI [1.08–3.21]), to have had sex in exchange for gifts or money (AOR 5.06, 95% CI [2.47–10.35]), and to report a positive HIV diagnosis (AOR 2.59, 95% CI [1.22–5.51]). Conclusions There is a hidden epidemic of IPV among MSM in China, especially among MSMW. The hidden nature of MSM and MSMW suggests the need for a clinical environment more conducive to disclosure. Research is needed to understand the pathways linking IPV and HIV risk among MSM in order to optimize the design of effective interventions.

Association between stigma towards HIV and MSM and intimate partner violence among newly HIV-diagnosed Chinese men who have sex with men

“…Further mixed methods research could provide critical information about the patterning of these experiences with MSM living with HIV. The observed prevalence of any IPV (23.7%) in our study is in accordance with the rates among Chinese MSM in other studies (24-29%) [14,16], but is higher than general males (7.6%) [49]. The prevalence of physical IPV experience in our study participants is higher than that among MSM in a Shanghai study (16.6% vs. 6.6%), whereas the rates of psychological IPV (7.4% vs. 8.2%) and sexual IPV (5.2% vs. 5.5%) were nearly the same [16].…”

“…Globally, prevalence rates among MSM range from 32 to 78% for experiencing any form of IPV [5,6], 12 to 45% for physical IPV [7,8], 5 to 33% for sexual IPV [8,9], and 28 to 64% for emotional/psychological IPV [10,11]. IPV has been associated with higher levels of potentially risky sexual behaviors, such as condomless sex [5,12,13], group sex [14], commercial and casual sex, as well as increased risks for substance abuse [15] and sexually transmitted infection [16].…”

Correlates of Sexual Violence Among Men Who Have Sex With Men in Tijuana, Mexico

“…Thus, in the final model, more experiences of sexual violence in the past 12 months were independently associated with not living with a spouse or steady partner, having a history of childhood sexual abuse, more adult experiences of homophobia, and higher scores on depression and hostility symptoms (see Table 2). Since previous research has shown differences between MSM and men who have sex with men and women (MSMW) in terms of sexual violence and other psychosocial factors (Davis et al, 2015; Dyer, Regan, Pacek, Acheampong, & Khan, 2015; Wang et al, 2015), we re-ran the hierarchical regression model excluding 48 participants who reported sex with women in the past two months. The substantive findings were mostly unchanged.…”

“…Also, studies in LMIC have identified key differences between MSM and MSMW. It has been shown that MSMW have greater risk of intimate partner violence (Davis et al, 2015), higher HIV prevalence, greater likelihood of trading sex, greater use of alcohol and illicit drugs (Wang et al, 2015), lower odds of prior HIV testing (Bowring, Veronese, Doyle, Stoove, & Hellard, 2016), and more inconsistent use of condoms with male partners (Ramakrishnan et al, 2015) compared to MSM only. Accordingly, future studies should examine correlates of sexual violence victimization in separate models for MSM and MSMW.…”

Seeking Male Sexual Partners via Internet and Traditional Venues among Chinese Men Who Have Sex with Men: Implications for HIV Risk Reduction Interventions

“…Although many HIV prevention intervention programs highlight Chinese MSM as a key population, MSM are documented to continue with a high prevalence of risky behaviors, such as condomless anal sex, substance abuse, multiple sexual partnership and lack of routine HIV testing [3][4][5][6][7]. Hence, continued HIV transmission occurs within and beyond this population through both homosexual and heterosexual contacts [8].…”