Intimate Partner Violence and Condom Negotiation among Gay and Bisexual Men Catherine Finneran, MPH Rob Stephenson, PhD Rollins School of Public Health.

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Intimate Partner Violence and Condom Negotiation among Gay and Bisexual Men Catherine Finneran, MPH Rob Stephenson, PhD Rollins School of Public Health Emory University Atlanta, GA, USA

In 2010:

HIV among MSM: A Syndemic Theory HIV Mental Health Internalized Homophobia Childhood Sexual Abuse Substance/ Alcohol Abuse Tobacco UseSTIs Hate Crimes/ Homophobia Intimate Partner Violence

Prevalence of IPV among MSM (Lifetime) Any 29% 78% Physical 13%38% 0100 Sexual 12% 30% 0100 Emotional/Psychological 5% 73% 0 100

IPV HIV Substance Abuse STIs Mental Health Unprotected Anal Sex

IPV HIV Unprotected Anal Sex Condom Negotiation

How does recent experience of Intimate Partner Violence impact gay and bisexual men’s self-reported condom negotiation efficacy?

Qualitative + Quantitative Largest ever undertaken (n=1,101) IPV & HIV Risk New MSM- specific IPV definition

% Age Race/Ethnicity White non-Hispanic46.0 Black non-Hispanic41.5 Hispanic/Latino/Other12.5 HIV Status (reported) Negative68.9 Positive24.6 DK/Never Tested6.6 % Education High School or Less17.2 Some College/2yr.34.2 College+48.7 Employment Employed76.6 Unemployed23.4 Identity Gay/Homosexual89.3 Bisexual10.7 Sample Characteristics (n=745)

Physical & Sexual Monitoring Controlling HIV-Related Emotional Slap you Punch you Hit you Kick you Push you Force you to do something sexually Rape you Damage your property Demand access to your cell phone Demand access to your Read your text messages Read your Repeatedly post on your social networking pages Prevent you from seeing your family Prevent you from seeing his family Prevent you from seeing your friends Prevent you from seeing his friends Lie to you about his HIV status Not tell you he had HIV before you had sex Intentionally transmit HIV to you Call you fat Ask or tell you to “act straight” around certain people Criticize your clothes The IPV-GBM Scale

Reporting of IPV-GBM IPV

Low Condom Negotiation Efficacy

Bivariate Analyses p < p < p < p < 0.003

Any: 1.62 (1.09, 2.39) Physical: 2.22 (1.46, 3.36) Monitoring: 1.30 (0.84, 2.02) Controlling: 2.43 (1.44, 4.11) HIV: 1.61 (0.91, 2.85) Emotional: 2.05 (1.38, 3.05)

Cross-sectional sample of urban-based MSM Analysis does not consider if facing multiple forms of IPV compounds risk Condom negotiation with last sex partner may not reflect overall condom negotiation skills Limitations

Recent experience of IPV is associated with reduced self-reported condom negotiation efficacy among gay and bisexual men – Non-physical, non-sexual forms of IPV may also impact condom negotiation Low condom negotiation efficacy may be a pathway through which IPV increases HIV risk Conclusion

Gay, bisexual, and other MSM should be screened for Intimate Partner Violence during routine HIV counseling and testing – See: Stephenson et al., “Towards the development of an Intimate Partner Violence screening tool for gay and bisexual men,” Western Journal of Emergency Medicine, in press Recommendations

Intimate Partner Violence and Condom Negotiation among Gay and Bisexual Men Posters: Wednesday 12:30-14:30 IPV and Sexual Risk (WEPE553) Minority Stress and IPV (WEPE552) Catherine Finneran, MPH Rob Stephenson, PhD

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