School of Public Health, San Diego State University, San Diego, California, USA.
RAND Corporation, Santa Monica, California, USA.
LGBT Health. 2023 Sep;10(S1):S39-S48. doi: 10.1089/lgbt.2023.0134.
This qualitative study explores the pathways by which various forms of intimate partner violence (IPV) impact the sexual health behaviors of cisgender identified sexual minority men (SMM). Semi-structured interviews were conducted with 23 racially and ethnically diverse SMM who recently experienced IPV and 10 clinical and social service providers focused on how experiences of IPV directly or indirectly influences sexual risk as well as engagement in HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use). Applied thematic analysis, including cycles of analytic memo writing and coding, aided the identification of patterns across the data. Analyses yielded three overarching themes: use of condoms, use of PrEP, and HIV and sexually transmitted infections (STIs). Participants described different ways condom use or nonuse was a mechanism by which power and/or control might be asserted by one partner over the other partner. A range of responses to questions about PrEP were identified, including partners encouraging PrEP use, as well as avoidance of conversations about PrEP or actual PrEP use, to prevent experiencing aggression or IPV from partners. Responses regarding HIV/STIs included those ranging from a new diagnosis being a potential trigger for violence to the exploitation of status to control partners. These findings suggest that in relationships with IPV, HIV prevention strategies can be sources of relationship control and trigger abuse. Addressing IPV may help to prevent HIV/STI transmission and promote the health of SMM. In addition, long-acting formulations of PrEP may be a promising strategy for SMM experiencing IPV when oral PrEP medications may be a risk factor for violence.
本定性研究探讨了各种形式的亲密伴侣暴力（IPV）如何影响顺性别认同的性少数男性（SMM）的性行为健康。对 23 名最近经历过 IPV 的种族和民族多样化的 SMM 进行了半结构化访谈，并对 10 名专注于 IPV 经历如何直接或间接影响性风险以及参与 HIV 预防行为（例如，暴露前预防 [PrEP] 使用）的临床和社会服务提供者进行了访谈。应用主题分析，包括分析备忘录写作和编码的循环，有助于识别数据中的模式。分析产生了三个总体主题：使用避孕套、使用 PrEP 和 HIV 和性传播感染（STI）。参与者描述了不同的方式，避孕套的使用或不使用是一种权力和/或控制可能由一方对另一方施加的机制。对 PrEP 问题的回答范围包括伴侣鼓励使用 PrEP，以及避免关于 PrEP 的对话或实际使用 PrEP，以防止伴侣遭受攻击或 IPV。关于 HIV/STI 的反应包括从新诊断可能成为暴力的潜在触发因素到利用地位来控制伴侣的各种反应。这些发现表明，在存在 IPV 的关系中，HIV 预防策略可能成为关系控制的来源，并引发虐待。解决 IPV 问题可能有助于预防 HIV/STI 的传播，促进 SMM 的健康。此外，当口服 PrEP 药物可能是暴力的一个风险因素时，长效 PrEP 制剂可能是经历 IPV 的 SMM 的一个有前途的策略。
