King Nicholas, Talebloo Jonanne, Smyrnov Pavlo, Vasylyeva Tetyana I
Joe C. Wen School of Population and Public Health, University of California Irvine, Irvine, CA, USA.
Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA, USA.
BMJ Glob Health. 2025 Jul 30;10(7):e017953. doi: 10.1136/bmjgh-2024-017953.
The Russian invasion of Ukraine has displaced millions, potentially exposing them to traumatic events in the process. Potentially traumatic events (PTEs) have been linked to negative health outcomes, including depression, substance abuse and risky sexual behaviours. Men who have sex with men (MSM) are especially vulnerable to the effects of displacement, given widespread MSM stigma in Ukraine. A cross-sectional survey of MSM was conducted as part of a peer-driven intervention between August 2023 and January 2024 across eight cities in Ukraine via respondent-driven sampling. Lifetime PTE exposure responses were grouped into three binary variables: accidental/injury, victimisation and death threat. The relationship between displacement and exposure to PTEs was modelled using multivariate covariance generalized linear models with a logistic link, extending logistic regression to all three PTE responses. n=3617 (mean age 29.8, SD 8.1; 93% of the 3886 surveyed) were analysed. Controlling for sampling structure, participation in military operations, adverse experience of unstable housing in the last 2 years and age, internal displacement was significantly associated (p<0.001) with all three types of PTEs: adjusted ORs for accidental/injury, victimisation and death threat were 2.04, 1.57 and 2.05, respectively. As the war continues, our results highlight the need for trauma-informed care for internally displaced MSM in Ukraine, as many of them have been exposed to various types of PTEs. Those with adverse experiences of unstable housing conditions or participating in military operations particularly need to be considered.
俄罗斯对乌克兰的入侵使数百万人流离失所，在此过程中他们可能遭遇创伤性事件。潜在创伤性事件（PTEs）与负面健康结果有关，包括抑郁、药物滥用和危险的性行为。鉴于乌克兰普遍存在对男男性行为者（MSM）的污名化现象，男男性行为者尤其容易受到流离失所影响。作为一项同伴驱动干预措施的一部分，于2023年8月至2024年1月期间在乌克兰八个城市通过应答驱动抽样对男男性行为者进行了横断面调查。将终生PTE暴露反应分为三个二元变量：意外/受伤、受害和死亡威胁。使用具有逻辑链接的多变量协方差广义线性模型对流离失所与PTE暴露之间的关系进行建模，将逻辑回归扩展到所有三种PTE反应。对n = 3617名（平均年龄29.8岁，标准差8.1；占3886名调查对象的93%）进行了分析。在控制抽样结构、参与军事行动、过去两年不稳定住房的不良经历和年龄后，境内流离失所与所有三种类型的PTEs均显著相关（p<0.001）：意外/受伤、受害和死亡威胁的调整后比值比分别为2.04、1.57和2.05。随着战争的持续，我们的结果凸显了为乌克兰境内流离失所的男男性行为者提供创伤知情护理的必要性，因为他们中的许多人都遭遇了各种类型的PTEs。那些有不稳定住房条件不良经历或参与军事行动的人尤其需要得到关注。
