Traumatic events exposure in men who have sex with men with and without experience of displacement in Ukraine.

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.