Violence and viral suppression among men living with HIV
Project Number5R01MH123388-05
Former Number1R01MH123388-01
Contact PI/Project LeaderKAHLE, ERIN M
Awardee OrganizationUNIVERSITY OF MICHIGAN AT ANN ARBOR
Description
Abstract Text
PROJECT SUMMARY/ABSTRACT
There is increasing evidence that men who have sex with men (MSM) experience dual epidemics of HIV and
intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is
underdeveloped. Gay, bisexual and other men who have sex with men (GBMSM) continue to be the risk group
most severely affected by HIV in the United States. In parallel, estimated prevalence for receipt of IPV among
MSM range from 12% to 78%. Emergent evidences demonstrates associations between the experience of IPV
among MSM and the risk of HIV acquisition or participation in risk behaviors that heighten the risk of HIV (i.e.
substance use), but the relationship between the experience of IPV for MSM living with HIV and HIV clinical
care is less understood. The overwhelming majority of evidence linking IPV and sub-optimal HIV care comes
from studies of heterosexual women. A recent meta-analysis showed that women's experience of IPV was
associated with 55% lower odds of self-reported adherence and 36% decreased odds of viral suppression. The
four studies that have looked at associations between clinical care and IPV for men living with HIV have all been
hampered by methodological limitations: cross-sectional study designs with clinic-based populations that limit
the ability to draw conclusions as to how IPV affects engagement in HIV care for partnered men living with HIV.
We propose an innovative 24-month cohort study of HIV-positive MSM, coupled with nested qualitative data, to
identify the pathways and points of intervention between IPV and HIV care for US MSM. The proposed research
activities include a prospective 24-month cohort of 300 HIV-positive partnered MSM (>18 years) recruited
through a combination of online and venue-based recruitment methods in Atlanta, GA and Detroit, MI. The
cohort study will employ a measure of IPV developed specifically to capture IPV as experienced by MSM, and
will consider the experience of IPV (victimization, perpetration and bidirectional IPV), and severity and
frequency of IPV as drivers of engagement in HIV care. Biomarkers of viral load and adherence to ARV will be
collected from all participants. The overall aim of the proposed activities is to provide new knowledge of how
victimization or perpetration of IPV shapes engagement in HIV care and is associated with the ability to achieve
and maintain viral suppression.
Public Health Relevance Statement
PROJECT NARRATIVE
There is increasing evidence that men who have sex with men (MSM) experience dual epidemics of HIV and
intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is
underdeveloped. The proposed 24 month cohort study examines associations between the experience and
perpetration of IPV and bio-markers of engagement in clinical HIV care among a large diverse sample of men
living with HIV.
NIH Spending Category
No NIH Spending Category available.
Project Terms
AddressAdherenceAffectAlberta provinceAlcohol consumptionAmerican menBehavior ControlBiological MarkersBisexualCanadaCaringClinicClinicalCohort StudiesCoupledCouplesCross-Sectional StudiesDataEmotionalEpidemicFemaleFrequenciesGaysHIVHIV SeropositivityHIV diagnosisHeterosexualsHospitalizationInterruptionInterventionKnowledgeLinkMeasuresMediatingMediationMen with HIVMeta-AnalysisMethodologyMethodsMonitorParticipantPathway interactionsPatient Self-ReportPatientsPhasePrevalencePsychosocial FactorRecommendationReportingResearchResearch ActivityResearch DesignRiskRisk BehaviorsRoleSample SizeSamplingSeveritiesSex BehaviorSexual PartnersShapesSocial supportUnited StatesVictimizationViolenceViralViral Load resultVirginiaWomanWorkaccess restrictionsbehavioral responsebiological adaptation to stressclinical careclinically relevantcohortcomparativecondomsdesignexperiencegender behaviorhealth care availabilityinattentioninnovationintimate partner violencemalemen who have sex with menmen's experienceminority stressminority stressorperpetratorspopulation basedprimary outcomeprospectiverecruitresiliencesecondary outcomesexsexual violencesocial stigmastructural determinantssubstance usesynergismviolence victimization
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