Description

Background: Sexual minority men (SMM) experience intimate partner violence (IPV) at disproportionately high rates. Previous research has identified both IPV victimization and perpetration as risk factors for HIV acquisition. However, little is known about the impact of IPV on HIV preventive measures, including HIV/STI testing, pre-exposure prophylaxis (PrEP) uptake, and adherence to PrEP use among SMM experiencing IPV. Objective: The objective of this analysis was to assess the opinions of 1) SMM on how IPV can affect their risk of acquiring HIV and access to preventative care, and 2) healthcare providers on treating SMM in relationships with IPV. Methods: SMM participants were recruited from partner LGBTQ+ organizations and providers were from the LA LGBT Center Clinic. Semi-structured interviews were conducted with providers (N=10) and SMM participants (N=24). The interviews were audio recorded and transcribed verbatim. An applied thematic analysis approach was conducted to create memos, inductively generate a codebook, apply codes to the transcripts, and identify key themes in data. Results: SMM participants discussed three main themes that influence their risk of HIV: coercion, protection and self-preservation, and vulnerability. Coercion describes the display of aggression from a partner for taking PrEP or wearing a condom during intercourse. Protection and self-preservation focused on when participants actively avoided discussing STI testing or HIV to avoid IPV. Vulnerability describes specific instances where participants experienced IPV that put them at immediate risk of acquiring HIV from their partner. Providers’ interviews demonstrated two key themes that provide insight on how patients they see are at risk for acquiring HIV: the role of race/stigma and relationship power dynamics. Stigma and racism can influence victims to remain in abusive relationships or not utilize preventative measures such as PrEP. Relationship power dynamics highlight instances such as financial dependency or controlling behavior where the abuser has the upper-hand. Conclusion: The findings from this study provided insight into the influence of IPV with the uptake of HIV preventative services among SMM and will be used for establishing a cohort of SMM experiencing IPV in a secondary phase of the project.