Prevalence, Determinants, and Trends in the Experience and Perpetration of Intimate Partner Violence Among a Cohort of Gay, Bisexual, and Other Men Who Have Sex with Men in Montréal, Toronto, and Vancouver, Canada (2017-2022).

Purpose: Longitudinal data on the experience and perpetration of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBM) are limited. We estimated the prevalence of past 6-month (P6M) physical and/or sexual IPV (hereafter IPV) experience and perpetration, identified their determinants, and assessed temporal trends, including the impact of the coronavirus disease (COVID)-19 pandemic. Methods: We used data from the Engage Cohort Study (2017-2022) of GBM recruited using respondent-driven sampling in Montréal, Toronto, and Vancouver. Adjusted prevalence ratios (aPRs) for determinants and self-reported P6M IPV were estimated using generalized estimating equations, accounting for attrition (inverse probability of censoring weights) and relevant covariates. Longitudinal trends of IPV were also assessed. Results: Between 2017 and 2022, 1455 partnered GBM (median age 32 years, 82% gay, and 71% White) had at least one follow-up visit. At baseline, 31% of participants experienced IPV in their lifetime and 17% reported ever perpetrating IPV. During follow-up, IPV experience was more common (6%, 95% confidence interval [CI]: 5%-7%) than perpetration (4%, 95% CI: 3%-5%). Factors associated with P6M IPV experience included prior IPV experience (aPR: 2.68, 95% CI: 1.76-4.08), lower education (aPR: 2.31, 95% CI: 1.32-4.04), and substance use (injection aPR: 5.05, 95% CI: 2.54-10.05, non-injection aPR: 1.68, 95% CI: 1.00-2.82). Similar factors were associated with IPV perpetration. IPV was stable over time; periods of COVID-19 restrictions were not associated with IPV changes in this cohort. Conclusion: Prevalence of IPV was high among GBM. Determinants related to marginalization were associated with an increased risk of IPV. Interventions should address these determinants to reduce IPV and improve health.

Syndemic Factors and Lifetime Bidirectional Intimate Partner Violence Among Gay, Bisexual, and Other Sexual Minority Men.

Purpose: Bidirectional intimate partner violence (IPV), the reporting of both IPV victimization and perpetration, is likely the most common form of violence among gay, bisexual, and other sexual minority men (GBM) and is thought to be part of a larger syndemic of stressors. This purpose of this study was to examine associations between syndemic factors and lifetime bidirectional IPV among GBM in three Canadian cities to inform future interventions. Methods: Data from GBM (N = 2449) were used to fit three logistic regression models with lifetime bidirectional IPV as the outcome and four syndemic factors (i.e., depressive symptomatology, childhood sexual abuse [CSA], illegal drug use, and alcohol misuse) as independent variables. Model 1 examined syndemic factors individually. Model 2 employed a summative scale of syndemic exposure. Model 3 used marginal analysis to examine the relative excess risk of each potential iteration of the syndemic. Results: Thirty-one percent (N = 762) of respondents reported lifetime bidirectional IPV. Each of the syndemic factors were significantly associated with greater odds of reporting bidirectional IPV (Model 1). Model 2 exhibited a dose-response relationship between the number of syndemic factors reported and bidirectional IPV. Model 3 suggested that the specific combination of depressive symptomatology, CSA, and alcohol misuse resulted in the highest risk of lifetime bidirectional IPV. Conclusion: Bidirectional IPV was common in this sample and was associated with a complex interplay of stressors. However, there may be opportunities to target interventions to the specific syndemic issues in an effort to prevent and mitigate this form of IPV in GBM.

Crystal methamphetamine use and bacterial sexually transmitted infections (STIs) among gay, bisexual and other sexual minority men in Canada.

OBJECTIVE: While crystal methamphetamine use by gay, bisexual, and other men who have sex with men (GBM) is associated with increased risk for sexually transmitted infection (STI) transmission, less is understood about the causal pathways between crystal methamphetamine use and STIs. We examined whether the association between greater crystal methamphetamine risk and prevalent bacterial STI diagnosis among GBM was mediated by two types of attitudinal variables: attitudes toward condoms, and sexual escape motives, defined as the use of substances to escape self-awareness during sex, and by sexual behaviors. METHODS: We used computer-assisted self-interview questionnaires from 2449 sexually active GBM (18% living with HIV; median age = 33, interquartile range, 27-45) recruited via respondent-driven sampling in Vancouver, Toronto, and Montreal, Canada. Using the baseline data from the Engage cohort study, we fit a series of structural mediation models of the associations between greater crystal methamphetamine risk and bacterial STI (syphilis, gonorrhea, and chlamydia) diagnosis. We estimated indirect paths from greater crystal methamphetamine risk, attitudes toward condoms, sexual escape motives, and sexual risk behaviors, adjusting for self-reported demographic variables. RESULTS: In the mediated model, the direct association between greater crystal methamphetamine risk and bacterial STI diagnosis was non-significant; however, five indirect paths were significant. Greater crystal methamphetamine risk was associated with bacterial STIs via condom use attitudes and escape motives, which in turn were associated with number of male anal sex partners, condomless anal sex, and oral sex. DISCUSSION: Public health and counselling interventions for GBM who use crystal methamphetamine and who are at higher risk for STIs should target evidence-based causal paths that consider sexual attitudes and sexual practices.

News of Biomedical Advances in HIV: Relationship to Treatment Optimism and Expected Risk Behavior in US MSM.

HIV treatment optimism and the ways in which news of HIV biomedical advances in HIV is presented to the most at-risk communities interact in ways that affect risk behavior and the incidence of HIV. The goal of the current study was to understand the relationships among HIV treatment optimism, knowledge of HIV biomedical advances, and current and expected increased risk behavior as a result of reading hypothetical news stories of further advances. Most of an online-recruited sample of MSM were quite knowledgeable about current biomedical advances. After reading three hypothetical news stories, 15-24% of those not living with HIV and 26-52% of those living with HIV reported their condom use would decrease if the story they read were true. Results suggest the importance of more cautious reporting on HIV biomedical advances, and for targeting individuals with greater treatment optimism and those living with HIV via organizations where they are most likely to receive their information about HIV.

Would You Say You "Had Masturbated" If ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation.

The term masturbation is often not clearly defined despite its prevalent use in sex education, sex research, and clinical settings. The purpose of this study was to understand what behaviors are typically considered to be masturbation as well as the situational and individual variables that may affect the labeling of a behavior as such. An online study of 564 individuals demonstrated that a wide variety of behaviors were considered to be masturbation by a majority of participants. No difference was found between men and women in the total number of behaviors labeled as masturbation. Both men and women were more likely to label a behavior as masturbation (1) if there was no sexual partner present than if there was and (2) if an orgasm occurred than if it did not. In addition, women were more likely than men to label a behavior as masturbation if they were alone and if no orgasm occurred. Younger age was associated with labeling more behaviors as masturbation, but sexual identity, self-pleasuring experience, partnered sexual experience, and attitudes toward masturbation were not related to the number of behaviors labeled as masturbation. Results speak to the importance of behavioral specificity when discussing masturbation with students, clients, and in sex research.