Are Partner Race and Intimate Partner Violence Associated with Incident and Newly Diagnosed HIV Infection in African-American Men Who Have Sex with Men?

J Urban Health. 2017 Oct;94(5):666-675. doi: 10.1007/s11524-017-0169-7.

Abstract

Black gay, bisexual, and other men who have sex with men (BMSM) experience a disparate rate of HIV infections among MSM. Previous analyses have determined that STI coinfection and undiagnosed HIV infection partly explain the disparity. However, few studies have analyzed the impact of partner-level variables on HIV incidence among BMSM. Data were analyzed for BMSM who attended the Los Angeles LGBT Center from August 2011 to July 2015 (n = 1974) to identify risk factors for HIV infection. A multivariable logistic regression was used to analyze predictors for HIV prevalence among all individuals at first test (n = 1974; entire sample). A multivariable survival analysis was used to analyze predictors for HIV incidence (n = 936; repeat tester subset). Condomless receptive anal intercourse at last sex, number of sexual partners in the last 30 days, and intimate partner violence (IPV) were significant partner-level predictors of HIV prevalence and incidence. Individuals who reported IPV had 2.39 times higher odds (CI 1.35-4.23) and 3.33 times higher hazard (CI 1.47-7.55) of seroconverting in the prevalence and incidence models, respectively. Reporting Black partners only was associated with increased HIV prevalence, but a statistically significant association was not found with incidence. IPV is an important correlate of both HIV prevalence and incidence in BMSM. Further studies should explore how IPV affects HIV risk trajectories among BMSM. Given that individuals with IPV history may struggle to negotiate safer sex, IPV also warrants consideration as a qualifying criterion among BMSM for pre-exposure prophylaxis (PrEP).

Keywords: Black MSM; HIV; Intimate partner violence; Partner-level factors.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • HIV Infections / diagnosis
  • HIV Infections / ethnology*
  • Homosexuality, Male / statistics & numerical data*
  • Humans
  • Intimate Partner Violence / ethnology*
  • Logistic Models
  • Los Angeles / epidemiology
  • Male
  • Prevalence
  • Risk Factors
  • Sexual Behavior
  • Sexual and Gender Minorities / statistics & numerical data*
  • United States / epidemiology