Physical and Sexual Violence and Sexual Behaviors Among Men Who Have Sex with Men in 22 U.S. Cities—National HIV Behavioral Surveillance,2017

Abstract

National prevalence of physical and sexual violence and its relationship to sexual behaviors are unknown among men who have sex with men (MSM). We estimated 12-month prevalence of physical and sexual violence and assessed relationships between violence and sexual behaviors among MSM. Data were obtained from National HIV Behavioral Surveillance 2017 that used time-space sampling methods to recruit and interview MSM in 22 U.S. cities. Weighted percentages with 95% confidence intervals (CI) were reported. Adjusted prevalence ratios (aPR) and 95% CIs were calculated using logistic regression with predicted marginal means. Overall, 10.2% (95% CI: 9.3%–11.2%) of MSM experienced physical violence only, 3.2% (95% CI: 2.7%–3.7%) experienced sexual violence only, and 2.3% (95% CI: 1.9%–2.7%) experienced both types of violence, in the past 12 months. Compared to MSM who did not experience violence, those who did reported higher percentages of unemployment, poverty, homelessness, same-sex discrimination, non-injection drug use, and binge drinking. Violence was not independently associated with condomless anal sex among MSM. MSM who experienced both types of violence were more likely than those who did not experience violence to have had four or more male sex partners (aPR=1.18, 95% CI: 1.02–1.37). MSM who experienced both types of violence (aPR=2.49, 95% CI: 1.52–4.09), sexual violence (aPR=2.27, 95% CI: 1.47–3.52), or physical violence (aPR=1.76, 95% CI: 1.27–2.44) were more likely than those who did not experience violence to have had exchange sex. Recent physical violence and sexual violence are common among MSM. Findings highlight the importance of violence screening and suggest the need for tailored interventions that improve the safety and economic security of MSM who experience violence, including those who exchange sex.