Young Men’s Relationships: Opportunities for HIV Intervention

Katrina Kubicek
Children’s Hospital Los Angeles
Social and Behavioral Sciences

Research indicates that the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) and young MSM (YMSM) is similar to rates with heterosexual women; however, to date no evidence-based intervention has been developed to address this need. IPV among MSM and YMSM has been linked to sexual risk, substance use, and mental health issues. These relationships are especially alarming as unprotected intercourse is the most common mode of HIV transmission. Additional research to obtain insight into the context of IPV is needed to develop effective HIV prevention interventions for YMSM, a group that accounts for the largest percentage of new HIV infections in the U.S.

The proposed study will address the following research questions: 1) How do YMSM describe relationship dynamics and challenges?; 2) How is power conceptualized in YMSM relationships and what role does it play in IPV? 3) What are the perceived causes for IPV in YMSM relationships?; 4) What are the help-seeking behaviors of YMSM involved in IPV?; 5) In what contexts do alcohol or other drugs play a role in IPV?; 6) To what extent and in what contexts does IPV influence sexual decision- making?; and 7) What are intervention opportunities to reduce IPV and HIV risk among YMSM? 

To answer these questions, we will focus on the following specific aims: 1. Characterize relationship dynamics among an ethnically diverse sample of YMSM to better understand underlying issues related to IPV (e.g., gender roles, power, internalized homophobia, conflict resolution); 2. Explore HIV risk and protective factors in the context of IPV, such as sexual decision-making processes and substance use; 3. Refine a conceptual model that delineates factors influencing IPV among YMSM and the relationship of those factors to HIV-risk behaviors; and 4.Use community participatory research techniques to work with community members in identifying possible IPV intervention strategies to reduce IPV among YMSM.

These aims will be accomplished through two phases of research.  In  Phase 1, we will recruit up to 120 YMSM of the four largest ethnic/racial groups in Los Angeles (i.e., Latino/Hispanic, African American, White/Caucasian, Asian) to participate in 12 focus groups. Using open-ended questions and vignette research, focus groups will be conducted to address Aim 1. Participants will also complete a short survey (e.g., demographics, correlates of IPV, involvement in IPV, HIV-risk behaviors). During Phase 2, we will recruit participants reporting prior or current involvement in IPV (based on survey responses) to complete qualitative interviews to address Aim 2. These will include couple interviews (n=20-25 dyads) for YMSM reporting current involvement in IPV (their current partners will also be recruited) and YMSM who report a history of IPV but are no longer involved in IPV (n=15-20). Data from both phases will be used to refine a conceptual model as described in Aim 3. To address Aim 4, we will convene community and youth advisory boards to participate in the design of data collection instruments, data interpretation, and identification of intervention strategies and opportunities.

The goals of this study are to obtain a better understanding of the context and correlates of IPV among YMSM. After completing this project, we will submit an intervention research application to NIH to develop/adapt and pilot test a culturally and developmentally appropriate prevention intervention for YMSM in Los Angeles.