Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Addressing Intimate Partner Violence, Drug Use, and HIV Among Men in Drug Treatment

The Temporal Relationships Between Partner Violence and HIV Risk Among Drug-Involved Men

Background: Accumulating evidence over the past decade indicates that IPV is associated with a number of sexual HIV risk factors among drug-involved women, including: inconsistent condom use, sexually transmitted infections (STIs), sex with multiple partners, and sex with a risky partner. To date, research on the relationship between perpetrating intimate partner violence (IPV) and sexual HIV risk behaviors among drug-involved men remains scarce. The purpose of this NIDA-funded, longitudinal study was to examine the temporal relationships between perpetrating IPV and sexual HIV risk factors among a random sample of 356 men in methadone maintenance treatment programs (MMTPs) in Harlem, who reported having had sex with a female intimate partner in the past 6 months. This study tested two hypotheses: (H1) engaging in sexual HIV risk behaviors is associated with subsequent greater likelihood of perpetrating physical and/or sexual IPV and (H2) perpetrating physical and/or sexual IPV is associated with subsequent greater likelihood of engaging in sexual HIV risk behaviors. Methods: Participants were assessed at three waves: baseline, 6 months and 12 months. Retention rates for the 6 and 12-month follow-up assessments were 81% and 79% respectively. IPV was measured by the Revised Conflict Tactics Scales. Multiple imputation was used for handling missing data. Propensity score matching and multiple logistic regression were employed for analyzing data. Results: Participants were predominantly Latino (45%) and African American (37%). The average age of participants was 43.6 years. Less than one-third of the men were married. In the 6 months prior to baseline, nearly three-quarters (72%) reported illicit drug use and 41% reported perpetrating physical and/or sexual IPV. Almost half of the sample (45%) reported never using a condom with their intimate partner(s) in the past 6 months and about one-tenth reported having had concurrent intimate partners. With respect to H1, findings indicate that after matching and controlling for age, ethnicity, education, homelessness, marital status, income and depression, men who self-reported STIs at baseline were 2.6 times (CI=2.0-3.6) more likely than men without self-reported STIs to indicate perpetrating IPV at waves 2 and 3. Increased risk of perpetrating IPV at wave 2 and 3 was also found for men who reported having had sex with an HIV positive partner at baseline (OR=2.3, CI=1.9-2.9), sex with multiple partners (OR=2.3, CI=1.8-3.0) and inconsistent condom use (OR=1.6, CI=1.1-2.4). With respect to H2, perpetrating IPV at baseline increased the subsequent risk of having sex with multiple partners (OR=2.7, CI=2.1-3.5) and having sex with an HIV positive partner (OR=1.4, CI=1.2-1.8) at wave 2 and wave 3, after matching and controlling for the same variables. Conclusion: The multiple causal associations between perpetrating IPV and engaging in sexual HIV risk found among this random sample of men in MMTPs highlight the need for effective intervention models that may best address the co-occurring problems of IPV and HIV/STI risk in this population. MMTPs may be an ideal setting to launch IPV and HIV/STI prevention interventions for men and their female intimate partners, who are affected by these co-occurring problems.

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