The Relationship between Intimate Partner Violence, Psychological Distress, and Marijuana Use Among Sexual Minority Men

Background: Sexual minority men (SMM) disproportionately experience intimate partner violence (IPV) compared to heterosexual couples. This stressful situation intersects with the minority stress inevitably faced by SMM, leading to adverse mental and behavioral consequences. However, studies focused on understanding the IPV experiences of SMM and the health consequences of this victimization are quite limited. In addition, most studies rely on IPV measurement tools designed for and validated on heterosexuals. Therefore, this study aims to 1) characterize the IPV experience among SMM, 2) identify the relationship between IPV and marijuana use, and (2) explore the path from SMM’s IPV experience to marijuana use through psychological distress (i.e., social phobia, generalized anxiety).

Methods: This study included 160 sexual minority men who were recruited through geospatial networking applications and who responded to all questions in the study model. IPV experience was measured using the IPV-GBM scale specifically developed for gay and bisexual men. It consisted of 21-item scales with 5 different domains: physical & sexual, monitoring, controlling, HIV-related, and emotional (α=.904). Social Phobia was assessed using the social phobia inventory scale consisted of 17 items (α=.937), and general anxiety was assessed using the generalized anxiety disorder-7 scale (α=.929). Marijuana use was measured with a single item asking frequency of use over the past 30, and transformed into a dichotomous variable due to severe positive skewness. A parallel mediation model was used to test the mediation effect of social phobia and general anxiety on the relationship between IPV victimization and marijuana use. Analysis also accounted for the effect of race, age, education level, household income, employment.

Results: Among participants, 50.6% were White and 36.9% were Black. Their average age was 35.15 years (SD=11.43). Our study confirmed the high experience rate of overall IPV (40%), along with the high rate of the type of IPV specific to SMM (e.g., ask to “act straight”; 23%; not talking about having HIV before sex, 19.4%). Results of our study model identified that the level of IPV experiences is positively associated with social phobia (B=.235, p=.006), general anxiety (B=.134, p<.001), and marijuana use (OR=1.037, 95% CI [1.008, 1.066]). In addition, general anxiety had a significant association with marijuana use (OR=1.110, 95% CI [1.030, 1.197]). The indirect effect of general anxiety on the relationship between IPV and marijuana use was significant (B=.014, 95% CI [.003, .031]).

Conclusion: Our results confirm that IPV is associated with increased odds of marijuana use among SMM. We also found that general anxiety may partially mediate this relationship. While the health consequences of marijuana use are still being investigated, our model focused on this outcome as a type of disengagement coping strategy. Future research should consider other mechanisms by which IPV experiences relate to substance use in SMM.