Intimate Partner Violence Experiences Among Men Who Have Sex with Men Living with HIV in Taiwan

Background and Purpose: Men who have sex with men (MSM) have been disproportionately affected by poor mental health compared to their heterosexual counterparts. One factor that may increase mental health problems among MSM is intimate partner violence (IPV). Despite escalating mental health issues among MSM in Taiwan, little is known about the prevalence and characteristics of types of IPV among this population. To better understand the impact of IPV on MSM living with HIV in Taiwan, the purpose of the present study was (1) to understand the prevalence of IPV, and (2) to examine the relationship between psychosocial factors and IPV victimization, in this population.

Methods: In a cross-sectional study through collaborative partnerships with seven AIDS Services Organizations in Taiwan, 571 MSM living with HIV completed the online survey from December 2021 to April 2022. Informed consent was obtained prior to the survey. Participants completed questions about socio-demographic characteristics and their experience of IPV. The experiences of IPV were assessed with a 7-item scale (yes/no, past 5 years), addressing experiences of physical, emotional, sexual, and financial violence in intimate partner. Other psychosocial factors, such as HIV treatment adherence, methamphetamine use, social service utilization, and social supports from partner and family members, were also examined. Bivariate analyses were computed for each factor. Multivariable logistic regression was conducted with IPV victimization as dependent variable.

Results: The mean age of participants was 36.5 years. The majority of participants were gay-identified (96.1%), had a college degree or higher (76.4%), had a full-time job (81.0%), had a religion (63.0%), were single (60.9%), were living with someone (69.8%), had a good HIV treatment adherence (81.9%). One-fourth (25.8%, n = 147) of participants reported exposure to some form of IPV in the past five years. The prevalence of each category of IPV exposure were: receiving threats of physical harm to themselves (18.6%), being hit (12.5%), being the target of thrown objects (12.4%), having personal items destroyed (11.0%), receiving threats of physical harm to others (10.0%), receiving threats of being “outed” (8.6%), or being forced to have sex (7.0%). Of participants who reported exposure to IPV, one-third of them (n = 51) reported experiencing more than four categories of IPV. Participants who were unemployment (OR = 0.44, 95% CI = 0.25–0.79), having bad HIV treatment adherence (OR = 2.12, 95% CI = 1.17–3.83), using methamphetamine (OR = 1.91, 95% CI = 1.15–3.18), and reported low levels of partner support (OR = 0.49, 95% CI = 0.25–0.96) had significant increased odds to report IPV-exposed.

Conclusions and Implications: Our findings are consistent with previous studies demonstrating that there was an intersection between IPV and HIV infection among MSM in Taiwan. Moreover, our findings indicate that other psychosocial factors were associated with IPV victimization. These results may have implications for social work practice. Sensitizing practitioners with competent case screening for psychosocial factors, such as employment status, methamphetamine use, level of partner support, and HIV treatment adherence may help identify MSM living with HIV who bear high risk of IPV victimization.