HIV / STI
The impact of intimate partner violence and relationship safety on HIV care engagement in GBMSM Alison Walsh* Alison Walsh Erin Kahle
Intimate partner violence (IPV) is known to reduce healthcare utilization, yet its impact on HIV care among gay, bisexual, and other men who have sex with men (GBMSM) remains underexplored. This study examined associations between IPV, relationship safety, and HIV care engagement using baseline data from a cohort of 330 partnered GBMSM (US, 2022-2024). Participants reported demographics, psychosocial factors, viral suppression, and HIV care engagement, defined as attending all scheduled HIV appointments in the past 3 months. IPV over the past 3 months was assessed with the IPV-GBMSM scale; victimization was categorized as experiencing ≥1 of the scale’s 18 items. Participants also indicated whether they felt safe in their relationship. Logistic models evaluated associations between HIV care engagement, IPV, and relationship safety. 90% of participants had attended all recent HIV care appointments. Sample IPV prevalence was 41%, and 7% felt unsafe in their relationship; only 14% of those experiencing IPV reported feeling unsafe. In unadjusted models, the odds of care engagement were 58% lower for those experienced IPV compared to those who had not (95% CI: 0.21-0.87) and 74% lower for those who felt unsafe versus safe (95% CI: 0.10-0.72). After adjusting for demographics, psychosocial and behavioral factors, and viral suppression, experiencing IPV was associated with 72% higher odds of care engagement (95% CI: 0.47-6.22), though this result was not statistically significant. The adjusted odds of care engagement associated with feeling unsafe were 83% lower than the odds associated with feeling safe (95% CI: 0.03-0.96; p = 0.04). These findings emphasize the complex interplay between care engagement, relationship violence, and safety among GBMSM living with HIV and suggest that enhancing feelings of safety, irrespective of IPV, may improve HIV care engagement. Further investigations are needed to understand measured IPV and its incongruency with perceived safety.