title: Prevalence, clinical associations, and impact of intimate partner violence among HIV-infected gay and bisexual men: a population-based study.
abstract: OBJECTIVE
  Intimate partner violence (IPV) is a risk factor for HIV infection. Little is known, however, about the prevalence, clinical associations, and impact of IPV among patients living with HIV.
  
  
  METHODS
  HIV-infected gay and bisexual men in Southern Alberta, Canada were screened for IPV between May 2009 and December 2011. The associations with IPV of sociodemographic factors, psychological factors, clinical status, and HIV-related and HIV-unrelated hospitalizations, data for which were obtained from a regional database, were evaluated using Poisson regression.
  
  
  RESULTS
  Of 687 gay and bisexual patients, 22.4% had experienced one or several types of IPV. Patients disclosing IPV were more likely to be Aboriginal [adjusted prevalence ratio (APR) = 2.48; 95% confidence interval (CI) 1.18-5.20], to be younger (APR/year = 0.97; 95% CI 0.95-0.99), to be victims of childhood abuse (APR = 4.27; 95% CI 2.84-6.41), to be smokers (APR = 2.53; 95% CI 1.59-4.00), to have had depression prior to HIV diagnosis (APR = 1.87; 95% CI 1.10-3.16), to use ongoing psychiatric resources (APR = 3.53; 95% CI 2.05-6.10), to have recently participated in unprotected sex (APR = 2.29; 95% CI 1.10-4.77), and to have poor or fair vs. very good or excellent health-related quality of life (APR = 2.91; 95% CI 1.57-5.39). IPV was also associated with a higher rate of clinically relevant interruptions in care (APR = 1.95; 95% CI 1.23-3.08), a higher incidence of AIDS among patients presenting early to care (CD4 count ≥ 200 cells/μL; APR = 2.06; 95% CI 1.15-3.69), and an increased rate of HIV-related hospitalizations [relative risk (RR) = 1.55; 95% CI 0.99-2.33], especially after HIV diagnosis was established (RR = 2.46; 95% CI 1.51-3.99).
  
  
  CONCLUSIONS
  The prevalence of IPV is high among HIV-infected gay and bisexual men and is associated with poor social, psychiatric, and medical outcomes. IPV is an under-recognized social determinant of health in this community that may be amenable to meaningful clinical interventions.
authors.affiliation: Southern Alberta HIV Program, Calgary, AB, Canada.
authors.forename: R A C
authors.initials: RA
authors.lastname: Siemieniuk
authors.forename: P
authors.initials: P
authors.lastname: Miller
authors.forename: K
authors.initials: K
authors.lastname: Woodman
authors.forename: K
authors.initials: K
authors.lastname: Ko
authors.forename: H B
authors.initials: HB
authors.lastname: Krentz
authors.forename: M J
authors.initials: MJ
authors.lastname: Gill
mesh_terms: D000328:Adult; D000416:Alberta / Q000453:epidemiology; D044467:American Indian or Alaska Native / Q000208:ethnology; D001727:Bisexuality; D044383:Black People / Q000208:ethnology; D018791:CD4 Lymphocyte Count; D002170:Canada; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D018451:Homosexuality, Male; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology / Q000517:prevention & control / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D047568:Unsafe Sex; D044465:White People / Q000208:ethnology; D016903:Drug Monitoring