title: Actor-partner effects associated with experiencing intimate partner violence or coercion among male couples enrolled in an HIV prevention trial.
abstract: BACKGROUND
  Intimate partner violence (IPV) and coercion have been associated with negative health outcomes, including increased HIV risk behaviors, among men who have sex with men (MSM). This is the first study to describe the prevalence and factors associated with experiencing IPV or coercion among US MSM dyads using the actor-partner interdependence model (APIM), an analytic framework to describe interdependent outcomes within dyads.
  
  
  METHODS
  Among MSM couples enrolled as dyads in an HIV prevention randomized controlled trial (RCT), two outcomes are examined in this cross-sectional analysis: 1) the actor experiencing physical or sexual IPV from the study partner in the past 3-months and 2) the actor feeling coerced to participate in the RCT by the study partner. Two multilevel APIM logistic regression models evaluated the association between each outcome and actor, partner, and dyad-level factors.
  
  
  RESULTS
  Of 190 individuals (95 MSM couples), 14 reported experiencing physical or sexual IPV from their study partner in the past 3 months (7.3%) and 12 reported feeling coerced to participate in the RCT by their study partner (6.3%). Results of multivariate APIM analyses indicated that reporting experienced IPV was associated (p < 0.1) with non-Black/African American actor race, lower actor education, and lower partner education. Reporting experienced coercion was associated (p < 0.1) with younger actor age and lower partner education.
  
  
  CONCLUSIONS
  These findings from an HIV prevention RCT for MSM show considerable levels of IPV experienced in the past 3-months and coercion to participate in the research study, indicating the need for screening tools and support services for these behaviors. The identification of factors associated with IPV and coercion demonstrate the importance of considering actor and partner effects, as well as dyadic-level effects, to improve development of screening tools and support services for these outcomes.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, 1518 Clifton Road NE, 4th Floor, Atlanta, GA 30322, Georgia. kmwall@emory.edu.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Wall
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.forename: David
authors.initials: D
authors.lastname: Kleinbaum
authors.forename: Rob
authors.initials: R
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D003068:Coercion; D003430:Cross-Sectional Studies; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012309:Risk-Taking; D012747:Sexual Partners; D013179:Spouse Abuse / Q000517:prevention & control* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires