142nd APHA Annual Meeting and Exposition

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311389
Forced sex and HIV infection among men who have sex with men (MSM) in South African townships: A complex relationship

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Farnaz Kaighobadi, PhD , Psychology Program, Bard College, Annandale-on-Hudson, NY
Theo G. M. Sandfort, PhD , Division of Gender, Sexuality, & Health: HIV Center for Clinical & Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
Curtis Dolezal, Ph.D. , HIV Center for Clinical & Behavioral Studies, New York State Psychiatric Institute, New York, NY
Tim Lane, PhD , Department of Medicine, University of California San Francisco, San Francisco, CA
Vasu Reddy , Human and Social development, HSRC, Pretoria, South Africa
Background: Although associations between sexual violence and HIV infection risk have been documented, little is known about this relationship. This study documents an association between sexual violence and HIV infection and psychosocial factors that explain this relationship among MSM in Tshwane, South Africa.

Methods:  Using respondent-driven sampling, 480 participants (18-44 years old) were recruited from Tshwane, South Africa to complete a computer-assisted, interviewer-administered survey and an HIV test.

Results: In this sample, 15% of participants reported to have ever experienced forced sex by a man after the age of 16. Participants with such experiences were more likely to be HIV positive (OR = 4.58, p < .001). Mediation analyses were used to explore the psychosocial factors that were statistically related to both and explain this relationship. Self-reported feminine gender presentation, gay-identity, internalized homophobia, number of lifetime male partners, lifetime transactional sex, and alcohol-use all mediated the relationship between ever forced sex and HIV status. Lifetime number of male partners was the strongest mediator of this relationship (reducing the regression coefficient by .16).

Conclusion: This is the first study to document pathways that link sexual violence and HIV risk among MSM in South Africa. The complexity of the relationship between sexual violence and HIV risk as suggested by the mediation analyses offer a new framework for the design of HIV prevention interventions. Targeting the mediating psychosocial variables that explain the relationship between sexual violence and HIV risk may not only effectively help prevent HIV infection but also reduce sexual violence.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the psychosocial factors that may explain the association between sexual violence and HIV infection risk Discuss the importance of including sexual violence in HIV prevention interventions Describe predictors of experienced forced sex among men who have sex with me in South Africa

Keyword(s): HIV Risk Behavior, Sexual Assault

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Social Psychologist and a Postdoctoral Fellow at the HIV Center for Clinical & Behavioral Studies at Columbia University. My research focus is on the intersections of sexuality, sexual violence and HIV-risk behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.