Black sexual minority men (SMM) are disproportionately impacted by HIV in the United States. Intimate partner violence (IPV), substance use, and depression are associated with HIV risk behavior such as condomless sex. In this study, we assessed cross-sectional associations between multiple types of IPV victimization and condomless sex with serodiscordant partners. We then evaluated the mediating roles of mental health and substance use, in a sample of 213 Black SMM living with HIV. We used validated scales to assess IPV victimization, depression, post-traumatic stress symptoms, general mental health, and substance use. All independent variables (IPV type) that had at least a marginal ( p < .10) association with the dependent variable (condomless sex with a serodiscordant partner) and any potential mediator were included in mediation models. Mediator role was determined based on a statistically significant outcome ( p < .05) in the mediation model. Physical assault, injury-inducing IPV, and sexual coercion were each positively correlated with condomless sex. Depression, overall mental health, and substance use were associated with physical assault and injury-inducing IPV, and depression was associated with sexual coercion IPV. Both physical assault and injury-inducing IPV were associated with overall mental health, but none of the mental health and substance use measures mediated the associations between IPV and condomless sex. Findings suggest that HIV prevention efforts for Black SMM may need to incorporate IPV screening and prevention services. Further research is needed to understand the psychosocial pathways by which physical forms of IPV relate to condom use.

中文翻译：

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物质使用和心理健康是感染艾滋病毒的黑人性少数男性中亲密伴侣暴力受害与与血清不一致伴侣发生无套性行为之间关联的中介因素

在美国，黑人性少数群体 (SMM) 受到艾滋病毒的影响尤为严重。亲密伴侣暴力 (IPV)、药物滥用和抑郁与无安全套性行为等艾滋病毒风险行为有关。在这项研究中，我们评估了多种类型的 IPV 受害与与血清不一致伴侣的无安全套性行为之间的横断面关联。然后，我们以 213 名感染 HIV 的黑人 SMM 为样本，评估了心理健康和药物滥用的中介作用。我们使用经过验证的量表来评估 IPV 受害情况、抑郁症、创伤后应激症状、一般心理健康和药物滥用。所有与因变量（与血清不一致的伴侣进行无安全套性行为）至少有边际关联（p < .10）的自变量（IPV 类型）以及任何潜在的中介变量均包含在中介模型中。中介角色是根据中介模型中的统计显着结果 (p < .05) 确定的。身体攻击、导致伤害的 IPV 和性胁迫均与无套性行为呈正相关。抑郁症、整体心理健康状况和药物滥用与身体攻击和伤害诱发的 IPV 相关，抑郁症与性胁迫 IPV 相关。身体攻击和伤害诱发的 IPV 均与整体心理健康相关，但没有任何心理健康和药物使用措施能够介导 IPV 与无套性行为之间的关联。研究结果表明，黑人 SMM 的艾滋病毒预防工作可能需要纳入 IPV 筛查和预防服务。需要进一步研究来了解物理形式的 IPV 与安全套使用相关的心理社会途径。