Self-reported intimate partner violence among men who have sex with men at an urban Australian sexual health clinic.

BACKGROUND: In Australia, 17% of women and 6% of men have experienced intimate partner violence (IPV). Although most IPV research has focused on heterosexual partnerships, studies suggest that men who have sex with men (MSM) may experience IPV at similar or higher rates than those documented among women. IPV may also take different forms among MSM and have different health and social impacts. This study aims to assess the utility of a screening tool for identifying and responding to IPV among MSM attending a sexual health clinic in Sydney, Australia. METHODS: Between 1 June 2020 and 30 June 2022, MSM clients were screened using standardised questions to identify IPV experienced within the preceding 12months. Answers to the screening questions were correlated with data collected routinely at the initial clinic visit, including age, employment, country of birth, drug and alcohol use, sexual partner numbers, and any history of sex work, pre-exposure prophylaxis use and HIV status, as well as any bacterial STI diagnosed at the initial visit. RESULTS: There were 2410 eligible clients and of these, 2167 (89.9%) were screened during the study period. A total of 64 men (3.0%) (95% CI 2.3-3.8%) reported experiencing physical violence or intimidation in the past 12months. Controlling for age, men who were born in Australia were 2.03 (95% CI: 1.04-3.01) times more likely to report IPV, and men who had Medicare were 2.43 (95% CI: 0.95-3.90) times more likely to report IPV than those who did not. Those who had ever injected drugs were 5.8 (95% CI: 1.87-9.73) times more likely to report IPV, and men with sexualised drug use were 4.11 (95% CI: 2.03-6.19) times more likely. Those that were employed or studying were 72% (95%CI: 0.13-0.42) less likely to report IPV. CONCLUSIONS: The prevalence of reported IPV in our study was lower than that reported by others, which may be due to differences in recruitment methods and questions asked. Associations between IPV in MSM and injecting drug use and sexualised drug use highlight that clinicians should be aware of the impact and potential for IPV particularly in those with risk factors.

Chemsex questions: what are we actually asking?

Among men who have sex with men (MSM), sexualised drug use (SDU) is related to high risk sexual behaviour and a higher chance of contracting STIs. Chemsex, a subset of SDU, has a particularly high risk factor for STIs. We describe the implementation of a new question about Chemsex for first time clients attending Sydney Sexual Health Centre through a retrospective review of electronic medical records. Between 1 December 2018 and 30 November 2019, 227 MSM reported engaging in 'Chemsex'. 74 respondents (33%) had a specific drug used during sex noted. Of these, the majority (52, 70%; 95% CI 60-81) used a drug commonly associated with Chemsex (crystal methamphetamine, gamma-hydroxybutyrate, or mephedrone), however, a sizeable minority (22, 30%; 95% CI 19-40) only described a drug not commonly associated with Chemsex. The question asked appeared to be more broadly interpreted as SDU. Broad SDU questions, not just questions on Chemsex, may be more appropriate for identifying risk behaviours in MSM in clinical contexts.