Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis
Abstract Background Adherence to antiretroviral therapy is crucial for determining health outcomes and secondary HIV transmission among people living with HIV/AIDS. Young men who have sex with men (YMSM) living with HIV are often challenged by the prevailing experiences of psychosocial stressors suc...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22055-1 |
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| author | Doug H. Cheung Alexis N. Reeves Worawalan Waratworawan Yamol Kongjareon Thomas E. Guadamuz |
| author_facet | Doug H. Cheung Alexis N. Reeves Worawalan Waratworawan Yamol Kongjareon Thomas E. Guadamuz |
| author_sort | Doug H. Cheung |
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| description | Abstract Background Adherence to antiretroviral therapy is crucial for determining health outcomes and secondary HIV transmission among people living with HIV/AIDS. Young men who have sex with men (YMSM) living with HIV are often challenged by the prevailing experiences of psychosocial stressors such as intimate partner violence and homophobic bullying, which may negatively affect their HIV care engagement. Methods This study is the first to utilize a prospective cohort design (N = 185) involving YMSM living with HIV in Thailand. We examined the effects of intimate partner violence and homophobic bullying on ART adherence. We also tested the mediating effect of depression on the relationship between intimate partner violence and homophobic bullying and ART adherence. Results We found that intimate partner violence (AOR: 2.58, 95% CI: 1.13, 5.42) and homophobic bullying (AOR: 2.40, 95% CI: 1.26, 4.48) were associated with subsequent ART nonadherence. Moreover, depression partially mediated 17.4% (95% CI: 0.75%–56%) of the effect of homophobic bullying on ART nonadherence. Conclusions The results suggest that tailored interventions to optimize ART adherence should address the impact of intimate partner violence and homophobic bullying among YMSM living with HIV. Screening and subsequent treatment of depression alone may not be sufficient to address the effects of intimate partner violence, homophobic bullying, and possibly other MSM-specific psychosocial stressors on ART adherence. |
| format | Article |
| id | doaj-art-cc0d839018d547d19c2d1b2564ee9bc2 |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| spelling | doaj-art-cc0d839018d547d19c2d1b2564ee9bc22025-08-20T02:10:10ZengBMCBMC Public Health1471-24582025-03-0125111210.1186/s12889-025-22055-1Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysisDoug H. Cheung0Alexis N. Reeves1Worawalan Waratworawan2Yamol Kongjareon3Thomas E. Guadamuz4Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Epidemiology and Population Health, Stanford University School of MedicineMahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol UniversityMahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol UniversityMahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol UniversityAbstract Background Adherence to antiretroviral therapy is crucial for determining health outcomes and secondary HIV transmission among people living with HIV/AIDS. Young men who have sex with men (YMSM) living with HIV are often challenged by the prevailing experiences of psychosocial stressors such as intimate partner violence and homophobic bullying, which may negatively affect their HIV care engagement. Methods This study is the first to utilize a prospective cohort design (N = 185) involving YMSM living with HIV in Thailand. We examined the effects of intimate partner violence and homophobic bullying on ART adherence. We also tested the mediating effect of depression on the relationship between intimate partner violence and homophobic bullying and ART adherence. Results We found that intimate partner violence (AOR: 2.58, 95% CI: 1.13, 5.42) and homophobic bullying (AOR: 2.40, 95% CI: 1.26, 4.48) were associated with subsequent ART nonadherence. Moreover, depression partially mediated 17.4% (95% CI: 0.75%–56%) of the effect of homophobic bullying on ART nonadherence. Conclusions The results suggest that tailored interventions to optimize ART adherence should address the impact of intimate partner violence and homophobic bullying among YMSM living with HIV. Screening and subsequent treatment of depression alone may not be sufficient to address the effects of intimate partner violence, homophobic bullying, and possibly other MSM-specific psychosocial stressors on ART adherence.https://doi.org/10.1186/s12889-025-22055-1HIV/AIDSMen who have sex with menART adherenceVictimizationIntimate partner violenceThailand |
| spellingShingle | Doug H. Cheung Alexis N. Reeves Worawalan Waratworawan Yamol Kongjareon Thomas E. Guadamuz Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis BMC Public Health HIV/AIDS Men who have sex with men ART adherence Victimization Intimate partner violence Thailand |
| title | Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis |
| title_full | Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis |
| title_fullStr | Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis |
| title_full_unstemmed | Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis |
| title_short | Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis |
| title_sort | effects of intimate partner violence and homophobic bullying on art adherence among young thai men who have sex with men a causal mediation analysis |
| topic | HIV/AIDS Men who have sex with men ART adherence Victimization Intimate partner violence Thailand |
| url | https://doi.org/10.1186/s12889-025-22055-1 |
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