Young Men Who Have Sex With Men's Experiences With Intimate Partner Violence

584011
research-article2015
JARXXX10.1177/0743558415584011Journal of Adolescent ResearchKubicek et al.
Article
Journal of Adolescent Research
2016, Vol. 31(2) 143175
Young Men Who The Author(s) 2015
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DOI: 10.1177/0743558415584011
Experiences With jar.sagepub.com
Intimate Partner
Violence
Katrina Kubicek1, Miles McNeeley1,

and Shardae Collins1
Abstract
Research estimating the prevalence of intimate partner violence (IPV) among
men who have sex with men (MSM) and other sexual minority populations
is limited. However, existing research indicates rates similar to heterosexual
women. This mixed-methods study was designed to inform intervention
development and provides a description of the types of IPV experienced
by young MSM (YMSM) within their dating and intimate relationships.
Data collected include 101 surveys with YMSM aged 18 to 25 and 26
semi-structured qualitative interviews. YMSM experienced high levels of
psychological aggression, physical assault, and sexual coercion both as
victims and perpetrators. The study also found that there were high rates of
mutual perpetration, young men reporting being both victim and perpetrator
of partner violence. Qualitative data provide context and descriptions of
these incidents to provide more information about the circumstances and
perceptions of these incidents. The findings indicate that interventions
should be multifaceted and include schools, communities, and families to
1Childrens Hospital Los Angeles, CA, USA
Corresponding Author:
Katrina Kubicek, Community, Health Outcomes and Intervention Research Program, The
Saban Research Institute, Childrens Hospital Los Angeles, MS#30, Los Angeles, CA 90027,
USA.
Email: kkubicek@chla.usc.edu
Downloaded from jar.sagepub.com at GEORGE WASHINGTON UNIVERSITY on April 4, 2016

144 Journal of Adolescent Research 31(2)
address anger management, conflict resolution, and communication skills

within young mens relationships.
Keywords
intimate partner violence, gay/homosexual, young men who have sex with
men, mixed methods
Intimate partner violence (IPV) is a term used to describe violence within

romantic or intimate relationships. When defined broadly, IPV includes dif-
ferent types of violence that may occur including physical, emotional, psy-
chological, and sexual aggression or violence (Talley, Sher, & Littlefield,
2010). Although the broader term of IPV was developed to be more inclusive
of different types of relationships, historically, research investigating the cor-
relates and outcomes of IPV has largely focused on situations that include a
male perpetrator and female victim (Lawson, 2003; Letelllier, 1994). More
recently, more attention has been paid to IPV that occurs within men who
have sex with men (MSM) and other same-sex relationships (Finneran &
Stephenson, 2013). While there is a growing body of research focused on this
area, much of the research has been hampered by lack of uniformity in defin-
ing IPV and a focus on childhood sexual abuse rather than IPV among MSM
(Stephenson, Khosropour, & Sullivan, 2010).
Public health interventions reflect these challenges. While there have been
a number of prevention and intervention efforts to address IPV among het-
erosexual men and women in the United States (Garofalo, Wolf, Wissow,
Woods, & Goodman, 1999; Marshal et al., 2008), no prevention intervention
has been developed for MSM or other sexual minority groups. In order to
develop effective interventions that can address this serious public health
issue, there are still a number of gaps in the literature that need to be filled
with regard to our knowledge base around IPV among MSM. This mixed-
methods study was designed to provide a basis for such an intervention by
providing a description of the types of IPV experienced by young MSM
(YMSM) within their dating and intimate relationships.
Emerging Adulthood and Young Men Who Have

Sex With Men
The body of research exploring IPV within same-sex relationships has largely
focused on lesbian relationships compared with MSM (Stephenson et al.,
2010). The research that does exist for MSM has included primarily adult

Kubicek et al. 145
MSM rather than YMSM, a distinct group comprised of men aged 18 to 25

(Finneran & Stephenson, 2013). This time period, called emerging adult-
hood, warrants special attention. Distinct from adolescence, emerging adult-
hood is a time of greater independence when young people may explore
different life goals and opportunities in school, work, and peer and romantic
relationships (Arnett, 2000). The focus during this period is often on self-
development, self-sufficiency, and greater independence from parents and
other family members (Arnett, 1998). The desire for exploration, experimen-
tation, and greater independence may also contribute to the increased fre-
quency of risk behaviors such as alcohol and drug use/misuse during this
developmental period (Arnett, 2005; Bachman, Wadsworth, OMalley,
Johnston, & Schulenberg, 1997; Tucker, Ellickson, Orlando, Martino, &
Klein, 2005).
Emerging adulthood is also when YMSM may first begin to explore and
define intimate relationships. This time period may be critical for understand-
ing IPV in these relationships; as YMSM begin to identify relationship
expectations and desires, we have an excellent opportunity to help them rec-
ognize aspects of unhealthy relationships and cultivate stronger communica-
tion and coping skills for the development of healthy intimate relationships.
Intimate Partner Violence Among Sexual Minority

Emerging Adults
Research designed to better understand IPV among YMSM and other sexual
minority groups is still in its infancy. However, some studies including an
analysis with the Youth Risk Behavior Survey, which collected data with high
school and young adult populations identifying as both heterosexual and
non-heterosexual, have found that individuals who identify as a sexual
minority may be at increased risk for dating violence compared with their
heterosexual peers (Morse, 1995; Sorenson, Upchurch, & Shen, 1996; Tharp,
Feijun, & Stone, 2013). While different theories such as feminist and disem-
powerment theories have been used to partially explain this phenomenon
(Letelllier, 1994; McKenry, Serovich, Mason, & Mosack, 2002), there are
still many gaps in our knowledge. To date, factors related to minority stress
(e.g., internalized homophobia, victimization) have been linked to IPV
behaviors among sexual minority youthboth men and women (Lewis,
Milletich, Kelley, & Woody, 2012). Minority stress is defined as both distal
and proximal stressors experienced due to the discrimination and prejudice of
stigmatized minority groups such as YMSM. Meyer (2003) defines minority
stress along a continuum from distal stressorsgenerally seen as objective

events and conditionsto proximal processes which are subjective as they

rely on the appraisal and perceptions of the individual. For example, distal
social attitudes such as homophobic policies and attitudes gain psychological
importance through individuals appraisals and become proximal concepts
with psychological importance to the individual.
In a study of sexual minority college students, of which 49% identified as
men, 44% women, 5% genderqueer, and 2% transgender, Edwards and
Sylaska (2013) found that perpetration of sexual and physical dating violence
was related to internalized homophobia, an important variable in minority
stress theory. Similar results have been found with adult lesbian and gay male
populations (Balsam & Szymanski, 2005; McKenry et al., 2002). One recent
study explored the correlates of involvement in IPV among MSM (Stephenson,
Sato, & Finneran, 2013). These results highlight the potential role of minority
stress factors in IPV as they found that men in ethnic discordant partnerships
were more likely to report perpetration of IPV as were men who were unem-
ployed. These factors indicate that individuals facing more financial stress
and those potentially facing racism and/or increased levels of homophobia
may be at greater risk for IPV.
A qualitative study with college-aged sexual minority men and women
found that participants perceived that societal and internalized homophobia
influenced IPV (Gillum & DiFulvio, 2012). A recent qualitative study with
YMSM found that young men felt that societal discrimination including mar-
riage laws and stereotypes of MSM contributed to stress in their relation-
ships. They also described instances in which gay people in general are
conditioned into needing to defend themselves due to homophobia and hate
crimes in their communities (Kubicek, McNeeley, & Collins, 2015). As we
learn more about the phenomenon of IPV among sexual minority groups, it
seems clear that issues related to internalized homophobia and societal pres-
sures play a role in its perpetration. Theories including minority stress and
intersectionality should be further explored and rigorously validated to pro-
vide a stronger foundation for intervention programs
Intimate Partner Violence Among Men Who Have

Sex With Men
These issues of internalized homophobia and discrimination are found across
sexual minority populations; for the purposes of this article, we want to further
examine IPV among YMSM specifically. Similar to what is found among
sexual minority populations more generally, research estimating the preva-
lence of IPV in adult MSM relationships indicates rates similar to heterosex-
ual women, ranging from 12% to 78%, depending on type of abuse, whether

Kubicek et al. 147
one is the victim or perpetrator of violence, sampling techniques, and mea-

surement of IPV (Finneran & Stephenson, 2013; Greenwood et al., 2002;
Houston & McKirnan, 2007; Nieves-Rosa, Carballo-Dieguez, & Dolezal,
2000; Pantalone, Schneider, Valentine, & Simoni, 2012; Tjaden, Thoennes,
& Allison, 1999; Waldner-Haugrud, Gratch, & Magruder, 1997; Waterman,
Dawson, & Bologna, 1989). Additionally, a recent study using the popula-
tion-based California Health Interview Survey found that lifetime and 1-year
IPV prevalence was higher among gay men compared with heterosexual indi-
viduals (Goldberg & Meyer, 2013). Similarly, a recent systematic literature
review identified 28 studies that describe IPV in MSM relationships, all of
which document rates that were similar to or higher than rates of heterosexual
women (Finneran & Stephenson, 2013).
Among younger populations, the research also indicates that YMSM
experience IPV at rates similar to those of heterosexual females (Freedner,
Freed, Yang, & Ausin, 2002; Halpern, Young, Waller, Martin, & Kupper,
2004). One study with YMSM found that as much as 41% of YMSM experi-
ence emotional abuse, 23% experience physical abuse, 18% experience sex-
ual abuse, and 12% perpetrate physical violence within their intimate
relationships (Wong, Weiss, Ayala, & Kipke, 2010). This study further found
that YMSM who were victims of physical abuse were more likely to report
recent drug use and symptoms of depression, which in turn was related to
unprotected anal intercourse, the most common mode of HIV transmission.
A recent qualitative study exploring how power is both conceptualized
and related to involvement in IPV among YMSM found that societal oppres-
sion as well as internalized homophobia and shame were perceived to influ-
ence both perpetration and victimization of IPV (Kubicek et al., 2015). In
addition, there is evidence that the syndemic described for older MSM
which posits that the additive effects of psychosocial health problems, such
as depression, IPV, drug use, and childhood sexual abuse, increase ones vul-
nerability for HIV/AIDSis also relevant for YMSM (Mustanski, Garofalo,
Herrick, & Donenberg, 2007; Stall et al., 2003). While IPV has long been
recognized as a public health issue among heterosexual couples, the contexts
of the underlying psychosocial issues of IPV among YMSM and other sexual
minority groups remain largely unexplored.
The current study is the first to take a mixed-methods approach to describ-
ing IPV among YMSM. This approach is important as quantitative data pro-
vide an opportunity to identify the frequency of and relationships between
different behaviors, while qualitative data have the potential to more fully
describe the contexts and experiences of IPV. These descriptions and contexts
are essential in order to develop more uniform definitions of IPV among
YMSM as well as develop and test appropriate prevention programs. Thus,

the research questions that will be addressed in this study include the follow-
ing: (a) What types of IPV do YMSM experience both as perpetrators and
victims, (b) how do YMSM describe these experiences of IPV?, and (c) to
what extent do the qualitative results provide insights into the quantitative
data?
Method
The Young Mens Relationships (YMR) Study consisted of a formative phase
of research and two phases of data collection that were completed between
March and December 2012 in Los Angeles, California. The study used a vari-
ant of the explanatory mixed-methods research design, focusing on the par-
ticipant selection model. This variant is used when one requires quantitative
data to identify and purposefully select participants for a follow-up, in-depth
qualitative study (Creswell & Plano Clark, 2007).
The formative phase included the facilitation of 11 focus groups with 86
total participants. To qualify to participate, a participant needed (a) to be 18
to 25 years of age, (b) to be male, (c) to identify as gay/bisexual or report
having sex with a man, and (d) to have been in a primary partner relation-
ship1 with another man within the past 12 months. Participants were recruited
using purposive sampling techniques from gay-identified venues including
service agencies, bars, clubs, and community events. More information on
the recruitment of the sample can be found in other publications (Kubicek
et al., 2015).2
Phase 1: Quantitative Methods and Measures

Following each focus group, participants completed a brief computer-
assisted, self-interviewing survey consisting of demographic items, sexual
behavior, substance use, sexual identity and attraction, experiences of racism
and homophobia, substance use, and a partner violence scale (Revised
Conflict Tactics Scale or [CTS2]; Straus, Hamby, Boney-McCoy, &
Sugarman, 1996). A total of 101 surveys were completed. Respondents were
provided a $50 incentive for completing the focus group and survey.3
The CTS2 was designed to measure concrete acts and events of IPV. The
CTS2 measures the behavior of both the respondent and the respondents
partner on different types of IPV including subscales that tap into psychologi-
cal aggression (8 items), physical assault (12 items), injury (6 items), and
sexual coercion (7 items). For example, one item in the physical assault scale
to assess perpetration is as follows: I grabbed my partner. To assess behav-
iors that the respondent has received, this is then followed by the follow-
ing: My partner did this to me (Straus et al., 1996).

Kubicek et al. 149
Respondents were asked whether each individual behavior occurred in the

last year and how often each behavior occurred on a 7-point scale: (0 times,
1 time, 2 times, 3-5 times, 6-10 times, 11-20 times, more than 20 times).
Based on the standard scoring method for the CTS2, a prevalence score was
obtained by creating a dichotomous variable for each behavior to assess
whether it occurred in the past year where a score of 1 is assigned if the
behavior occurred at least once. A chronicity score for each subscale was also
obtained to estimate how often these types of violence occur in YMSMs
intimate relationships. This is calculated to account for the potential skewed
distribution of assaults among couples. Chronicity is scored using the mid-
points for responses categories. Midpoints are the same as the response cat-
egory numbers for Categories 0, 1, and 2. For Category 3 (3-5 times) the
midpoint is 4; for Category 4 (6-10 times) the midpoint is 8; for Category 5
(11-20 times) the midpoint is 15; and for Category 6 (more than 20 times) the
recommended midpoint is 25 (Straus et al., 1996).
Phase 2: Qualitative Methods and Measures

Phase 2 consisted of 26 semi-structured qualitative interviews to better under-
stand the experiences of young men who have been involved in partner vio-
lence. Phase 2 participants were recruited based on responses to key survey
items. When completing the quantitative survey, if a respondent reported that
he had experienced physical partner violence (as assessed by the CTS), but
was not in a current relationship, a programmed message appeared on the
computer screen explaining that he was eligible for an additional part of the
study. Participants who were currently in a verbally or emotionally abusive
relationship were also eligible to participate in the interview. The exclusion
of participants who were currently in physically violent relationships was
made for participant safety considerations. Project team members explained
the individual interview to the participant, and if he was interested, a qualita-
tive interview was scheduled.
The interview discussion guide was designed to obtain in-depth data on
the following factors: (a) the history and onset of IPV and other violence in
their lives (e.g., how many different partners/relationships; contexts in which
fights occur; escalation of violence), and (b) the perceived causes of IPV in
YMSM relationships (e.g., types of things cause conflict most often; conflict
resolution techniques). These broad questions were then explored with indi-
vidual respondents to better understand each scenario and its impact on the
respondent.
Each interview lasted 1 to 2 hours (average length of about 2 hours)
and was digitally recorded and professionally transcribed. All interviews

were conducted in the project offices or a location convenient to the respon-

dent (e.g., cafe, park). Respondents were provided a $35 incentive for com-
pleting the Phase 2 interview. All study procedures were approved by the
Institutional Review Board at Childrens Hospital Los Angeles.
Analysis
Quantitative analysis.Statistical analyses were conducted using SPSS 19.
Because the current study is largely descriptive, results presented are based
on univariate analyses of key variables of interest. Results from frequency
analyses characterized key demographics (e.g., age, ethnicity, employment)
of the study sample. The CTS2 was scored as described above and frequency,
means, and standard deviations were calculated for each item.
Table 1 presents demographic information for the study sample. The mean
age was 21.5 years. A quarter identified as African American/Black, 35% as
Latino/Hispanic, 15% as White/Caucasian, 7% as Asian/Pacific Islander, and
19% identified with more than one race/ethnicity. About half of the respon-
dents (47%) reported living at home with family members. About a third
(34%) reported being in school and being employed; about 16% were neither
in school nor employed. Most (72%) identified as gay or some other same-
sex identity with an additional 27% identifying as bisexual. A little less than
half (43%) had not run out of money for basic needs in the past 3 months,
indicating some level of financial stability.
Qualitative analysis.Transcripts for each of the individual interviews were

included in the qualitative analysis for this article. The qualitative analysis for
this article utilized a constant comparative approach, an aspect of grounded
theory that entails the simultaneous process of data collection, analysis, and
description. In this process, data are analyzed for patterns and themes to dis-
cover the most salient categories, as well as any emergent theoretical implica-
tions (Strauss & Corbin, 1990). As the data are collected, they are immediately
analyzed for patterns and themes, with a primary objective of discovering
theory implicit in the data. Interview transcripts were included in the analy-
sis. Atlas.ti was used for coding and analysis of relationships between and
within text segments.
Members of the research team, including the principal investigator and
individuals who were involved in the recruitment and data collection for this
study, reviewed an initial sample of 10% of the transcripts to identify key
themes, which formed the basis of the project codebook. Codes focusing on
a range of topics were identified and defined based on the key constructs
included in the discussion guide and an initial conceptual model that guided

Kubicek et al. 151
Table 1. Sample Demographics (N = 101).
Total sample (N = 101)
M (SD)
Age
Range [18, 25] 21.46 (6.16)
n (%)
Age category
18-20 years 39 (39)
21-23 years 38 (38)
23-25 years 24 (24)
Primary ethnicity
Asian/Asian American/Pacific Islander 7 (7)
Black/African American 25 (25)
Latino/Hispanic 35 (35)
White/Caucasian 15 (15)
Multiethnic 19 (19)
Residential status
Family 47 (47)
Own place/apartment 26 (26)
Friends/partner place 18 (18)
No regular place/other 10 (10)
School/work combined
In school 23 (23)
In school, employed 34 (34)
Employed 28 (28)
Not in school, not employed 16 (16)
Sexual identity
Gay/other same sex 72 (72)
Bisexual 27 (27)
Attraction
Men only 69 (69)
Men and women 30 (30)
Women only 1 (1)
Neither/dont know 1 (1)
How often did you run out of money for basic needs in past 3 months
Not at all 43 (43)
About once a month 27 (27)
1-3 times a month 14 (14)
Once a week or more 16 (16)

the work. The codebook was modified as needed, and once finalized, three
members of the research team were responsible for coding the interviews. A
total of 42 codes were developed and defined. To establish the coding system,
15% of the transcripts were double-coded. Differences in coding were dis-
cussed and resolved by the team.
The open coding process included identifying text segments that matched
the predefined codes (e.g., physical violence, sexual violence, and emotional
violence) as well as adding to and refining codes based on the data. These
codes were then imported into network maps that helped the team visualize
the relationships between codes and text segments. For this article, the team
pulled codes related to different types of violence (e.g., emotional violence,
respondent as victim, respondent as perpetrator, physical violence, sexual
coercion), experiences of IPV (e.g., onset of IPV, emotional reaction to IPV,
sources of conflict), relationship characteristics (e.g., relationship back-
ground, cycle of violence), and codes related to attitudes toward violence
(e.g., definition of IPV, attitudes) to include in the current analysis. This pro-
cess led to the structure of the present study, which provides data on the
prevalence of different types of IPV within this sample as well as qualitative
descriptions of each type of violence.
Results
Psychological Aggression/Verbal Abuse
Quantitative results. As shown in Table 2, respondents reported a variety of
different types of verbal abuse or psychological aggression. The most com-
mon of these behaviors were shouting at ones partner (71% as a perpetrator,
77% as a victim), insulting or swearing (66% as perpetrator, 71% as victim),
and doing something to spite ones partner (52% as perpetrator, 55% as vic-
tim). When examining mutual perpetrationthat is the respondent reported
being both a victim and a perpetrator of a specific behaviorthe same behav-
iors were the most common, with 65% reporting being both victim and per-
petrator of insulting or swearing, 69% shouting, and 44% doing something to
spite their partner (or vice versa). Table 3 presents data on the chronicity of
violence using CTS2 subscales. On average, respondents reported perpetrat-
ing about 27 acts of psychological aggression (SD = 35.4) and being the
recipient of about 29 acts (SD = 36.3) in the past year.
Qualitative results.Qualitative data provide additional information on the

context in which these behaviors occur and how young men describe these
experiences. When asked to define domestic violence or IPV, respondents

Kubicek et al. 153
Table 2. Revised Conflict Tactics ScalePast Year Prevalence (N = 101).
Prevalence (any instance)
Perpetrator Victim Mutual

Psychological aggression 84% 86%
1. Insulted or swore at partner 66% 71% 65%
2. Shouted at partner 71% 77% 69%
3. Stomped out of room 51% 51% 18%
4. Threatened to hit or throw something at 28% 23% 25%
partner
5. Destroyed something of partners 29% 32% 44%
6. Did something to spite partner 52% 55% 10%
7. Called partner fat or ugly 19% 15% 17%
8. Accused partner of being a lousy lover 30% 23% 30%
Physical assault 66% 67%
1. Kicked, bit, or punched partner 25% 18% 18%
2. Slapped partner 29% 27% 23%
3. Beat up partner 12% 12% 9%
4. Hit partner with something that could hurt 20% 19% 15%
5. Choked partner 15% 19% 13%
6. Slammed partner against wall 22% 30% 21%
7. Grabbed partner 42% 45% 38%
8. Threw something at partner that could hurt 31% 24% 22%
9. Used knife or gun on partner 4% 5% 3%
10. Pushed or shoved partner 43% 37% 36%
11. Twisted partners arm or hair 21% 17% 16%
12. Burned or scalded partner on purpose 7% 8% 7%
Sexual coercion 58% 64%
1. Used force to make partner have sex 5% 6% 5%
2. Used threats to make partner have anal/oral 4% 5% 3%
sex
3. Used force to make partner have anal/oral 6% 8% 6%
sex
4. Insisted on anal/oral sex (no force) 35% 35% 26%
5. Used threats to make partner have sex 4% 5% 3%
6. Insisted on sex (no force) 28% 38% 23%
7. Insisted on sex without a condom (no force) 29% 37% 28%
Injury 24% 27%
1. Passed out from fight 5% 7% 4%
2. Went to doctor for injury 7% 9% 6%
3. Needed to see doctor but didnt 6% 7% 4%
4. Felt pain the next day 14% 15% 12%
5. Sprain or bruise from fight that you could see 21% 22% 18%
6. Broken bone from fight 4% 7% 4%

Table 3. Past Year Chronicity of IPV: Revised Conflict Tactics Scale Subscale
(N = 101).
Perpetrator Victim
Minimum, Minimum,
Type of violence M (SD) Maximum M (SD) Maximum
Psychological aggression 27.24 (35.37) 0, 160 29.17 (36.29) 0, 175
Physical assault 16.47 (27.71) 0, 152 16.07 (28.96) 0, 181
Sexual coercion 10.66 (15.20) 0, 84 10.93 (18.69) 0, 110
Injury 3.33 (8.89) 0, 68 3.95 (11.81) 0, 72
Note. IPV = intimate partner violence.
generally described situations of physical violence; only when prompted did

young men mention verbal abuse being included in their definition. After
considering it, one young man stated that when a bruise is gone, you almost
forget it was ever there. But once someone cuts you emotionally with words,
its kind of like, it takes on another level. Young men described scenarios in
which their partners called them ugly, stupid, youre never going to find
anybody better than me, destroyed their cell phones, or made them feel like
I am fucking worthless.
He would just be mean to me maybe like about image things, I wasnt attractive
. . . I wasnt smart enough, like that I couldnt understand some of these issues
and emotions that I had because I wasnt smart enough. And then when he was
just getting mad he would just throw it all out, like he would combine it, hell
like breakdown my character and make it so negative. Hes like, I dont even
know why Im with you and stuff like that.
Generally, the data indicate that these types of verbal abusive behaviors
occur relatively early on in YMSMs relationships (within the first couple of
months) and are typically a precursor to other forms of IPV. Young men usu-
ally described a trajectory where they spent time getting to know their part-
ners. After this initial period (which could be anywhere from a couple of
weeks to a few months), some of these verbal and emotionally aggressive
behaviors may appear.
For some young men, these early relationships were opportunities to share
troubling or difficult situations they experienced with their family; for many,
this was the first time they had an opportunity to share these experiences. For
example, one young man reported being raised by his mother who did not
accept the fact that I like boys, and she essentially acted as if I wasnt her

Kubicek et al. 155
kid. When the respondent did anything wrong, she would snap and
become verbally and physically abusive to him. This young man reported that
he held in his feelings about his home life until he started dating his first
boyfriend. During the first month of their relationship, this boyfriend wit-
nessed some of these instances of abuse and the respondent confided in him
his feelings and fears. The respondent felt that because his boyfriend knew
what was going on and knew my deep thoughts, he would use those against
me. Thats when it [the abuse] started . . . The boyfriend would say hurtful
things, making the respondent feel even worse about his situation. He
lamented that when you expect someone to be there you dont expect them
to bring you down as well.
This type of behavior, seen as betrayal by many young men, was relatively
common among our sample. Another respondent reported that his boyfriend
would say really hurtful things, almost, where you tell somebody a secret
and you want them to keep it in confidence and they use it against you.
By far, the most common reason given for instances of psychological
aggression/verbal abuse was jealousy. Young men described being jealous
because their partner looked nicer than them; other instances of jealousy
occurred when talking with other menwhether they be friends, ex-boy-
friends, or strangers. Technology and social media seem to play an important
role in these instances of jealousy. Young men described seeing text messages
on their boyfriends phones, reading emails, or seeing Facebook updates or
pictures that created tension or caused conflicts in their relationships. One
young man reported seeing text messages on his boyfriends phone from
another guy. After seeing this and while stopped at a gas station he got out
of the car and then I took his phone and smashed it in his car. At times,
young men reported talking to other men or similar behaviors as a way to hurt
their partners for something they had done.
When we were mad at each other we would try whatever to spite each other as
much as, like it has to hurt. That was the whole point, whos gonna make who
hurt more. So I was texting my ex-boyfriend behind his back. And I did it on
purpose so he can find out, because he hurt me so much that I was just like you,
youre gonna pay for this.
Social media in particular was often cited as a source of conflict in young

mens relationships. This occurred when seeing ex-boyfriends included as
friends on peoples pages, seeing pictures posted where partners might be
with other men, or seeing messages on ones wall. While eventually most
young men recognized that social media was not the ultimate cause of their
relationship conflicts, it was very common for respondents to initially cite

Facebook or similar mechanisms as the reason for conflict in their relation-

ships. One young man described a situation in which he went on to his boy-
friends Facebook page and was upset by his partners profile picture. He
describes a situation that started with verbal abuse and quickly escalated into
a physical altercation.
And then Facebook got in the way. He had a picture of his body. To me
personally its like, if youre going out with somebody you shouldnt have
something so indecent on something so public. So I asked him to take it
down[he said] No. And then I asked him for his Facebook password and
he didnt want to give it to me, I said why? So, pretty much it started from
Facebook, from not giving me the password, from him calling me a bitch, and
Im no good, that I have loose screws in my head, just stuff like that. It just
escalated to him choking me and then me socking him, giving him a black eye.
It was just dumb, I guess.
The qualitative data identified other types of behavior that appear to be

common among our sample that would likely be categorized as psycho-
logical aggression or verbal/emotional abuse. Most common among these
types of behavior were stalking, manipulating, and controlling behaviors
in which one partner tried to exert control over another. One respondent
described a situation in which his partner brought flowers and other gifts
to his mother and siblings, buying his way into my family. When this
partner became emotionally abusive, his family was not supportive because
they saw his partner in a positive light. Others described situations in
which one partner overpowered another by making them feel bad about
themselves: I felt like I had nobody else and this is what I had to settle for.
This is what my futurethis is the only person that would love me. I was
just stupid.
Unique to YMSM and other sexual minority populations were instances of
one partner threatening to out the other to family or others who provide
some type of support. One young man described a relationship in which both
he and his boyfriend were perpetrators of violence. He described his boy-
friend as more the physical one because he realized words cant hurt me.
He went on to explain that the only thing that would hurt him:
I get fired from this job, whats gonna hurt me is you stop my money from
coming. And thats what he tried to do it, in dumb ways like calling my job . . .
and tell them they should random drug test me. Or he used to call my house and
tell my grandparents the reason I dont want to come out to them is because Im
scared they gonna cut me off andhe would go into sex with my grandparents.
Like talk about our sex life to my grandparents.

Kubicek et al. 157
In general, the young men in this study reported high levels of psychologi-
cal/emotional aggression in their relationships. In many instances, these
behaviors were accompanied by other types of violence including more phys-
ical violence. Jealousy was cited as one of the most common sources of con-
flict. Social media and text messaging in particular were often blamed for
these conflicts as the young men often had access to more private information
about their partners through these media. Young men also related instances of
fearing they would be outed by their partners to family or othersa factor
that is unique to sexual minority populations such as YMSM and one that
should not be overlooked when examining partner violence within these
relationships.
Physical Violence and Abuse

Quantitative results. Table 2 also presents the frequency in which respondents
reported being involved in more physical types of violence or abuse. The
most common types of physical violence include grabbing (42% as perpetra-
tor, 45% as victim), pushing or shoving (43% as perpetrator, 37% as victim),
and throwing something at ones partner (31% as perpetrator, 24% as victim).
Prevalence of mutual perpetration of physical abuse/violence was similar
with grabbing (38%), pushing/shoving (36%), and throwing something
(22%) being the most prevalent behaviors. Two thirds reported at least one
instance of physical violence in the last year either as a victim or perpetrator.
While the more severe forms of physical violence (e.g., beating up, choking,
burning, or use of a weapon) were less prevalent, these rates are still rela-
tively high when compared with other studies (Stephenson et al., 2010; Straus
et al., 1996). Table 3 again provides frequency of these behaviors and on
average, YMSM reported perpetrating about 16.5 acts of physical aggression
(SD = 27.7) and being the recipient of about 16 acts (SD = 28.9) in the past
year.
When examining injuries as a result of physical violence, about a quarter
(24% as perpetrator, 27% as victim) reported at least one instance of an injury
in the past year. Specifically, 21% reported being a perpetrator and 22% a
victim of having a sprain or bruise from a fight with a partner. Feeling pain
the day after a fight was also somewhat common, with 14% perpetrating and
15% a victim. Frequency of injuries is presented in Table 3 where we see
respondents inflicting about 4 instances of injuries in the past year (SD =
11.8) and sustaining about 3.3 injuries in the last year (SD = 8.9).
Qualitative results. Qualitative data also found that the physical forms of IPV
initiated as some of the less severe forms as indicated by the survey data. Of

the 26 qualitative interviews, about half (n = 12) described a trajectory of

smaller instances of violence leading to more severe forms; importantly, in
the interviews in which physical violence was discussed, 16 included more
severe forms of violence. While these numbers represent larger proportion of
the qualitative sample than seen in the quantitative data, one explanation for
this discrepancy may be the time period in which young men were reporting
these behaviors. The CTS2 specifically asks for experiences of violence in
the past year; qualitative interviews allowed young men to discuss lifetime
events of violence.
Oftentimes, instances of physical violence were seen to be instigated by
one partner either bringing up past arguments or other contentious issues. At
these times, respondents tended to place the blame of these physical alterca-
tions on the one who was talking or started the argument, as this young man
who described a situation in which his boyfriend brought up someone from
their past. The respondent got angry because his boyfriend would not stop
talking, and he slapped him really, really hard. Afterward, the respondents
described the situation as intense with both he and his boyfriend crying
but clearly indicating that the boyfriend had provoked and pushed him to the
physical violence:
After that, he was like, I cant believe you fucking hit me. I am all, I cant
believe you fucking told me that. No oneI have never had to get to that
place. Ever since that thats when more violence started going on.
The qualitative data indicate that young men oftentimes minimize some of
the less severe forms of violence as being a normal part of their relation-
ships: little pats and slaps and stuff like that, I wouldnt consider that crucial
[violence]. However, while these types of behaviors may be seen as some-
what common place in their conflicts, many respondents reported believing
that these conflicts can quickly escalate into more severe forms of violence.
It starts off really small and it escalates into bigger problems. Bigger beatings.
It starts with a slap. Next time maybe itll be a punch. Or push you down the
stairs. Break your arm for no apparent reason. Ive noticed that its like an
escalator. It goes up and up.
This was a common perception, with many of the young men describing a
similar trajectory. Most of the time, respondents were not able to describe
how or why their fights escalated so quickly. They also usually admitted that
what started as a particular fight typically was something dumbbut
something would happen to quickly spiral the situation into violence.

Kubicek et al. 159
He was just joking aroundhe was watching this gay video on TV . . . he was
messing around about how he would love to fuck that one, and that one. I just
had a really bad day and I just wasnt having it, so I just threw a plate and it hit
his head and then we started fighting.
This young man described one of his first relationships and how it became
violent in its first few months.
The first time something happened was he called me a slut and I told him shit
and he smacked me and I slapped him backand he slapped me again. I was
like, What the fuck? This bitch, who does he think he is hitting me? So, after
that he just kept thinking that he could overpower me. He would hit me. He
would tell me shit. One time I was sleeping and he choked me. It was really,
really bad. That day, he was choking me and I was on the floor. I ended up
pushing him off. I just started hitting him and I just like ran out of the house that
day.
When asked whether there was ever any discussion about these violent
fights, respondents usually said they were not discussed. Some respondents
would avoid their partners for a few days and then would try to get back to
normal. Another common outcome was for these instances of violence to be
followed by a honeymoon phase where the primary perpetrator would
apologize profusely and try to make amends: I would take him somewhere
and get him something real nice and just try to make, try to make it better.
One young man described his relationship as having multiple instances of
jealousy sparked by seeing each others text messages or email. After a day
of fighting, the respondent described this scenario:
He [boyfriend] was in the shower and I had a glass of wine, and I poured a glass
of wine on his head when he was in the shower. Im thinking its funny . . . So
I ran out of the restroom laughing, thinking oh its cute, trying to break the
mood from the night before. And he runs out of the shower, and he throws a
bottle at me. Busted my whole arm open. It was huge, really big. And I was
bleeding so much it was so scary. And I got stitches and stuff.
After this fight, the respondent reported that his boyfriend treated him
really good for about the next month: He would call me a lot more, texted
me, he used to bathe me cause I couldnt move [my] arm, cause [the stitches]
would rip out. He cooked for me . . . it was just really nice.
Many of the young men reported their relationships involving both partners
perpetrating violence, although in most instances there was one partner who
they saw as the primary perpetratorthe one who initiated the physical

violence. For some respondents, the mutual physical violence would occur
after the first instance of violencetit for tat as one young man explained.
For others, there was often a build-up to mutual perpetration over time, such
as this young man who was involved with a physically violent partner for 2
years before he too turned to physical violence:
I used to tell him to keep his hands off me. I used to be like, man thats not good
for us. Like its only gonna help me resent you in the long run. And it did. Like
after a while, I started to really resent him. Like dude, thats not right. I dont
believe in hitting the person that you love . . . And then when I finally started
putting my hands on him, like when I was hitting him, I really felt like every
time he hit me, I had to go with the punch. [I: How often would that happen?
Either him hitting you or you hitting him?] Once or twice a week. Yeah, thats
crazy.
In some instances, respondents described this mutual perpetration as self-

defense, with one partner resorting to physical violence only when pushed to
his limit and needing to protect himself. For example, one young man
described seeing his boyfriends Facebook page and realizing that he was
cheating on him with multiple other men. When the respondent confronted
his boyfriend about it and his boyfriend denied it, the argument quickly esca-
lated into a physical altercation:
I guess I threw the first punch or I pushed him. I dont know how it started. But
I started hitting him. At first I felt like he wasnt trying to hit me. He was just
trying to like pin me down, but I was getting more mad. And then he put me in
a headlock and then I started punching him. We just went at it. He started
hitting me back. I think he was just defending himself at that time.
Another factor that young men discussed when describing physical vio-
lence in their relationships is the role that alcohol played in these fights. For
some young men, they felt that alcohol tended to escalate their arguments: if
I wasnt drinking that wouldnt have happened. When asked to explain these
types of statements, respondents would report that when sober, they would
more than likely ignore cutting remarks or other troubling behaviors.
However, after drinking, young men felt that they often became much more
volatile.
Thats pretty much how the last one started. Cause I was drunk. And he called
me a bitch . . . And thats when I pushed his head, I didnt push it hard but I put
a little bit of effort to move his head. Thats when he jumped up on me, started
choking me and told me that I was gonna be nothing, Im worthless and just die

Kubicek et al. 161
already or stupid stuff like that. I was like, oh my God, is this really freaking
happening? And I just remembered, I was so scared . . . I swung twice. I didnt
know I gave him a black eye. He was just holding his eye. It just started
swelling up, and I just broke down on the floor and I was crying and crying, and
crying . . . I was like oh my God, did I really just sock himlike [in the first
times of violence] I would slap him. I would never use a closed fist and then
this time was a different story. It was just like, oh my God, Im turning into my
mother, thats what I thought.
These instances of physical violence provide us a more intimate view of

violence in young mens relationships. The data here indicate that generally,
fights began over small issues and quickly escalated into violence. The initial
less severe forms of violence were oftentimes seen as a normal part of the
relationshipindicating some sense of normalization of violence in their
lives. Interestingly, some young men could not really pinpoint the source of
conflict, but the conflict itself was very memorable. The issue of mutual per-
petration is also seen in these relationships. In some instances, there was a
clear primary perpetrator or one man acting in self-defense, but this may
not always be the case. Similar to what is seen in heterosexual couples, young
men described a honeymoon phase in their violence relationship when the
primary perpetrator would treat them well.
Sexual Coercion/Violence
Quantitative results.As shown in Table 2, respondents reported relatively
high levels of sexual coercion. The most common of these behaviors were
insisting on anal or oral sex (35% as perpetrator, 35% as victim) and insisting
on sex without a condom (29% as perpetrator, 37% as a victim). With regard
to mutual perpetration of sexual coercion or violence, 28% reported being
both victim and perpetrator of insisting on sex without a condom and 26%
reported being both victim and perpetrator of insisting on anal or oral sex.
Respondents reported low levels of using force or being forced to have sex.
Table 3 presents the frequency of sexual coercion and shows that on average,
young men perpetrated about 10.7 acts of sexual coercion (SD = 15.2) and
were the recipient of about 10.9 acts (SD = 18.7) in the past year.
Qualitative results. The qualitative data provide some additional insight into
these behaviors. In general, instances of sexual partner violence were mini-
mally discussed. While some young men recognized that being involved in a
violent relationship could contribute to ones ability to negotiate protected
sexwell since they are already abusing them . . . they want to do it without

a condom I guessmost felt that this would happen only in those relation-
ships in which sexual violence was occurring.
Young men in the study described instances of sexual coercion that
occurred most often when respondents were younger and exploring their first
intimate relationships. For example, one young man described his first boy-
friend as a quarterback on the varsity team and much bigger than the 54
respondent. The boyfriend tried to tell me I was a bottom . . . And me not
having a lot of experience, I would kind of believe it. The boyfriend would
kind of try and force himself onto me but physically he was too big for me,
so we never had sex. Another respondent reported that he found his first
boyfriend on the mobile phone application Grindr; he described himself as
someone who had morals, and I told him Im a virgin and I do not want to
have sex until weve been dating for like, one or two months. After dating
for a couple weeks, he reported that they did have sex, but it was not
consensual:
He came over . . . and he was drinking and, I dont know, maybe he had like
four, five shots of alcohol and we were just like messing around and then he
kind of like turned me over and kind of like forced himself on me and I kept
telling him, No, no, Im not ready. No, Im not ready. And hes like No,
come on, come on. Its okay, its okay. He just like kept ignoring me.
After describing this situation, this respondent was still confused as to

what to call this incident: it was like not healthy, I guess, is the best way to
describe it. Now when I think back on it, would I consider that rape? Not
necessarily, I dont know.
When sexual violence was described, alcohol or other drugs were almost
always involved. For example, one young man described meeting up with his
ex-boyfriend at a party. Both young men were drunk, and the respondent
reported that this ex-boyfriend
all of a sudden he just pushes me against the wall and starts making out with me
and then throws me on the ground and then just gets on top of me and starts
touching me and Im just like, Wow, like what are you doing? Calm down, Im
trying to push him off of me. He just kind of forcing, you know, on me. But
then, of course I was drinking too, so I just kind of gave up on, you know, trying
to get him off of me.
While the respondent indicated that this is what I wanted, he also sensed
that both partners were out of control, and the situation would likely have not
occurred or been different had they not been drinking. Another respondent
who was using methamphetamines with his partner at the time reported there

Kubicek et al. 163
were multiple times when we would be high and personally I didnt want to
have sex and it would be kind of be forced. He described his partner as
someone who wanted control over someone. This respondent also did not
feel he could call these instances rape as described below:
I wouldnt say it was rape because it was my boyfriend so I cant. I dont

associate that with that. But, it was kind of like I didnt want to and he would
justits almost like people on the outside would think it was role playing but
it really wasnt. So, the things he would be saying to me while we were having
sex was just like degrading things and thingsnow when I think back, I get so
mad because I would never let anyone say something like that to me ever in my
life.
Drivers of sexual coercion and violence described by these young men

included inexperience in dating, alcohol, and other illicit substances. Similar
to what is seen in heterosexual instances of sexual violence/coercion, the
victim in these cases was oftentimes at a loss as to what to call what occurred.
When a young man is taken advantage of by a partner or boyfriend, is that
rape? These are the questions young men grappled with in these interviews,
and the answers are not always clear for them.
Discussion
This study is the first to provide context and descriptions of YMSMs experi-
ences of violence in their intimate relationships. Prior research with this pop-
ulation has been limited in its use of inconsistent definitions of IPV and
reliance on survey data to provide a description of the types of violence expe-
rienced within young mens relationships. This study provides additional
context to these behaviors and a glimpse of how these behaviors are described
by YMSM. Survey data found high prevalence rates of all types of IPVas
both victim and perpetratoras measured by the CTS2. While it should be
noted again that some of the highest reported rates involved behaviors that
one might categorize as less severe, rates of the more severe types of vio-
lence, including injuries resulting from IPV, were still higher in this popula-
tion than what has been documented in other studies including one using the
same scale with an older population of MSM as well as rates reported by the
developers of the scale (Stephenson et al., 2010; Straus et al., 1996).
It should also be noted that while relatively high prevalence of different
violent behaviors were reported, these rates have large standard deviations and
range when examining the chronicity of IPV, which indicates a very heteroge-
neous sample of YMSM with a variety of different relationship experiences.

The survey data therefore describe a sample of young men who have experi-
enced severe forms of IPV as well as those with less severe forms and those
with little to no IPV behaviors. The qualitative data provide narrative to
describe these instances for a better understanding of the issue. The narratives
presented here may appear to focus on those more extreme instances of IPV;
however, that may also be a result of the use of eliciting narrative accounts in
qualitative work where respondents may be more likely to recount the more
dramatic instances in their relationships. More research on this topic that
specifically elicits both severe and less severe instances of IPV in YMSMs
relationships is important to make sure we understand the full spectrum of
behaviors. The survey data indicate there are a range of behaviors that can be
considered violent, and future research should delve into each of these to
provide a clearer understanding.
The qualitative data provide insight into the contexts of these violent
behaviors and also provide a sense of the trajectory of violence in these young
mens lives. For those young men experiencing the more severe forms of
violence, they typically described an escalation of violence in their relation-
ships, with less severe forms of emotional and physical violence occurring
before the more severe forms. This supports the need for earlier intervention
for these young men to help them recognize the early signs of IPV and
develop stronger coping and anger management skills. In addition, similar to
studies of IPV in other populations, the young men in the study identified
alcohol and illicit substances as contributing to the violence in their relation-
ships. One young man even acknowledged that alcohol likely exacerbated
one of his fights, and without the alcohol, it likely would not have gotten to
the level it did. The relationship between IPV and alcohol is well documented
but continues to be an issue (Abramsky et al., 2011; Kelly, Izienicki, Bimbi,
& Parsons, 2011; Smith, Homish, Leonard, & Cornelius, 2012; Tran et al.,
2014). This indicates that programs need to continue to focus on the use and
misuse of alcohol and other substances and promote more responsible use
among emerging adults.
Research with adolescents and young adults has generally found higher
rates of IPV in these younger populations than their older counterparts (Wolfe
et al., 2003). This has generally been thought to be related to issues of low
self-esteem, limited experiences in relationships, and lack of conflict resolu-
tion skills (Offenhauer & Buchalter, 2011). The developmental phase of
emerging adulthood may be a particularly vulnerable period for YMSM and
other sexual minority youth due to their comparatively limited dating oppor-
tunities in early adolescence. The young men in this study oftentimes described
partner violence being a part of their earlyif not firstrelationships.
Therefore, providing intervention opportunities early on, before YMSM begin

Kubicek et al. 165
to explore intimate relationships, is important for their maturity and sexual

development. While YMSM-specific interventions would be preferable,
schools should consider providing healthy relationship development and con-
flict resolution training that is non-gender specific in their current curricula.
Prior research has found that sexual education and similar programs in
schools are generally designed for heterosexual adolescents, making YMSM
and other sexual minority youth feel left out of the conversation (Kubicek,
Beyer, Weiss, Iverson, & Kipke, 2010). Offering gender-neutral programs in
relationship development would be beneficial to all students and may help to
make sexual minority youth more comfortable and feel that the information
is relevant to them.
Something unique that was identified in the qualitative data is the role
social media can play in young mens relationships. It was not unusual for
young men to describe the catalyst for an argument or fight to be related to
seeing a text message or Facebook posting that caused instances of jealousy
in their relationships. These instances could result in violent outbursts as
young men jumped to conclusions and/or were unable to control their impul-
sive behaviors. The ubiquitous nature of social media in the lives of these
young men and its potential influence on their relationships should not be
surprising. Technology has developed rapidly during the life span of todays
emerging adults. For example, since the early 1990s when the current genera-
tion of emerging adults was born, the first search engines, web browsers, and
webcams were just being developed. By the early 2000s, as these young men
were entering adolescence, Pandora, Wikipedia, MySpace, and
Skype were founded, followed by Facebook, YouTube, and Twitter
just a few years later (Coyne, Padilla-Walker, & Howard, 2013). To date,
research examining the role of social media in ones intimate relationships is
limited. For example, a recent survey of high school students found that
about a quarter of young people are victims of cyber dating violence; sex-
ual minority youth reported significantly higher rates of cyber dating abuse
victimization and perpetration than heterosexual youth (Zweig, Dank,
Lachman, & Yahner, 2013). However, what is seen in the work presented
here is not exactly cyber violence, but rather how social media and its role in
young peoples lives may influence behaviors and serve as a stimulus for
relationship issues. Researchers and interventionists should consider how
programs can address this issue and provide young people the tools to build
more trusting and honest relationships that are not as volatile to social media
and technology.
The high rates of violent behaviors among the YMSM in this sample
should be a cause of concern as there are serious public health implications
related to IPV. Among adolescents and young adults, IPV has been associated

with numerous other health issues including substance use (Tyler & Melander,
2012; Wong et al., 2010), cancer, coronary heart disease (Exner-Cortens,
Eckenrode, & Rothman, 2013), and mental health (e.g., anxiety, suicidality,
depression; Campbell, 2002; Wolitzky-Taylor et al., 2008). Prior research has
shown that sexual minority populations experience higher rates of mental
health issues than heterosexual populations (Cochran & Mays, 2006;
DAugelli, 2002; Kipke et al., 2007). In addition, the syndemics theory asserts
that as the number of psychosocial issues one experiences in their life
increases, so too does their risk for other issues such as HIV (Stall et al., 2003).
Given the high rates of both mental health issues and IPV among YMSM,
addressing IPV through primary and secondary intervention programs may
also be an effective means of addressing HIV/sexually transmitted infection
(STI) risk in this population as well as other potential comorbidities.
Related to this idea of a syndemic among YMSM are some of the external
factors that may contribute to IPV in YMSMs relationships. Qualitative data
hinted at some of these issues such as familial abuse, fear of being outed to
family members, and losing support as well as a sense that violence between
two men is more accepted by society. Prior research has been found that fac-
tors such as these influence power dynamics within YMSMs relationships,
which in turn influence involvement in IPV (Kubicek et al., 2015). Prior
work has also suggested that factors related to minority stress may also exac-
erbate involvement in IPV among sexual minority populations (Kelly et al.,
2011; Stephenson et al., 2013). Further exploration into these factors and
other external factors may be unique to sexual minority relationships and
should be considered in intervention development.
Research also indicates that those who are victims of violence are more
likely to become perpetrators and/or revictimized later in life (Chiodo et al.,
2012). Data from this study do indicate that after being the victim of emo-
tional or physical violence, many young men do become perpetrators of vio-
lence. By providing young men tools to develop safe and healthy intimate
relationships, we may have the opportunity to curb future instances of IPV.
Prior research has found that victims of IPV may not have the ability to
advocate for protected sex (Houston & McKirnan, 2007; Mustanski et al.,
2007; Relf, Huang, Campbell, & Catania, 2004). While young men in this
study did not discuss at great length their experiences involving sexual coer-
cion such as insisting on sex without a condom or when one partner did not
want to have sex, the survey data indicate that these behaviors occur rela-
tively frequently. Young men also seemed to struggle with what to call these
types of behaviors, as they felt that because they occurred with a known part-
ner, it was not necessarily rape. The young mens narratives presented here
seem analogous to those of young women in the 1980s and 1990s when the

Kubicek et al. 167
idea of date rape was first openly discussed. This points to the need to extend
the date rape conversation to young men and sexual minorities to ensure they
are included in the conversations. This uncertainty about what constitutes
sexual violence or coercion within intimate relationship may also be one rea-
son these instances were not discussed at length during the interviews.
Analyses related to the relationship between being involved in violent rela-
tionships and engaging in HIV risk behaviors such as unprotected sex are
beyond the scope of this descriptive article (but will be tackled in future
efforts). However, prior research with this population found that victims of
physical IPV are more likely to engage in HIV risk behaviors such as sub-
stance use and unprotected sex (Wong et al., 2010). Given that unprotected
sex is the most common mode of HIV transmission, this is an important area
for intervention.
The use of the CTS2 in this study may be somewhat problematic. For
example, some of the behaviors included in the scale may be representative
of typical issues in relationships such as shouting at ones partner. Scoring the
scale for prevalence is the standard and recommended method for a commu-
nity-based sample such as ours. However, this method may overestimate the
prevalence of IPVin particular psychological aggression. At times, young
men were also at a loss as to how to describe instances of sexual coercion,
and the higher rates of these behaviors in the survey data were not as well
documented in the qualitative data. Therefore, adapting the CTS2 or develop-
ing a new scale for same sexparticularly MSM relationshipsmay be
important for future research efforts. Qualitative data such as those presented
here are integral for scale development, and data from this study identified
additional behaviors that may be common in YMSM relationships such as
manipulating and stalking. Researchers should consider the development and
standardization of an IPV scale for MSM/YMSM relationships in order to
more consistently define and measure IPV in these specific populations. This
would provide better consistency in this nascent field and ideally lead to
more comparable studies.
Finally, this study also found that there are high rates of mutual perpetra-
tion of IPV in this sample. While some research has found similarly high
rates of mutual perpetration among adolescents, this research has often been
limited to describing the behaviors of just one partner in an intimate relation-
ship (Gray & Foshee, 1997). Qualitative data further identified that in some
cases, this may occur because one partner is defending himself from a pri-
mary perpetrator. In other cases, young men reported both partners being
similarly violent toward each othertit for tat as one respondent described
it. Anger management and conflict resolution skills may help address this
issue so that arguments do not escalate into violence, and young men are able

to find compromises and other solutions to their relationship problems.

Future research should focus on differentiating mutual perpetration from
self-defensive measures.
Limitations
There are a number of limitations to this study that should be acknowledged.
These analyses are based on experiences and perceptions of young men
recruited in Los Angeles. Although various recruitment methods were
employed, the majority of young men in our sample were recruited from gay-
identified venues (e.g., bars, clubs, and service providers). The experiences of
our participants may not be reflective of men outside of Los Angeles and/or
young men who do not patronize gay venues. For prevention efforts, future
studies should include data collected in other cities and communities. It should
also be noted that all of the young men in this sample were recruited for a
study that was focused on their relationships and challenges they may have.
While IPV was not explicitly mentioned as part of the study, there may be
some biases in who self-selected to participate based on this description.
While the goal of qualitative data is not to be generalizable to other samples
but rather provide context and depth to specific phenomenon, it should still be
noted that because this was largely a qualitative analysis, the data reported
were derived from a small sample; therefore, attempts at generalizability can-
not be made. In addition, this was a community sample, not a population-
based sample, and thus generalizations cannot be extrapolated to other YMSM.
Also, the findings rely on respondents self-reported behaviors, which cannot
be independently verified. Also, while the data from the CTS2 reported here
specifically ask respondents about behaviors in the past 12 months, qualitative
interviews did not have this time constraint. Thus, some of the narratives pre-
sented here may have occurred much farther in the past and may not be exem-
plary of their current relationships. Additionally, the data reported here are
cross-sectional and therefore, do not contain information about the trajectory
of their IPV perceptions over time. The developmental stage in which these
young men currently reside, emerging adulthood, involves many changes and
transitions, and it is unclear how these behaviors and perceptions may develop
with age (Arnett, 2000). We encourage others to further explore these areas to
better understand the temporal relationships.
Conclusion
In spite of these limitations, the data presented here speak to a number of
recommendations for service providers and researchers to develop effective

Kubicek et al. 169
IPV prevention programs for YMSM. In spite of the high prevalence of IPV
among YMSM and its associated risk, no evidence-based prevention pro-
grams addressing IPV and healthy relationship development have been
developed for YMSM. The research presented here provides some initial
insight into the factors that such programs should address as well as some
considerations for policymakers. Considering how schools can be more
inclusive in their curricula and violence prevention programs is one impor-
tant area for consideration, especially knowing that young people are com-
ing out at an earlier age, and prevention messages need to be promoted
starting in early adolescence. Additionally, with the recent renewal of the
Violence against Women Act (VAWA), sexual minority victims of IPV are
now provided, for the first time, equal protection when reporting IPV and
seeking assistance. Studies such as this can provide direct examples of how
YMSM experience violence and help to consider new policies and programs
that can address the violence in their lives.
Research continues to show that sexual minority individuals experience
more violence and in more contexts than their heterosexual peers (Huebner,
Rebchook, & Kegeles, 2004; Kosciw, Greytak, Bartkiewicz, Boesen, &
Palmer, 2012). Further, research has found that societal homophobia, dis-
crimination, and other external stressors are related to violence and other
stressors in YMSMs lives (Meyer, 1995, 2003), which can lead to the poor
health outcomes that we see across sexual minority group (Meyer &
Northridge, 2007). Thus, it is time that policymakers recognize that IPV is
yet another area in which sexual minority individuals may face inequitable
disparities, and research and programs to address these disparities are desper-
ately needed. Subsequent research should continue to better understand the
contexts in which IPV exists in young mens relationships so that we can
develop theoretically sound models to address this pressing public health
issue.
Acknowledgments
We would like to thank the staff members who contributed to the data collection and
analysis for this study including Claudia Barcenas, Heather Reyes, and Luis Salazar.
We would also like to thank Donta Morrison from AIDS Project Los Angeles for his
assistance and willingness to help in our data collection efforts. Finally, the authors
would also like to acknowledge the insightful and practical commentary of the mem-
bers of the Community Advisory Board: Noel Alumit, Asian Pacific AIDS Intervention
Team; Chi-Wai Au, Los Angeles County Department of Health Services; Mary Case,
Los Angeles Gay and Lesbian Center; Matt Harwood, AIDS Project Los Angeles;
Susan Holt, Los Angeles Gay and Lesbian Center; Dustin Kerrone, Los Angeles Gay
and Lesbian Center; Miguel Martinez, Division of Adolescent Medicine, Childrens

Hospital Los Angeles; and Ricki Rosales, City of Los Angeles, AIDS Coordinators
Office. We are especially grateful to all of the young men who participated in this
study and were willing to share their diverse personal experiences.
Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This study was funded by the California
HIV/AIDS Research Program (ID10-CHLA-048). The content is solely the responsi-
bility of the authors and does not necessarily represent the official views of the
California HIV/AIDS Research Program.
Notes
1. Potential participants were told to consider a primary partner as someone who
you consider yourself to be in a relationship with, for example, boyfriend, part-
ner, in the last 12 months.
2. Focus groups were conducted to serve as a mechanism for recruitment and iden-
tification of young men who have sex with men (YMSM) involved in intimate
partner violence (IPV). The focus groups were focused on understanding rela-
tionship challenges more generally and how they deal with conflicts in their rela-
tionships. This facilitated recruitment as identifying YMSM involved in violence
through street outreach efforts would be unsafe and likely unproductive.
3. While 86 young men completed focus groups, an additional 15 young men were
not able to attend one of the scheduled groups but were able to come to the proj-
ect offices to complete the survey; thus, a total of 101 surveys were completed.
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Author Biographies
Katrina Kubicek is the program manager of the Community, Health Outcomes and
Intervention Research program at Childrens Hospital Los Angeles. She is the princi-
pal investigator of the Young Mens Relationships Study and is completing her doco-
toral studies in Health Behavior Research at the Department of Preventive Medcine at
University of Southern Californias Keck School of Medicine.
Miles McNeeley is a reseach associate at the Community, Health Outcomes and
Intervention Research program at Childrens Hospital Los Angeles. He holds a
Masters in Social Work and was the project coordinator for the Young Mens
Relationships Study.
Shardae Collins is a research assistant at the Community, Health Outcomes and
Intervention Research program at Childrens Hospital Los Angeles. She contrbuted to
the data collection and analysis for this study.

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Young Men Who Have Sex With Men's Experiences With Intimate Partner Violence

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Katrina Kubicek1, Miles McNeeley1,

1Childrens Hospital Los Angeles, CA, USA

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address anger management, conflict resolution, and communication skills

Intimate partner violence (IPV) is a term used to describe violence within

Emerging Adulthood and Young Men Who Have

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MSM rather than YMSM, a distinct group comprised of men aged 18 to 25

Intimate Partner Violence Among Sexual Minority

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events and conditionsto proximal processes which are subjective as they

Intimate Partner Violence Among Men Who Have

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one is the victim or perpetrator of violence, sampling techniques, and mea-

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Phase 1: Quantitative Methods and Measures

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Respondents were asked whether each individual behavior occurred in the

Phase 2: Qualitative Methods and Measures

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were conducted in the project offices or a location convenient to the respon-

Qualitative analysis.Transcripts for each of the individual interviews were

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Table 1. Sample Demographics (N = 101).

Total sample (N = 101)

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Qualitative results.Qualitative data provide additional information on the

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Table 2. Revised Conflict Tactics ScalePast Year Prevalence (N = 101).

Prevalence (any instance)

Perpetrator Victim Mutual

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Note. IPV = intimate partner violence.

generally described situations of physical violence; only when prompted did

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Social media in particular was often cited as a source of conflict in young

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Facebook or similar mechanisms as the reason for conflict in their relation-

The qualitative data identified other types of behavior that appear to be

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Physical Violence and Abuse

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the 26 qualitative interviews, about half (n = 12) described a trajectory of

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In some instances, respondents described this mutual perpetration as self-

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These instances of physical violence provide us a more intimate view of

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After describing this situation, this respondent was still confused as to

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I wouldnt say it was rape because it was my boyfriend so I cant. I dont

Drivers of sexual coercion and violence described by these young men

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to explore intimate relationships, is important for their maturity and sexual

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to find compromises and other solutions to their relationship problems.

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