# Continuous Traumatic Violence and the HIV Continuum of Care Outcomes Among BMSM

> **NIH NIH R21** · MEDICAL COLLEGE OF WISCONSIN · 2022 · $154,660

## Abstract

Project Summary
The goals of this project are to (1) examine how exposures to continuous traumatic violence are related to engagement and
retention in HIV care; (2) illuminate the pathways through which violence exposures affect HIV engagement and
retention to care; and (3) identify factors that promote resilience among people living with HIV who have been exposed to
violence.
Continuous traumatic violence is conceptualized as chronic violence exposure,
continuous danger, or ongoing
threats that can manifest as structural, economic, psychological, interpersonal and social violence. This study examines
continuous traumatic violence as inclusive of community and police violence, intimate partner violence, race- and
sexuality-based stigma and discrimination, and the lingering effects of childhood sexual abuse, and explore these types of
violence through the syndemic framework. Each of these various dimensions of violence disproportionately affects Black
males, including YBMSM and a syndemic approach to continuous traumatic violence itself, may, therefore, better explain
disparities in HIV care outcomes.
Experiences of violence have been identified as an important aspect of syndemics that
significantly contribute to lower engagement in HIV care and lower rates of viral suppression among Black MSM. Yet,
much like multiple syndemic conditions contribute to disparities in HIV risk and outcomes, the experience of violence
is not monolithic. Various types of violence exposures may cluster to have negative interactive effects on HIV care
outcomes.
This study will promote a deeper understanding of how these multiple dimensions of violence may have an
additive and interactive correlation to poor engagement and retention in HIV care of YBMSM, despite significant
outreach and retention efforts. This study focuses on YBMSM, a high priority population with regard to improving HIV
outcomes. We will test an empirically informed conceptual model describing mediating and moderating factors that link
continuous traumatic violence exposure to HIV care cascade outcomes. This model is based on our two decades of
focused research on how violence impacts HIV risks and health outcomes among Black youth and young adults and
BMSM. Documenting significant correlations among various dimensions of violence across a single sample of YBMSM
is a necessary first step before developing costly longitudinal studies and interventions. Study results will inform a
trauma-informed R34 application for HIV positive YBMSM.

## Key facts

- **NIH application ID:** 10155559
- **Project number:** 5R21MH122010-02
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Katherine G Quinn
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $154,660
- **Award type:** 5
- **Project period:** 2020-05-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10155559

## Citation

> US National Institutes of Health, RePORTER application 10155559, Continuous Traumatic Violence and the HIV Continuum of Care Outcomes Among BMSM (5R21MH122010-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10155559. Licensed CC0.

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