# Alcohol Use, Intimate Partner Violence, and ART Adherence among Men Living with HIV who Have Sex with Men

> **NIH NIH R21** · RHODE ISLAND HOSPITAL · 2022 · $218,108

## Abstract

While there are many variables that impact adherence to antiretroviral therapy (ART) among men living with
HIV who have sex with men (MLWHSM), alcohol use is one of the most prevalent and significant factors.
Event-level studies have identified a temporal association between alcohol use, particularly heavy drinking,
and ART nonadherence but have not examined the interactive effects of alcohol use and other psychosocial
factors on ART nonadherence. One key factor that intersects with alcohol use is intimate partner violence
(IPV), which is highly prevalent among MLWHSM. While the extant literature points to a potential relationship
between IPV and poor HIV treatment outcomes among MLWHSM, research thus far has relied on cross-
sectional designs and has produced mixed results. Cross-sectional research has also produced data that
suggest an association between unhealthy alcohol use and IPV in this population. No research to date has
attempted to capture event-level experiences of both alcohol use and IPV among MLWHSM, which could
elucidate both temporal associations among these variables and the interactive effect of alcohol use and IPV
on ART nonadherence. Identification of modifiable risk factors that precede ART nonadherence could be used
to guide interventions aimed at improving the health of MLWHSM. Further, little is understood about the
individual differences that enable some MLWHSM to be resilient in the face of risk factors for poor HIV
treatment outcomes. Two factors that may contribute to resilience and merit examination are coping style and
social support. Using a causal modeling analytic approach, the proposed study will examine temporal
associations among alcohol use, IPV (perpetuation and victimization), and ART adherence among 100
MLWHSM. In addition, we will examine the moderating effect of protective factors (coping style and social
support) and will explore the impact of other proximal and distal syndemic factors (drug use, mental health,
sexual minority stress, HIV stigma, and childhood abuse). We propose a design consisting of a baseline
assessment, followed by 60 consecutive days of daily diaries. There is an urgent need to sharpen our
understanding of how alcohol use, IPV, and their interaction impact ART nonadherence among MLWHSM.
Cross-sectional data can be used to identify candidate variables for intervention. However, event-level data are
key to pinpointing the variables that most commonly precede ART nonadherence and could represent prime
intervention targets to improve the health of MLWHSM. Further, there are striking examples in the literature of
discrepant predictors of ART nonadherence when data are global and cross-sectional versus prospective,
event-level data. The proposed study will be the first empirical test of temporal associations among alcohol
use, IPV, other syndemic factors, protective factors, and ART adherence among MLWHSM. This line of
research will be used to inform future intervention development to re...

## Key facts

- **NIH application ID:** 10557265
- **Project number:** 1R21AA030523-01
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Susan E Ramsey
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $218,108
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10557265

## Citation

> US National Institutes of Health, RePORTER application 10557265, Alcohol Use, Intimate Partner Violence, and ART Adherence among Men Living with HIV who Have Sex with Men (1R21AA030523-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10557265. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*