Chronicity of depressive symptoms and intimate partner violence experiences over time among sexual minority men: Substance use as a pathway.

Objective –: Past research found depression, substance use, and intimate partner violence (IPV) to be prevalent among sexual minority men (SMM) and noted on their synergistic relationship, based on the syndemic framework. In exploration of potential mechanisms, we examined depression as a predictor of future IPV experiences, with substance use as a mediator. Method –: We used three timepoints of longitudinal data (baseline, 6-month, and 12-month follow-up) of 500 SMM from the US. Directionality between IPV experiences and depressive symptoms was assessed using cross-lagged panel modeling across three timepoints. Then we used linear and generalized structural equation modeling (SEM) to examine the associations between depressive symptoms from baseline to 6-month follow-up and IPV experiences at 12-month follow-up with mediation via substance use at 6-month follow-up. For generalized SEM models, depressive symptoms were categorized as no symptoms, intermittent, and chronic. All SEM models adjusted for corresponding baseline IPV experiences and sociodemographic characteristics. Results –: Prevalence of any experiences of IPV at 12-month was 25.5% for victimization and 17.9% for perpetration. Chronic depressive symptoms were directly associated with any experiences of both IPV victimization and perpetration, with no evidence of mediation through substance use. Conversely, substance use fully mediated the association between intermittent depressive symptoms and IPV victimization. Conclusion –: These findings suggest that IPV prevention programs for SMM should incorporate strategies to address mental health and its coping mechanisms, including substance use. There is a need for greater investment towards raising awareness and development of syndemic-focused interventions to address multiple, co-occurring health challenges among SMM.