BACKGROUND:
Intimate partner violence (IPV) among sexual minority men (SMM) is largely unreported in South Africa due to stigma and discrimination and masculinity norms within relationships.1-3 Further, SMM living with HIV are at increased risk for IPV. Estimated rates for sexual violence and physical violence are 8-12% and ~5% respectively.4 Interventions are needed to lower IPV in SMM.

METHODS:
A randomized controlled trial of a coping intervention for HIV treatment engagement was delivered to SMM (60 per arm) in Eastern Cape, South Africa.5 Participants (≥18 years, living with HIV, in a romantic relationship <3 months ago) received either standard of care or a five-session coping skills intervention for HIV status-sharing management with partners to boost treatment dosing. Measures for IPV and resiliency were collected at Weeks 0, 17 and 28. All analyses were conducted using linear mixed-effects models. Fixed effects included study arm, time, and the interactions with age as a covariate.

RESULTS:
Among 120 SMM, IPV prevalence was 5% overall. Compared to control, the intervention is associated with lower Total IPV (b=−0.08, p=0.044) to include significantly lower physical, sexual and emotional abuse. No group difference was shown for monitoring and controlling behaviors. There was significantly higher resiliency (b=0.38, p<.001) in the intervention arm compared to control. Trajectories over time showed significant interactions for physical and sexual abuse (b=0.005, p=0.004), emotional abuse (b=0.007, p<.001) and resiliency (b=−0.011, p=0.004).

CONCLUSIONS:
The intervention not only reduced IPV levels at the average time point but also altered how IPV subdomains and resilience evolved over time. Higher resilience in the intervention (with an interaction) suggests the intervention boosts coping resources early or differently over time. Findings support integrating IPV and resilience‑focused status‑sharing interventions into HIV treatment programs for SMM in high‑burden settings.