The relationship between emotional dysregulation and, HIV acquisition risk behaviours and intimate partner violence perpetration among young men in rural areas and urban informal settlements in South Africa

Previous literature links emotional dysregulation (ED) to HIV acquisition risk and intimate partner violence (IPV) perpetration. This study assessed the relationship between ED, HIV acquisition risk, and IPV perpetration cross-sectionally and longitudinally among men (18-30 years) in urban informal settlements and rural areas in KwaZulu-Natal, South Africa. Data were drawn from 163 young men enrolled in a pilot randomized controlled trial of Stepping Stones and Creating Futures Plus (SSCF+). Regression models were used to examine baseline and longitudinal associations. Informed by previous findings that SSCF+ reduced ED among men with elevated depressive symptoms, we assessed whether the intervention modified ED - HIV/IPV associations in this subgroup using ED × intervention interaction terms among participants with elevated depressive symptoms (<i>n</i> = 56). Cross-sectionally, ED was associated with multiple sexual partners, alcohol use and drug use. Longitudinally, only alcohol abuse remained significantly associated with ED (adjusted odds ratio [aOR] 1.06, 95% CI 1.02-1.11). ED increased the risk of emotional and combined IPV perpetration cross-sectionally, and longitudinally ED was associated with physical (aOR 1.07, 95% CI 1.02-1.13), emotional (aOR 1.06, 95% CI 1.02-1.11), sexual (aOR 1.05, 95% CI 1.01-1.10), and combined IPV perpetration (adjusted beta coefficient [aβ] 0.16, 95% CI 0.03-0.34). Among men with elevated depressive symptoms, combined IPV perpetration increased with ED in the control group but remained relatively flat in the intervention group. Addressing ED within IPV and HIV prevention programming may be an important strategy for reducing men's IPV perpetration and HIV risk.