Displaying publications 1 - 20 of 51 in total

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  1. Ahmed A, Saqlain M, Akhtar N, Hashmi F, Blebil A, Dujaili J, et al.
    Health Qual Life Outcomes, 2021 Feb 08;19(1):48.
    PMID: 33557861 DOI: 10.1186/s12955-021-01693-0
    BACKGROUND: Reliable Health-Related Quality of Life (HRQoL) assessment will be useful in identifying health issues and in identifying health care actions. Due to the lack of a psychometrically valid tool in Urdu, we aim to translate and examine the psychometric and cross-cultural adaptation of WHOQOL HIV Bref among people living with HIV/AIDS (PLWHA) in Pakistan.

    METHODS: The standard forward-backwards translation technique was used to convert English version of the WHOQOL HIV Bref into Urdu. After cognitive debriefing, final Urdu version of instrument was developed. Based on the principle of at least 5 subjects for each item, a sample of 182 patients was used using a universal random sampling technique from the Pakistan Institute of Medical Sciences, Islamabad. The Cronbach's alpha and intra-class correlation coefficients (ICC) were estimated to assess internal validity and reliability of the translated version. Exploratory factor analysis was carried out to determine the factor structure and independent associations between the instrument domains and CD-4T-cell count were assessed using multivariable linear regression RESULTS: High Cronbach alpha 0.93 was found for all WHOQOL HIV Bref facets. The test-retest reliability demonstrated a statistically significant ICC ranged from 0.88 to 0.98 (p HIV Bref is a psychometrically valid and culturally well-adapted HRQoL measurement tool for PLWHA in Pakistan.

    Matched MeSH terms: HIV Infections/psychology*
  2. Adekunjo FO, Rasiah R, Dahlui M, Ng CW
    Afr J AIDS Res, 2020 Dec;19(4):287-295.
    PMID: 33337980 DOI: 10.2989/16085906.2020.1834417
    HIV/AIDS is a major health issue faced by the world, generally, but particularly sub-Saharan Africa. Nigeria ranked third in the world by number of people living with HIV/AIDS in 2019. Despite prominent HIV counselling and testing (HCT) intervention programmes, Nigeria faces serious challenges, such as inadequate funding and low utilisation rates. Paucity of research into such a critical topic has restricted the capacity of policy makers to address the problem adequately. Consequently, a cross-sectional study was carried out using the contingent valuation method to assess the economic quantum of payment and determining factors associated with people's willingness to pay for HCT services. Data were collected from 768 people selected by convenience sampling of three local government areas - Alimosho, Ikorodu and Surulere in Lagos State, Nigeria. Data were analysed using descriptive statistics, chi-square, Mann-Whitney, and general linear regression model analysis. Findings show that 75% of respondents were willing to pay an average fee of N1 291 ($4.22) for HCT services. Significant determinants of willingness to pay were: income; knowledge of someone living with HIV or died of AIDS; worry about HIV infection; and fear of HIV-related stigma. The findings offer vital information germane to co-payment schemes aimed at financial sustainability of HCT and HIV/AIDS programmes in Nigeria.
    Matched MeSH terms: HIV Infections/psychology
  3. Mohd Salleh NA, Van Draanen J, Nosova E, Barrios R, Milloy MJ, Richardson L
    AIDS, 2020 06 01;34(7):1037-1045.
    PMID: 32073444 DOI: 10.1097/QAD.0000000000002501
    OBJECTIVE: To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care.

    DESIGN: We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 to 2017.

    METHODS: We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score. We then estimated the association between achieving at least 95% adherence to ART and overall mean material score, as well as mean score for three factors derived from a factor analysis. The three-factor structure, employed in the current analyses, were factor 1 (basic needs); factor 2 (housing-related variables) and factor 3 (economic resources).

    RESULTS: Recent incarceration [β-coefficient (β) = -0.176, 95% confidence interval (95% CI): -0.288 to -0.063], unmet health needs [β = -0.110, 95% CI: -0.178 to -0.042), unmet social service needs (β = -0.264, 95% CI: -0.336 to -0.193) and having access to social services (β= -0.102, 95% CI: -0.1586 to -0.0465) were among the factors associated with lower material security scores. Contrary to expectations that low levels of material security in this population would lead to poor ART adherence, we did not observe a significant relationship between adherence and overall material security score, or for each factor individually.

    CONCLUSION: Our findings highlight the potentially important role of no-cost, universal access to HIV prevention and treatment, in mitigating the impact of socioeconomic disadvantage on ART adherence.

    Matched MeSH terms: HIV Infections/psychology*
  4. Islam R, Ahmad R, Ghailan K, Hoque KE
    J Relig Health, 2020 Jun;59(3):1327-1343.
    PMID: 31134517 DOI: 10.1007/s10943-019-00832-8
    People with HIV/AIDS (PLWHA) commonly pose problems to their family as well as to society because of their vulnerable health and economic conditions. Contrarily, PLWHA encounter social discrimination and adverse realities while finding it difficult to continue in their jobs. These complex phenomena interact to push them into a low economic status. A microfinance program can hopefully assist poor patients to cope with the negative economic consequences of this disease. But the conventional market-oriented microfinance institutions show reluctance to serve this group of people due to the possibilities of having credit risk. In this paper, we propose an alternative microfinancing technique that can provide a better economic life of the PLWHA while absorbing the credit risks. A comprehensive model is designed using specific Islamic financial instruments in conjugation with household economic portfolio theory. Critical realism method was adopted to construct this model. We concluded that the application of Islamic microfinance can enhance income of HIV patients while reducing the productivity-loss. This model can be useful to the microfinance practitioners and policymakers for addressing a different market segment, diversifying products, and formulating policy.
    Matched MeSH terms: HIV Infections/psychology*
  5. Ng RX, Guadamuz TE, Akbar M, Kamarulzaman A, Lim SH
    Int J STD AIDS, 2020 05;31(6):568-578.
    PMID: 32299293 DOI: 10.1177/0956462420913444
    Matched MeSH terms: HIV Infections/psychology
  6. Lim SH, Brown SE, Shaw SA, Kamarulzaman A, Altice FL, Beyrer C
    J Homosex, 2020;67(1):104-126.
    PMID: 30307803 DOI: 10.1080/00918369.2018.1525946
    Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.
    Matched MeSH terms: HIV Infections/psychology*
  7. Culbert GJ, Waluyo A, Wang M, Putri TA, Bazazi AR, Altice FL
    AIDS Behav, 2019 Aug;23(8):2048-2058.
    PMID: 30465106 DOI: 10.1007/s10461-018-2344-6
    With adequate support, people with HIV (PWH) may achieve high levels of adherence to antiretroviral therapy (ART) during incarceration. We examined factors associated with ART utilization and adherence among incarcerated PWH (N = 150) in Indonesia. ART utilization was positively associated with HIV status disclosure (adjusted odds ratio [aOR] = 5.5, 95% CI 1.2-24.1, p = 0.023), drug dependency (aOR = 3.9, 95% CI 1.2-12.6, p = 0.022), health service satisfaction (aOR = 3.2, 95% CI 1.7-6.2, p 
    Matched MeSH terms: HIV Infections/psychology
  8. Lim SH, Alias H, Kien JKW, Akbar M, Kamarulzaman A, Wong LP
    AIDS Educ Prev, 2019 06;31(3):193-205.
    PMID: 31145000 DOI: 10.1521/aeap.2019.31.3.193
    This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.
    Matched MeSH terms: HIV Infections/psychology
  9. Ross JL, Teeraananchai S, Lumbiganon P, Hansudewechakul R, Chokephaibulkit K, Khanh TH, et al.
    J Acquir Immune Defic Syndr, 2019 06 01;81(2):e28-e38.
    PMID: 30865173 DOI: 10.1097/QAI.0000000000002008
    BACKGROUND: Adolescents living with HIV (ALHIV) have poorer adherence and clinical outcomes than adults. We conducted a study to assess behavioral risks and antiretroviral therapy outcomes among ALHIV in Asia.

    METHODS: A prospective cohort study among ALHIV and matched HIV-uninfected controls aged 12-18 years was conducted at 9 sites in Malaysia, Thailand, and Vietnam from July 2013 to March 2017. Participants completed an audio computer-assisted self-interview at weeks 0, 48, 96, and 144. Virologic failure (VF) was defined as ≥1 viral load (VL) measurement >1000 copies/mL. Generalized estimating equations were used to identify predictors for VF.

    RESULTS: Of 250 ALHIV and 59 HIV-uninfected controls, 58% were Thai and 51% females. The median age was 14 years at enrollment; 93% of ALHIV were perinatally infected. At week 144, 66% of ALHIV were orphans vs. 28% of controls (P < 0.01); similar proportions of ALHIV and controls drank alcohol (58% vs. 65%), used inhalants (1% vs. 2%), had been sexually active (31% vs. 21%), and consistently used condoms (42% vs. 44%). Of the 73% of ALHIV with week 144 VL testing, median log VL was 1.60 (interquartile range 1.30-1.70) and 19% had VF. Over 70% of ALHIV had not disclosed their HIV status. Self-reported adherence ≥95% was 60% at week 144. Smoking cigarettes, >1 sexual partner, and living with nonparent relatives, a partner or alone, were associated with VF at any time.

    CONCLUSIONS: The subset of ALHIV with poorer adherence and VF require comprehensive interventions that address sexual risk, substance use, and HIV-status disclosure.

    Matched MeSH terms: HIV Infections/psychology*
  10. Tee YC, Earnshaw VA, Altice FL, Jin H, Kamarulzaman A, Wickersham JA
    AIDS Behav, 2019 Apr;23(4):1039-1047.
    PMID: 30560483 DOI: 10.1007/s10461-018-2362-4
    People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.
    Matched MeSH terms: HIV Infections/psychology*
  11. Mukherjee T, Sakthivel R, Fong HY, McStea M, Chong ML, Omar SF, et al.
    AIDS Behav, 2018 Oct;22(10):3226-3233.
    PMID: 29508103 DOI: 10.1007/s10461-018-2073-x
    This study determines the optimal cut-off scores for the Montreal Cognitive Assessment (MoCA) to detect HIV-associated neurocognitive disorders (HAND) in a multi-ethnic Malaysian HIV-positive cohort by developing demographically corrected normative standards among 283 HIV-negative community-based controls with overlapping demographic characteristics. The norms (corrected for age, sex, education, ethnicity) were applied to 342 HIV-positive virally suppressed individuals on cART. Impairment rates were classified using the Global Deficit Score (GDS ≥ .5) method. The MoCA was also scored according to the recommended cut-off of ≤ 26, and functional decline was applied to both impairment definitions to classify HAND per the Frascati criteria. The ≤ 26 cut-off considerably overestimated cognitive impairment in both samples (59.4% HIV-negative; 69.3% HIV-positive). In contrast, corrected scores yielded impairment rates consistent with what has been reported internationally in virally suppressed cohorts (23.4% with 83.3% mild impairment, 16.7% moderate impairment). A supplemental file allowing the computation of corrected MoCA scores and impairment status is included.
    Matched MeSH terms: HIV Infections/psychology*
  12. Khan MAN, Md Rosly NA, Abdul Majeed AB, Ismail NE
    Pak J Pharm Sci, 2018 Sep;31(5):1985-1990.
    PMID: 30150198
    The school students are of particular importance in the HIV/AIDS awareness policies at both local and international level. This study was conducted to assess the level of knowledge of the modes of HIV transmission among urban and rural public secondary school students in Malaysia. In this cross-sectional study, post local ethics approval, 600self-administered questionnaires were randomly disseminated to students in 6 different secondary schools and areas (i.e. 3 urban schools and 3 rural schools). Data were descriptively and inferentially analyzed using Statistical Package of Social Sciences (SPSS®), version 17. The Pearson Chi-Square test was applied where applicable. Most respondents had heard about HIV (overall response rate: 96.2%). However, 8.9% of rural respondents (27/302) never heard about HIV and were excluded. Therefore, 275 urban students (Kuala Lumpur, Selangor, and Pahang) and 275 rural students (Terengganu) who successfully completed and returned the questionnaires were included in data analysis. Many respondents were female and within the age range of 15-16 years old. Most respondents in both areas knew that sharing needles can transmit HIV (93.5% urban; 97.1% rural). Out of 15 items concerning transmission modes of HIV, eight items showed significant values (p < 0.05) of rural vs. urban: saliva, urine, tears, using same swimming pool, blood transfusion, mosquito bites, sharing foods and donating blood to HIV patients. About 90.2% and 79.6% of respondents in urban and rural areas used television and newspapers as main source of knowledge on HIV, respectively. The implementation of incessant HIV and AIDS education programme could be useful in order to enhance and sustain awareness concerning HIV/AIDS among secondary school students.
    Matched MeSH terms: HIV Infections/psychology
  13. Prasitsuebsai W, Sethaputra C, Lumbiganon P, Hansudewechakul R, Chokephaibulkit K, Truong KH, et al.
    AIDS Care, 2018 06;30(6):727-733.
    PMID: 29336591 DOI: 10.1080/09540121.2018.1425363
    We studied behavioral risks among HIV-infected and uninfected adolescents using an audio computer-assisted self-interview. A prospective cohort study was initiated between 2013 and 2014 in Malaysia, Thailand, and Vietnam. HIV-infected adolescents were matched to uninfected adolescents (4:1) by sex and age group (12-14 and 15-18 years). We enrolled 250 HIV-infected (48% male; median age 14.5 years; 93% perinatally infected) and 59 uninfected (51% male; median age 14.1 years) adolescents. At enrollment, HIV-infected adolescents were on antiretroviral therapy (ART) for a median (IQR) of 7.5 (4.7-10.2) years, and 14% had HIV-RNA >1000 copies/mL; 19% reported adherence <80%. Eighty-four (34%) HIV-infected and 26 (44%) uninfected adolescents reported having ever smoked cigarettes or drunk alcohol (p = 0.13); 10% of HIV-infected and 17% of uninfected adolescents reported having initiated sexual activity; 6 of the HIV-infected adolescents had HIV-RNA >1000 copies/mL. Risk behaviors were common among adolescents, with few differences between those with and without HIV.
    Matched MeSH terms: HIV Infections/psychology*
  14. Burch WJ, Hart GJ, Lim SH
    AIDS Educ Prev, 2018 04;30(2):85-95.
    PMID: 29688771 DOI: 10.1521/aeap.2018.30.2.85
    Young men who have sex with men (YMSM) are a group at high risk for HIV infection, yet no research has been conducted to understand this population in Malaysia. Semistructured interviews from a combination of YMSM aged 18-25 (n = 20) and local service providers of sexual health services (n = 4) were conducted from May to June 2015. Thematic analysis was used to identify common themes in participant responses from transcripts. Participants reported societal and internalized homophobia, an absence of sex education and difficulty accessing confidential HIV testing. This study provides insights into how homophobia in Malaysian society influences individual risk behavior for HIV in Malaysian YMSM, and makes practical suggestions for more effective HIV prevention in this population.
    Matched MeSH terms: HIV Infections/psychology
  15. Bazazi AR, Vijay A, Crawford FW, Heimer R, Kamarulzaman A, Altice FL
    AIDS Care, 2018 Jan;30(1):59-64.
    PMID: 28803503 DOI: 10.1080/09540121.2017.1363852
    HIV testing services are the gateway into HIV treatment and are critical for monitoring the epidemic. HIV testing is recommended at least annually in high-risk populations, including people who inject drugs (PWID). In Malaysia, the HIV epidemic is concentrated among PWID, but their adherence to testing recommendations and the proportion of HIV-positive PWID who are aware of their status remain unknown. We recruited 460 PWID in Greater Kuala Lumpur using respondent-driven sampling and conducted HIV testing. We examined past testing behaviors, estimating testing frequency, correlates of testing in the past 12 months, and the proportion of those living with HIV who were aware of their status. Results showed that most PWID living with HIV (90.4%, 95% CI: 83.6%-95.9%) were aware of their status. Among those never previously diagnosed with HIV, few had accessed HIV testing in the past 12 months (14.3%, 95% CI: 11.1%-18.0%). Prison (57.0%) and compulsory drug detention centers (36.1%) were the primary locations where PWID reported ever being HIV tested, and the main correlate of recent testing in regression was recent criminal justice involvement. Although awareness of HIV status may be high among PWID living with HIV in Kuala Lumpur, testing occurs primarily in prisons and compulsory drug detention centers, where it is involuntary and linkage to care is limited. A shift in HIV testing policy is needed to align health and human rights objectives, replacing mandatory testing with voluntary testing in settings where individuals can be rapidly linked to HIV care.
    Matched MeSH terms: HIV Infections/psychology
  16. Lemin AS, Rahman MM, Pangarah CA
    J Environ Public Health, 2018;2018:2194791.
    PMID: 30186334 DOI: 10.1155/2018/2194791
    Background: Disclosure of HIV-positive status is an essential prerequisite for the prevention and care of person living with HIV/AIDS as well as to tackle hidden epidemic in the society.

    Objective: To determine the intention to disclose the HIV/AIDS status among adult population in Sarawak, Malaysia, and factors affecting thereof.

    Methods: This cross-sectional community-based study was conducted among adult population aged 18 years and above in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the participants. A total of 900 respondents were successfully interviewed by face-to-face interview using interview schedule. Stepwise binary logistic regression models were fitted in SPSS version 22.0 to identify the factors associated with the disclosure of HIV/AIDS status. A p value less than 0.05 was considered as statistically significant.

    Results: The mean (SD) age of male and female respondents was 41.57 (13.45) and 38.99 (13.09) years, respectively. A statistically significant difference of intention to disclosure of HIV status was found between males and females (p < 0.05). A stepwise binary logistic regression analysis revealed that age, occupation, knowledge on HIV transmission, and content of discussion about HIV/AIDS appeared to be potential predictors for male respondents to disclose HIV status, while ethnicity and content of discussion on HIV/AIDS were found to be important predictors among the female respondents (p < 0.05).

    Conclusion and Recommendation: Though the study did not depict the national prevalence of disclosure of HIV/AIDS status, the findings of the study would provide an important basic information for programme intervention, policy, and future research agenda.
    Matched MeSH terms: HIV Infections/psychology*
  17. Bisallah CI, Rampal L, Lye MS, Mohd Sidik S, Ibrahim N, Iliyasu Z, et al.
    PLoS One, 2018;13(2):e0192276.
    PMID: 29470530 DOI: 10.1371/journal.pone.0192276
    INTRODUCTION: The risk of development of active TB in HIV-infected individuals is 20-37 times higher than those that are HIV negative. Poor knowledge of TB amongst people living with HIV has been associated with high transmission.

    OBJECTIVES: To determine the effectiveness of a new health education intervention module in improving knowledge, attitude, and practice (KAP) regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria.

    METHODS: A randomized control trial was carried out from July 2015 to June 2017. A random number generating program was used to allocate 226 respondents into 2 groups. The intervention group received health education regarding tuberculosis using the developed module. The control group received the normal services provided for HIV patients. Data were collected from December 2015 to September 2016 at baseline, immediate post intervention, three, six and nine months. The outcome measures were knowledge, attitude, and practice.

    RESULTS: There was no significant difference with respect to socio-demographic characteristics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, group main effect (F = (1,218) = 665.889, p = 0.001, partial ἠ2 = 0.753, d = 5.4); time (F = (3.605, 218) = 52.046, p = 0.001, partial ἠ2 = 0.193, d = 1.52) and interaction between group with time (F = (3.605, 218) = 34.028, p = 0.001, partial ἠ2 = 0.135, d = 1.23). Likewise, there was significant improvement in attitude, group main effect (p = 0.001, d = 1.26) and time (p = 0.001, p, d = 0.65). Similarly, there was improvement in practice, group main effect, time, and interaction of group with time (p < 0.05).

    CONCLUSION: The health education intervention program was effective in improving KAP regarding tuberculosis among HIV patients.

    Matched MeSH terms: HIV Infections/psychology*
  18. Shrestha R, Weikum D, Copenhaver M, Altice FL
    AIDS Behav, 2017 Apr;21(4):1070-1081.
    PMID: 27544515 DOI: 10.1007/s10461-016-1526-3
    Prior research has widely recognized neurocognitive impairment (NCI), depression, and alcohol use disorders (AUDs) as important negative predictors of health-related quality of life (HRQoL) among people living with HIV (PLWH). No studies to date, however, have explored how these neuropsychological factors operate together and affect HRQoL. Incarcerated male PLWH (N = 301) meeting criteria for opioid dependence were recruited from Malaysia's largest prison. Standardized scales for NCI, depression, alcohol use disorders (AUDs) and HRQoL were used to conduct a moderated mediation model to explore the extent to which depression mediated the relationship between NCI, HRQoL, and AUDs using an ordinary least squares regression-based path analytic framework. Results showed that increasing levels of NCI (B = -0.1773, p HIV treatment, negatively influenced HRQoL via depression for individuals with AUDs. This highlights the need for future interventions to target these complex interplay between neuropsychological factors in order to improve HRQoL among PLWH, particularly incarcerated PLWH with AUDs.
    Matched MeSH terms: HIV Infections/psychology*
  19. Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL
    AIDS Behav, 2017 Apr;21(4):1059-1069.
    PMID: 28108877 DOI: 10.1007/s10461-017-1693-x
    Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p HIV-related stigma and depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.
    Matched MeSH terms: HIV Infections/psychology*
  20. Bijker R, Jiamsakul A, Kityo C, Kiertiburanakul S, Siwale M, Phanuphak P, et al.
    J Int AIDS Soc, 2017 03 03;20(1):21218.
    PMID: 28362063 DOI: 10.7448/IAS.20.1.21218
    INTRODUCTION: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia.
    METHODS: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at follow-up clinic visits using a 30-day visual analogue scale. Determinants of suboptimal adherence (<95%) were assessed for six-month intervals, using generalized estimating equations multivariable logistic regression with multiple imputations. Region of residence (Africa vs. Asia) was assessed as a potential effect modifier.
    RESULTS: Of 13,001 adherence assessments in 3934 participants during the first 24 months of ART, 6.4% (837) were suboptimal, with 7.3% (619/8484) in the African cohort versus 4.8% (218/4517) in the Asian cohort (p 
    Matched MeSH terms: HIV Infections/psychology
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