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  1. Mims FM
    Nature, 1997 Nov 20;390(6657):222-3.
    PMID: 9384366 DOI: 10.1038/36715
    Matched MeSH terms: Indonesia
  2. Saroinsong WP, Boonroungrut C
    Acta Psychol (Amst), 2026 Oct;270:107967.
    PMID: 42887080 DOI: 10.1016/j.actpsy.2026.107967
    Within the framework of the stress-buffering model and ecological systems theory, the increasing integration of digital engagement into motherhood underscores the need to understand how psychosocial and technological factors relate to maternal mental health. This study examined the associations of demographic factors, social support, quality of life (QoL), and sharenting behavior with Indonesian mothers' emotional well-being (EWB). A cross-sectional survey was conducted with 300 Indonesian mothers aged 21-55 years who had children aged 0-8 years. Pearson correlations were used to examine bivariate associations, and an artificial neural network (ANN) was used to classify participants into below-median and above-median EWB groups based on a median split, using demographic, psychosocial, and sharenting-related predictors. EWB was positively associated with QoL (r = 0.68, p 
    Matched MeSH terms: Indonesia
  3. Zerguine H, Tamrin SBM, Jalaludin J
    Ind Health, 2018 Jun 01;56(3):264-273.
    PMID: 29398685 DOI: 10.2486/indhealth.2017-0205
    Malaysian construction sector is regarded as critical in the field of health because of the high rates of accidents and fatalities. This research aimed to determine the prevalence, sources and severity of injuries and its association with commitment to safety among foreign construction workers. A cross-sectional study was conducted among 323 foreign construction workers from six construction projects of a large organization in Malaysia, using a simple random sampling method. Data was collected using a structured questionnaire to assess work-related injuries and safety commitment. The collected data was analysed by SPSS 22.0 using descriptive statistics and χ2 test. The prevalence of work-related injuries in a one year period was 22.6%, where most of the injuries were of moderate severity (39.7%) and falls from heights represented the main source (31.5%). The majority of the foreign construction workers had perceived between moderate and high safety commitment, which was significantly associated with work-related injuries. The results also showed a significant association of work-related injuries with the company's interest in Safety and Health, Safety and Health training, and safety equipment. Thus, the implementation of new procedures and providing relevant trainings and safety equipment; will lead to a decrease in injury rates in construction sites.
    Matched MeSH terms: Indonesia/ethnology
  4. Hong SA, Peltzer K
    Subst Use Misuse, 2019;54(2):288-296.
    PMID: 30463459 DOI: 10.1080/10826084.2018.1517797
    BACKGROUND: Though alcohol and tobacco are the most commonly used substances among adolescents, little is known about the patterning of early adolescent substance use in Association of South-East Asian Nations (ASEAN) member states.

    OBJECTIVES: This study examined past month patterns of substances use and its gender difference among adolescents.

    METHODS: Cross-sectional samples among adolescents aged 13-16 years who completed the Global School-based Student Health Survey (GSHS) from eight ASEAN countries were included in the analysis (n = 40,212).

    RESULTS: Prevalence of past month any tobacco use was relatively high in Brunei, Indonesia, Malaysia, Thailand, and the Philippines (11-15%), but prevalence of dual cigarette and other forms of tobacco use was about 2-5% in the five countries. Past month alcohol consumption prevalence was also high in Thailand, Viet Nam, and the Philippines (16-24%), compared to the rest countries (1.4-8.2%). Moreover, prevalence of the concurrent alcohol and tobacco use was higher in Thailand and the Philippines (7 and 10%, respectively), particularly in boys (13 and 15%, respectively). Conclusions/importance: Almost 30-40% of the boys and 10-20% of girls in Malaysia, Philippines, Thailand, and Viet Nam are engaged in at least one of the two risk behaviors, and the concurrent alcohol and tobacco use was also relatively high among boys in those countries (5-15%). This study may provide some valuable insights on alcohol and tobacco policy in the region and requires to begin prevention and treatment programs in ASEAN member states.

    Matched MeSH terms: Indonesia/epidemiology
  5. Hartono RK, Hamid SA, Hafizurrachman M
    Asian Pac J Cancer Prev, 2019 May 25;20(5):1403-1408.
    PMID: 31127899
    Background: The incident of malignant cancer due to smoking habit becomes a public health problem especially
    in the developing countries. Active smokers neglect to stop smoking even though various studies proved that smoking
    increases the risk of cancer. While, previous studies have assessed the incident risk of cancer but have not performed the
    validity of the measurement. The aim of this study is to know the number of cigarettes that contribute to the incidence
    of malignant cancer. Methods: A study with retrospective cohort design has been conducted by using a set of public
    data of Indonesia Family Life Survey (IFLS) in 2007 and 2014. All active smokers (n= 748) who were in good health
    condition in 2007, were traced in 2014 and then being diagnosed with cancer with considering age, gender, healthy
    eating habit, and regular physical activity. Data has been analysed by using logistic regression by performing Adjusted
    Risk Ratio (ARR) and the result of validity measurement. Results: The incident of malignant cancer in 2014 were skin,
    liver, stomach and oral cavity. Smoking 21-30 per day in 2007 were significantly increased risk of having malignant
    cancer in 2014 at ARR: 6.88; SE:6.13 with the accuracy were 93.8%. The risk and accuracy were higher if smoke >30
    cigarettes per day (ARR:7.523; SE:7.019; accuracy 95.5%). This study also found that the risk of cancer was significantly
    increase with age (99% CI; ARR: 1.065; SE: 0.026). Conclusions: Cigarette smoking behaviour increased the risk any
    types incident of cancer. Total number >20 cigarettes smoked per day contributes to the incidence of malignant cancer.
    Matched MeSH terms: Indonesia/epidemiology
  6. Allia S, Norazmi MN, Panneerchelvam S, Zafarina Z
    Hum Immunol, 2019 Jul;80(7):423-424.
    PMID: 30836128 DOI: 10.1016/j.humimm.2019.02.015
    "Bumiputra" or "son of the soil" is a term used to represent the Malays and other indigenous populations of Malaysia. The Malays are Austronesian speaking population and originated from different parts of the Indo-Malay Archipelago. The migration of Malay population from different parts of Indo-Malay Archipelago were mainly due to trading purposes which shaped the current Malay sub-ethnic groups with unique culture and with distinctive dialects. In this study, HLA typing was carried out using Sequence-based Typing (SBT) method on 109 individuals comprising of four Malay sub-ethnic groups namely Kelantan (n = 28), Champa (n = 29), Patani (n = 25) and Mandailing (n = 27) Malays. The HLA data is available in the Allele Frequencies Net Database (AFND).
    Matched MeSH terms: Indonesia/ethnology
  7. Myzabella N, Fritschi L, Merdith N, El-Zaemey S, Chih H, Reid A
    Int J Occup Environ Med, 2019 10;10(4):159-173.
    PMID: 31586381 DOI: 10.15171/ijoem.2019.1576
    BACKGROUND: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety.

    OBJECTIVE: To identify and summarize occupational hazards among oil palm plantation workers.

    METHODS: A search was carried out in June 2018 in PubMed, Web of Science, Scopus, and Ovid. Relevant publications were identified by a systematic search of four databases and relevant journals. Publications were included if they examined occupational hazards in oil palm plantation workers.

    RESULTS: 941 publications were identified; of these, 25 studies were found eligible to be included in the final review. Of the 25 studies examined, 19 were conducted in Malaysia, 2 in Costa Rica, and one each in Ghana, Indonesia, Myanmar, Papua New Guinea, and Cameroon. Oil palm plantation workers were found to be at risk of musculoskeletal conditions, injuries, psychosocial disorders, and infectious diseases such as malaria and leptospirosis. In addition, they have potential exposure to paraquat and other pesticides.

    CONCLUSION: In light of the potential of palm oil for use as a biofuel, this is an industry with strong growth potential. The workers are exposed to various occupational hazards. Further research and interventions are necessary to improve the working conditions of this already vast and growing workforce.

    Matched MeSH terms: Indonesia/epidemiology
  8. Yunihastuti E, Teeratakulpisarn N, Jeo WS, Nilasari H, Rachmadi L, Somia IKA, et al.
    AIDS, 2020 11 01;34(13):1933-1941.
    PMID: 32773478 DOI: 10.1097/QAD.0000000000002654
    OBJECTIVES: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence.

    DESIGN: Prospective cohort study.

    METHODS: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence.

    RESULTS: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence.

    CONCLUSION: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.

    Matched MeSH terms: Indonesia/epidemiology
  9. Ferrario A, Stephens P, Guan X, Ross-Degnan D, Wagner A
    Bull World Health Organ, 2020 Jul 01;98(7):467-474.
    PMID: 32742032 DOI: 10.2471/BLT.19.243998
    OBJECTIVE: To assess sales of anti-cancer medicines in the 2017 World Health Organization's WHO Model list of essential medicines in China, Indonesia, Kazakhstan, Malaysia, Philippines and Thailand from 2007 (2008 for Kazakhstan and Malaysia) to 2017.

    METHODS: We extracted sales volume data for 39 anti-cancer medicines from the IQVIA database. We divided the total quantity sold by the reference defined daily dose to estimate the total number of defined daily doses sold, per country per year, for three types of anti-cancer therapies (traditional chemotherapy, targeted therapy and endocrine therapy). We adjusted these data by the number of new cancer cases in each country for each year.

    FINDINGS: We observed an increase in sales across all types of anti-cancer therapies in all countries. The largest number of defined daily doses of traditional chemotherapy per new cancer case was sold in Thailand; however, the largest relative increase per new cancer case occurred in Indonesia (9.48-fold). The largest absolute and relative increases in sales of defined daily doses of targeted therapies per new cancer case occurred in Kazakhstan. Malaysia sold the largest number of adjusted defined daily doses of endocrine therapies in 2017, while China and Indonesia more than doubled their adjusted sales volumes between 2007 and 2017.

    CONCLUSION: The use of sales data can fill an important knowledge gap in the use of anti-cancer medicines, particularly during periods of insurance coverage expansion. Combined with other data, sales volume data can help to monitor efforts to improve equitable access to essential medicines.

    Matched MeSH terms: Indonesia/epidemiology
  10. Lee HS, Khoo YM, Chua BC, Ng AS, Tan SS, Chew SL
    Ther Drug Monit, 1995 Aug;17(4):336-41.
    PMID: 7482686
    The pharmacokinetics of propofol was studied in 11 Asian patients with fentanyl-isoflurane anaesthesia during cardiopulmonary bypass (CPB) and undergoing elective coronary artery bypass grafting (CABG). Instead of the usual increments of morphine and a benzodiazepine, propofol (4 mg/kg/h) was initiated at the start of CPB and ceased at CPB separation. Whole blood propofol concentrations were determined during and postinfusion using high-performance liquid chromatography with fluorescence detection. Data from four patients seemed to fit a two-compartment model, whereas those from seven patients were significantly (F test, p < 0.05) better fitted to a three-compartment model. The pharmacokinetic parameters were as follows: The mean (SD) of the initial distribution phase t1/2 pi, intermediate distribution phase t1/2 alpha, and elimination phase t1/2 beta were 2.22 (1.04) min, 42.9 (16.4) min, and 370 (138) min, respectively. The mean clearance of 1.31 (0.50) L/min was lower than those reported from other studies, whereas the mean blood concentration of 2.2 (1.0) mg/L at the 1-h infusion period was higher. The mean calculated apparent Css was 3.9 (1.5) mg/L. The low clearance is likely to be due to hemodynamic changes during CPB and CABG, thereby affecting drug distribution and blood flow to the liver.
    Matched MeSH terms: Indonesia/ethnology
  11. Suryana K K, Widiana RIG, Suharsono H, Pujasakti MP, Putra WWS, Yaniswari NMD
    Med J Malaysia, 2021 07;76(4):461-465.
    PMID: 34305105
    INTRODUCTION: COVID-19 pandemic has a substantial impact on human life including the tourism sector (TS). Bali as a tourism destinations and the TS as major incomes of its population is greatly impacted, causing many to be jobless among those involved in TS. This situation may give psychological impact causing anxiety disorder (AD).

    OBJECTIVE: To investigate the association between severe anxiety disorder and other factors with COVID-19 disease severity.

    METHODS: This was cross-sectional study during March - November 2020. The diagnosis of SARS-CoV-2 was done by using RT-PCR from throat swabs, based on WHO's interim guidelines. AD was measured using self-reporting Generalized Anxiety Disorder-7 (GAD-7). All participants underwent, history taking, physical examinations, blood routine examination and chest radiography. Association between severe AD and other factors with COVID-19 disease severity were analyzed. Chi-square test (bivariate) and Logistic regression (multivariate) with the precision value of 95% was done and p-value less than 5% was considered significant.

    RESULTS: Positive rate of Covid-19 patients was 43% (292 / 678). Among those 292 with Covid-19, 74 (25.3%) participants had severe disease. Multivariate analysis showed severe anxiety (OR 696.11; 95%CI: 78.54 to 6169.98; p<0.001), hypertension (OR 37.02; 95%CI: 4.49 to 305.39; p=0.001) and neutrophyl lymphocyte ratio (NLR) less than 2.89 (OR 0.15; 95%CI: 0.04 to 0.62; p=0.009).

    CONCLUSION: Severe anxiety, hypertension and NLR less than 2.89 are potential independent risk factors for severe infection of SARS-CoV-2 (COVID-19).

    Matched MeSH terms: Indonesia/epidemiology
  12. Musa R, Draman S, Jeffrey S, Jeffrey I, Abdullah N, Halim NA, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S13-6.
    PMID: 23318005 DOI: 10.1016/j.comppsych.2012.12.002
    In 2004, the province of Aceh, Indonesia was rocked by tsunami and in September 2009, West Sumatra, Indonesia was hit by an earthquake. The aim of this study was to determine the long-term psychological impact on the residents inhabiting these regions and to identify factors associated with it.
    Matched MeSH terms: Indonesia/epidemiology
  13. Sahbandar IN, Takahashi K, Djoerban Z, Firmansyah I, Naganawa S, Motomura K, et al.
    AIDS Res Hum Retroviruses, 2009 Jul;25(7):637-46.
    PMID: 19621986 DOI: 10.1089/aid.2008.0266
    HIV infection is a major problem in Indonesia. The number of people living with HIV has been increasing from year to year, especially among injecting drug users (IDUs). Since there were only limited data about molecular epidemiology profiles of HIV/AIDS in Indonesia, a cross-sectional study involving 208 HIV-1-seropositive individuals was conducted in 2007 in Jakarta. The majority of participants were 16-30 years of age (64.9%) and 74.5% were male. The most frequent risk factor was injecting drug use (IDU) (45.7%) followed by heterosexual transmission (34.1%). Phylogenetic analysis of gag (p17 and p6) and env C2V3 regions showed 200 (96.2%) of 208 DNA samples were CRF01_AE and only 3 (1.4%) were subtype B. Five samples (2.4%) indicated discordant subtypes between the three aforementioned regions: three of them showed unique CRF01_AE/B recombination patterns in 2.3-kbp nucleotide sequences (from p17 to part of RT), including one sample showing similarity to CRF33_01B, reported previously in Malaysia. This study shows the current predominant subtype is CRF01_AE in every risk group, with a decreasing number of pure subtype B, and the first identification of CRF01_AE/B recombinant forms among HIV-1-seropositive Indonesians.
    Matched MeSH terms: Indonesia/epidemiology
  14. Mizuno Y, Kato Y, Takeshita N, Ujiie M, Kobayashi T, Kanagawa S, et al.
    J Infect Chemother, 2011 Jun;17(3):419-23.
    PMID: 20862507 DOI: 10.1007/s10156-010-0124-y
    Chikungunya fever (CHIKF) is currently distributed in Africa and in South and Southeast Asia; outbreaks have occurred periodically in the region over the past 50 years. After a large outbreak had occurred in countries in the western Indian Ocean region in 2005, several countries reported cases of CHIKF from travelers who had visited affected areas. In Japan, there have been only 15 cases of CHIKF patients so far, according to the National Institute of Infectious Diseases. Therefore, to evaluate the clinical and radiological features associated with the disease, we describe 6 imported cases of CHIKF. All of the patients had had prolonged arthralgia on admission to our hospital, and diagnosis was confirmed with specific antibodies by using an IgM-capture enzyme-linked immunoassay and a plaque reduction neutralizing antibody assay. Magnetic resonance imaging (MRI) of one patient revealed erosive arthritis and tenosynovitis during the convalescence stage. Clinicians should be aware of the late consequences of infection by the chikungunya virus (CHIKV) and recognize the possible association of subacute and chronic arthritis features. In addition, competent vectors of CHIKV, Aedes aegypti, can now be found in many temperate areas of the eastern and western hemispheres, including Japan. This fact raises concern that the virus could be introduced and become established in these areas. This necessitates an increased awareness of the disease, because imported cases are likely to contribute to the spread of CHIKV infection wherever the competent mosquito vectors are distributed.
    Matched MeSH terms: Indonesia/epidemiology
  15. Singh B, Simon Divis PC
    Emerg Infect Dis, 2009 Oct;15(10):1657-8.
    PMID: 19861067 DOI: 10.3201/eid1510.090364
    After orangutans in Indonesia were reported as infected with Plasmodium cynomolgi and P. vivax, we conducted phylogenetic analyses of small subunit ribosomal RNA gene sequences of Plasmodium spp. We found that these orangutans are not hosts of P. cynomolgi and P. vivax. Analysis of >or=1 genes is needed to identify Plasmodium spp. infecting orangutans.
    Matched MeSH terms: Indonesia/epidemiology
  16. Ng CH, Pathy NB, Taib NA, Teh YC, Mun KS, Amiruddin A, et al.
    Asian Pac J Cancer Prev, 2011;12(11):2943-6.
    PMID: 22393968
    INTRODUCTION: The age standardised incidence rate (ASR) of breast cancer in Malaysia which is a high middle- income country is similar to Indonesia, a low middle-income country. (Globocan 2008) It is however unknown whether the presentation of breast cancer differs between these two countries.

    OBJECTIVE: We compared the stage, age at presentation, and pathological characteristics of breast cancer between two tertiary hospitals in Indonesia and Malaysia; Dharmais Cancer Centre (DCC), which is the national cancer referral centre in Indonesia, and University Malaya Medical Centre (UMMC), which is an academic hospital with established breast oncology services in Kuala Lumpur. One thousand, one hundred and fourteen consecutive women (477 in UMMC: 637 in DCC) who were newly diagnosed with breast cancer between January and December, 2010 were included. Patient's age, TNM stage at presentation, and pathological characteristics were compared. Estrogen receptor (ER) and progesterone receptor (PR) were considered positive if 10% or greater of invasive cell nuclei were stained while HER2 was considered positive with an immunohistochemistry staining intensity of 3+ . Logistic regression analyses were performed to identify differences.
    RESULTS: Median age at diagnosis was 52 years in UMMC and 47 years in DCC, whereby patients in DCC were more likely to be very young at diagnosis (aged < 35 years) compared to their counterparts in UMMC (Odds ratio (OR): 2.09; 95%CI: 1.32-3.31). Approximately one third of patients in UMMC presented with TNM stage III or IV, compared to 63% in DCC. Patients in DCC were three times more likely to present with metastatic breast cancer compared to patients in UMMC (OR: 3.01; 95% CI: 2.02-4.48). The percentage of low grade tumours in DCC was higher than in UMMC (28% vs 11% respectively), and the difference persisted even after multivariate adjustment. Although the frequency of ER and PR positivity appeared to be higher in UMMC (65% and 55% respectively) compared to DCC (48% and 40% respectively), these differences were not statistically significant following adjustment for age, stage, HER2 status and grade. The frequency of HER2 positivity was 45% in DCC compared to 26% in UMMC, and remained significantly higher even after multivariate adjustment (multivariate OR:1.76; 95%CI:1.25-2.47, in DCC compared to UMMC). The proportion of triple negative breast cancer was however similar in the two centres (19% in UMMC vs 21% in DCC).
    CONCLUSION: Indonesian women with breast cancer seem to present at a younger age and at later stages compared to Malaysian women. Their tumors were more likely to be of low grade and HER2 positive, even after adjustment for other factors, while hormone receptor positivity proved similar in the two groups. The higher HER2 positivity rate in Indonesian patients warrants further study.
    Matched MeSH terms: Indonesia/epidemiology
  17. Hwang JC, Sadiq K
    Nationalism Ethn Polit, 2010;16(2):192-215.
    PMID: 20648997 DOI: 10.1080/13537113.2010.490757
    The Chinese minority plays a dominant role in the economies of Indonesia and Malaysia, a fact that evokes indigenous resentment. However, Indonesia and Malaysia dealt differently with the issue. Malaysia legislated the Malays into the economy and protected Chinese citizenship, making them an integral part of a multicultural state. By contrast, New Order Indonesia adopted policies of economic manipulation, forced assimilation, and unequal citizenship. Only when the New Order regime fell did Chinese integration begin. The policy trajectories of Indonesia and Malaysia offer important lessons for plural states.
    Matched MeSH terms: Indonesia/ethnology
  18. Isabelle M, Chan P
    Asia Pac J Clin Nutr, 2011;20(1):141-7.
    PMID: 21393122
    The Seminar on Young Child Nutrition: Improving Nutrition and Health Status of Young Children in Indonesia held in Jakarta on November 2009 reviewed the current nutritional and health status of young children in Indonesia and identified key nutrient deficiencies affecting their optimal growth. The continuation of child growth from fetal stage is of paramount importance; and maternal and child health should be a central consideration in policy and strategy development. Clinical management of nutrient deficiency and malnutrition, as well as strategies and education to improve feeding practices of young Indonesian children were discussed in the seminar. Relevant experiences, approaches and strategies from France, New Zealand and Malaysia were also shared and followed with discussion on how regulatory systems can support the development of health policy for young children. This report highlights important information presented at the seminar.
    Matched MeSH terms: Indonesia/epidemiology
  19. Sutomo R, Talib NA, Yusoff NM, Van Rostenberghe H, Sadewa AH, Sunarti, et al.
    Pediatr Int, 2004 Oct;46(5):565-9.
    PMID: 15491385
    There are significant differences in the prevalence and severity of neonatal jaundice among various populations. Recently, it has been reported that a mutation of the UGT1A1 gene, glycine to arginine at codon 71 (G71R), is related to the development of neonatal jaundice in East Asian populations. However, whether the G71R mutation contributes to the high incidence of neonatal jaundice in different Asian populations remains unknown. The authors screened for this mutation in the Javanese-Indonesian and Malay-Malaysian populations.
    Matched MeSH terms: Indonesia/epidemiology
  20. Culbert GJ, Waluyo A, Iriyanti M, Muchransyah AP, Kamarulzaman A, Altice FL
    Drug Alcohol Depend, 2015 Apr 01;149:71-9.
    PMID: 25659895 DOI: 10.1016/j.drugalcdep.2015.01.018
    BACKGROUND: In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released.

    AIMS: This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia.

    METHODS: 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory.

    RESULTS: Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment.

    CONCLUSIONS: Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.

    Matched MeSH terms: Indonesia/epidemiology
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