Exploring Factors for Future HIV Prevention in Malaysia

探索马来西亚未来艾滋病毒预防的因素

• 批准号: 8410349
• 负责人: TOORU NEMOTO
• 金额: $ 18.39万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8410349
• 关键词: AIDS prevention; AIDS/HIV problem; Abstinence; Acquired Immunodeficiency Syndrome; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Anal Sex; Asians; Caring; Categories; Collaborations; Communities; Country; Discrimination; Drug usage; Drug user; Education; Epidemic; Ethnic Origin; Exploratory/Developmental Grant; Female; Foundations; Future; Gays; Gender; Gender Identity; Goals; Government; HIV; Harm Reduction; Health; Health Promotion; Homosexuality; Human Rights; Illicit Drugs; Immigrant; Immigration; Incidence; Individual; Injecting drug user; Institutes; Intervention Studies; Interview; Laws; Legal; Letters; Malaysia; Malaysian; Methods; Modeling; Muslim population group; Muslim religion; Needle-Exchange Programs; Participant; Police; Policies; Population; Prevention; Prevention Research; Prevention program; Preventive Intervention; Prostitution; Provider; Public Health; Punishment; Recruitment Activity; Regulation; Religion; Religion and Spirituality; Reporting; Research Personnel; Respondent; Risk; Risk Behaviors; Sampling; Scientist; Services; Sex Orientation; Sexuality; Solid; Substance abuse problem; Surveys; Testing; Texas; Theoretical model; Universities; Woman; Work; base; experience; high risk; improved; informant; insight; intervention program; male; member; men; men who have sex with men; methadone maintenance; programs; sex; sex risk; social; transgender; transmission process

DESCRIPTION (provided by applicant): The proposed exploratory/developmental study will investigate homophobia/transphobia and other sociocultural factors that influence HIV-related risk behaviors among stigmatized high-risk groups in Malaysia: men who have sex with men (MSM) and male-to-female transgender women (mak nyah). In Malaysia, where the national religion is Islam; homosexuality, transgenderism, and alcohol use are punished among Muslims; and illicit drug use risks severe punishment by law. Through the collaborative efforts among researchers in Malaysia and the U.S. and service providers at the AIDS service organizations (ASOs), we will conduct an exploratory study to prepare future intervention studies to reduce substance abuse and HIV risk behaviors among MSM and mak nyah in Malaysia. Our study team which consists of experienced researchers has ample experience in conducting HIV prevention research for MSM and transgender populations in Malaysia, other Asian countries, and the U.S. The study will provide a solid foundation for understanding homophobia, transphobia, and other significant and meaningful sociocultural factors in relation to substance use and HIV risk behaviors, and will provide a better understanding of the lives of MSM and mak nyah in Malaysia. Based on study findings, our study team will be able to develop substance abuse and HIV prevention intervention studies in the future and recommend policy changes in Malaysia in collaboration with ASOs. The specific aims of the study are: 1) To explore and describe substance use and HIV-related sexual risk behaviors among MSM and mak nyah in Malaysia in relation to background variables; 2) To explore and describe homophobia and transphobia and other sociocultural factors which influence substance use and HIV risk behaviors among MSM and mak nyah in relation to background variables; 3) To explore and determine the theoretical models for future substance abuse and HIV prevention intervention studies specific to MSM and mak nyah; 4) To nurture and sustain the collaborative efforts and build capacity among Malaysian and the U.S. researchers and service providers at ASOs in Malaysia and to lay the groundwork for future substance abuse and HIV prevention intervention studies and programs; 5) To describe the policies and regulations regarding substance abuse and HIV prevention in Malaysia based on key informant interviews, summarize study findings, and recommend future policy changes. Based on purposive sampling, 24 MSM and 24 mak nyah will be recruited for the qualitative interviews. After completion of qualitative analysis, we will recruit 200 MSM and 200 mak nyah for survey interviews based on respondent driven sampling (RDS) methods. Based on mixed methods, we will test the hypotheses and conceptual models. In order to inform future policy changes in substance abuse and HIV prevention in Malaysia, we will also conduct qualitative interviews with 20 key informants. We will sustain our efforts in HIV prevention, health promotion, and human rights improvement for MSM and mak nyah in collaboration with ASOs. PUBLIC HEALTH RELEVANCE: In recent years, some progress has been made in Malaysia in terms of HIV/AIDS care and prevention. However, substance use and HIV prevention programs are underdeveloped despite the exponential increase in HIV/AIDS cases and incidences in recent years. The proposed study will have a significant public health impact on understanding the sociocultural contexts of substance use and HIV risk behaviors among MSM and mak nyah (transgender women) in Malaysia who have been facing the institutional and individual discrimination due to their sexuality and/or gender expression. The proposed study will provide new insights in understanding homophobia, transphobia, and other sociocultural factors in relation to substance use and HIV risk behaviors among highly stigmatized MSM and mak nyah in Malaysia, where the national religion is Islam. The study will also provide a scientific basis fr developing future intervention studies and programs to reduce substance abuse and the incidence of HIV/AIDS in Malaysia. Theoretical HIV prevention models developed by the proposed study would be applicable to MSM and transgender populations in other South East Asian countries. The collaborative efforts to implement the study among Malaysian, the U.S. researchers, service providers, and community members will be sustained to improve health and human rights for MSM and mak nyah in Malaysia.

描述（由申请人提供）：拟议的探索/发育研究将研究马来西亚污名化的高风险群体中影响HIV相关风险行为的同性恋恐惧症/恐惧症和其他社会文化因素：与男性发生性关系（MSM）和男性 - 女性跨性别妇女（Mak Nyah）。在马来西亚，民族宗教为伊斯兰；同性恋，变性主义和饮酒在穆斯林中受到惩罚；和非法毒品使用风险法律受到严厉的惩罚。通过马来西亚，美国和艾滋病服务组织（ASOS）的研究人员之间的合作努力，我们将进行一项探索性研究，以准备未来的干预研究，以减少马来西亚MSM和MAK NYAH之间的药物滥用和HIV风险行为。由经验丰富的研究人员组成的我们的研究团队在马来西亚，其他亚洲国家和美国对MSM和跨性别人群进行艾滋病毒预防研究方面具有丰富的经验，该研究将为理解同性恋恐惧症，跨性别恐惧症以及其他重要且有意义的社会文化文化提供稳固的基础。与物质使用和艾滋病毒风险行为有关的因素，并将更好地了解马来西亚MSM和Mak Nyah的生活。根据研究结果，我们的研究团队将来能够在将来开发滥用药物和艾滋病毒的干预研究，并建议与ASOS合作进行马来西亚的政策变化。该研究的具体目的是：1）与背景变量有关的MSM和Mak Nyah中与MSM和Mak Nyah之间的物质使用和与HIV相关的性风险行为； 2）探索和描述同性恋恐惧症和恐惧症以及其他社会文化因素，这些因素影响了与背景变量有关MSM和Mak Nyah的物质使用和HIV风险行为； 3）探索和确定未来药物滥用和艾滋病毒预防干预研究的理论模型； 4）在马来西亚ASOS的马来西亚和美国研究人员和服务提供商中培养和维持合作努力并建立能力，并为未来的滥用药物滥用和艾滋病毒预防干预研究和计划奠定基础； 5）描述有关马来西亚药物滥用和艾滋病毒预防的政策和法规，根据关键的线人访谈，总结研究结果，并建议未来的政策变化。根据有目的的抽样，将招募24个MSM和24个Mak Nyah进行定性访谈。完成定性分析后，我们将根据受访者驱动的抽样（RDS）方法招募200 MSM和200 Mak Nyah进行调查访谈。基于混合方法，我们将测试假设和概念模型。为了告知马来西亚药物滥用和预防艾滋病毒的未来政策变化，我们还将与20位主要线人进行定性访谈。我们将与ASOS合作，在预防艾滋病毒预防，健康促进和人权改善方面的努力。 公共卫生相关性：近年来，马来西亚在艾滋病毒/艾滋病护理和预防方面取得了一些进展。但是，尽管近年来艾滋病毒/艾滋病案件和事件呈指数增长，但药物使用和艾滋病毒预防计划的发展欠发达。拟议的研究将对了解马来西亚MSM和Mak Nyah（Transgender妇女）之间的物质使用和HIV风险行为的社会文化背景产生重大影响表达。拟议的研究将提供有关了解与物质使用和艾滋病毒风险行为有关的同性恋恐惧症，跨性别恐惧症和其他社会文化因素的新见解，而在马来西亚，在马来西亚高度污名化的MSM和Mak Nyah，国家宗教是伊斯兰教。这项研究还将提供科学基础，以开发未来的干预研究和计划，以减少马来西亚艾滋病毒/艾滋病的发生率。拟议研究开发的理论艾滋病毒预防模型将适用于其他东南亚国家的MSM和跨性别人群。在马来西亚，美国研究人员，服务提供商和社区成员之间实施这项研究的合作努力将得到维持，以改善马来西亚MSM和Mak Nyah的健康和人权。