1 AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
2 Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
LGBT Health. 2018 Nov/Dec;5(8):484-493. doi: 10.1089/lgbt.2018.0021. Epub 2018 Nov 27.
In Malaysia, an estimated 9.7%-12.4% of transgender women (TW) are HIV positive, with higher estimates among those engaged in sex work. According to the 90-90-90 Joint United Nations Programme on HIV/AIDS strategy, HIV testing is the first crucial step in curbing the HIV epidemic. This study examines correlates of recent HIV testing among TW in Greater Kuala Lumpur, Malaysia.
TW (N = 199) in Greater Kuala Lumpur completed a survey on healthcare access and utilization, including HIV testing history. Bivariate logistic regression and penalized multivariate logistic regression were used to explore correlates of HIV testing in the last 12 months.
Overall, 41.7% of TW reported having ever been tested for HIV. Among participants who were HIV negative or not sure of their HIV status (n = 187), only 18.7% (n = 35) had been tested for HIV in the last 12 months. The multivariate analysis indicated that having a primary care provider (PCP), being 26-40 years of age, and having higher mental health functioning were positively associated with recent HIV testing. Active amphetamine use and previous depression diagnosis were also associated with recent HIV testing.
HIV testing is the first step in linking individuals to prevention and treatment interventions. Our findings suggest that having a PCP can improve engagement in HIV testing. Moreover, PCPs can serve as a valuable link to HIV treatment and prevention services. Current interventions that target social and behavioral risk factors for HIV, on their own, may be insufficient at engaging all HIV-vulnerable TW.
在马来西亚,估计有 9.7%-12.4%的跨性别女性(TW)HIV 呈阳性,其中从事性工作者的估计值更高。根据联合国艾滋病规划署的 90-90-90 联合战略,HIV 检测是遏制 HIV 流行的关键第一步。本研究调查了马来西亚吉隆坡大都市区 TW 最近 HIV 检测的相关因素。
吉隆坡大都市区的 TW(N=199)完成了一项关于医疗保健获取和利用的调查,包括 HIV 检测史。使用双变量逻辑回归和惩罚多元逻辑回归探讨了最近 12 个月内 HIV 检测的相关因素。
总体而言,41.7%的 TW 报告曾经接受过 HIV 检测。在 HIV 阴性或不确定 HIV 状况的参与者中(n=187),只有 18.7%(n=35)在过去 12 个月内接受过 HIV 检测。多变量分析表明,有初级保健提供者(PCP)、年龄在 26-40 岁之间以及心理健康功能较高与最近的 HIV 检测呈正相关。安非他命的使用和以前的抑郁诊断也与最近的 HIV 检测有关。
HIV 检测是将个体与预防和治疗干预措施联系起来的第一步。我们的研究结果表明,有 PCP 可以提高 HIV 检测的参与度。此外,PCP 可以作为与 HIV 治疗和预防服务联系的有价值的纽带。目前针对 HIV 社会和行为风险因素的干预措施,仅凭自身可能不足以让所有易感染 HIV 的 TW 参与其中。