Willingness to use HIV self-testing and associated factors among transgender women in Malaysia

Background: While global research on the implementation of HIV self-testing (HIVST) has increased exponentially, few studies have assessed information on HIVST uptake factors (i.e., willingness, preferences) in transgender women (TW) and none in the Malaysian context. We therefore sought to assess w...

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Main Authors: Shrestha, Roman, Galka, Jonathan M., Azwa, Iskandar, Lim, Sin How, Guadamuz, Thomas E., Altice, Frederick L., Wickersham, Jeffrey A.
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Published: Mary Ann Liebert, Inc 2020
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Online Access:http://eprints.um.edu.my/31671/
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spelling my.um.eprints.316712022-10-18T06:29:24Z http://eprints.um.edu.my/31671/ Willingness to use HIV self-testing and associated factors among transgender women in Malaysia Shrestha, Roman Galka, Jonathan M. Azwa, Iskandar Lim, Sin How Guadamuz, Thomas E. Altice, Frederick L. Wickersham, Jeffrey A. BF Psychology GE Environmental Sciences Background: While global research on the implementation of HIV self-testing (HIVST) has increased exponentially, few studies have assessed information on HIVST uptake factors (i.e., willingness, preferences) in transgender women (TW) and none in the Malaysian context. We therefore sought to assess willingness to use HIVST among this understudied key population. Methods: A cross-sectional survey was conducted among 361 HIV-negative Malaysian TW in 2017. Participants were recruited using flyers, announcements through social media, and direct referral from staff members of the community-based organizations serving the TW communities. Multivariable logistic regression was used to identify correlates of willingness to use HIVST. Results: Nearly half of the participants (47.6%) reported that they would be willing to use HIVST. Multivariable analysis showed that willingness to use HIVST was positively associated with having experienced sexual assault in childhood (adjusted odds ratio aOR]=3.239, p<0.001), having ever used mobile phone or apps to find sex work clients (aOR=1.677, p=0.040), and having engaged in condomless sex in the past 6 months (aOR=1.886, p=0.018). In contrast, living in Kuala Lumpur (aOR=0.559, p=0.032), having higher number of sex work clients per day (aOR=0.927, p=0.004), and current depressive symptoms (aOR=0.576, p=0.026) were negatively associated with willingness to use HIVST. Conclusions: Findings in this study suggest that TW in our sample were moderately willing to use HIVST. Especially important here is the increased interest in HIVST among TW who are at higher risk for HIV infection. Overall, our findings underscore the need for additional research on how to most effectively implement HIVST for key populations, including TW, such that uptake and retention in regular HIV screening is sustained. Mary Ann Liebert, Inc 2020-09-01 Article PeerReviewed Shrestha, Roman and Galka, Jonathan M. and Azwa, Iskandar and Lim, Sin How and Guadamuz, Thomas E. and Altice, Frederick L. and Wickersham, Jeffrey A. (2020) Willingness to use HIV self-testing and associated factors among transgender women in Malaysia. Transgender Health, 5 (3). pp. 182-190. ISSN 2688-4887, DOI https://doi.org/10.1089/trgh.2019.0085 <https://doi.org/10.1089/trgh.2019.0085>. 10.1089/trgh.2019.0085
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic BF Psychology
GE Environmental Sciences
spellingShingle BF Psychology
GE Environmental Sciences
Shrestha, Roman
Galka, Jonathan M.
Azwa, Iskandar
Lim, Sin How
Guadamuz, Thomas E.
Altice, Frederick L.
Wickersham, Jeffrey A.
Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
description Background: While global research on the implementation of HIV self-testing (HIVST) has increased exponentially, few studies have assessed information on HIVST uptake factors (i.e., willingness, preferences) in transgender women (TW) and none in the Malaysian context. We therefore sought to assess willingness to use HIVST among this understudied key population. Methods: A cross-sectional survey was conducted among 361 HIV-negative Malaysian TW in 2017. Participants were recruited using flyers, announcements through social media, and direct referral from staff members of the community-based organizations serving the TW communities. Multivariable logistic regression was used to identify correlates of willingness to use HIVST. Results: Nearly half of the participants (47.6%) reported that they would be willing to use HIVST. Multivariable analysis showed that willingness to use HIVST was positively associated with having experienced sexual assault in childhood (adjusted odds ratio aOR]=3.239, p<0.001), having ever used mobile phone or apps to find sex work clients (aOR=1.677, p=0.040), and having engaged in condomless sex in the past 6 months (aOR=1.886, p=0.018). In contrast, living in Kuala Lumpur (aOR=0.559, p=0.032), having higher number of sex work clients per day (aOR=0.927, p=0.004), and current depressive symptoms (aOR=0.576, p=0.026) were negatively associated with willingness to use HIVST. Conclusions: Findings in this study suggest that TW in our sample were moderately willing to use HIVST. Especially important here is the increased interest in HIVST among TW who are at higher risk for HIV infection. Overall, our findings underscore the need for additional research on how to most effectively implement HIVST for key populations, including TW, such that uptake and retention in regular HIV screening is sustained.
format Article
author Shrestha, Roman
Galka, Jonathan M.
Azwa, Iskandar
Lim, Sin How
Guadamuz, Thomas E.
Altice, Frederick L.
Wickersham, Jeffrey A.
author_facet Shrestha, Roman
Galka, Jonathan M.
Azwa, Iskandar
Lim, Sin How
Guadamuz, Thomas E.
Altice, Frederick L.
Wickersham, Jeffrey A.
author_sort Shrestha, Roman
title Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
title_short Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
title_full Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
title_fullStr Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
title_full_unstemmed Willingness to use HIV self-testing and associated factors among transgender women in Malaysia
title_sort willingness to use hiv self-testing and associated factors among transgender women in malaysia
publisher Mary Ann Liebert, Inc
publishDate 2020
url http://eprints.um.edu.my/31671/
_version_ 1748181063799144448
score 13.209306