期刊
ADDICTIVE BEHAVIORS
卷 53, 期 -, 页码 31-39出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.addbeh.2015.09.013
关键词
Women; Substance abuse; HIV; Sex work; Malaysia; Violence
资金
- National Institutes on Drug Abuse for Research (Altice) [R01 DA025943]
- Career Development Awards (Altice) [K24 DA017072, K01 DA038529]
- National Institutes of Health Medical Scientist Training Program at Yale University [TG T32GM07205]
- Ministry of Education, University of Malaya High Impact Research Grant [E-000001-20001]
Background: Substance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders. Objectives: To explore HIV risk behaviors, substance use, and social factors associated with poor health outcomes among women who use drugs in Malaysia. Methods: A cross-sectional survey of 103 drug-using women in Kuala Lumpur, Malaysia were recruited to assess their medical, psychiatric and social comorbidity as well as their engagement in nationally recommended HIV testing and monitoring activities. Results: One-third reported having ever injected drugs, with most (68.2%) having recently shared injection paraphernalia. Sex work (44.7%) and infrequent condom use (42.4%) were common as was underlying psychiatric illness and physical and sexual violence during childhood and adulthood. Most women (62.1%) had unstable living situations and suffered from an unmet need for social support and health services. HIV prevalence was high (20%) with only two thirds of women eligible for antiretroviral therapy having received it. Suboptimal HIV testing and/or monitoring was positively associated with interpersonal violence (AOR 2.73; 95% Cl 1.04-7.14) and negatively associated with drug injection (AOR 0.28; 95% CI 0.10-0.77). Conclusions/Importance: Women who use drugs in Malaysia demonstrate considerable medical, psychiatric and social co-morbidity, which negatively contributes to optimal and crucial engagement in HIV treatmentas-prevention strategies. Mental health and social support may be key targets for future public health interventions aimed at drug-using women in Malaysia. 2015 Elsevier Ltd. All rights reserved.
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