2024
Adaptation of a Theory-Based Mobile App to Improve Access to HIV Prevention Services for Transgender Women in Malaysia: Focus Group Study
Gautam K, Shrestha R, Dlamini S, Razali B, Paudel K, Azwa I, Saifi R, Toh Y, Lim H, Sutherland R, Restar A, Phanuphak N, Wickersham J. Adaptation of a Theory-Based Mobile App to Improve Access to HIV Prevention Services for Transgender Women in Malaysia: Focus Group Study. JMIR Formative Research 2024, 8: e56250. PMID: 39137407, PMCID: PMC11350319, DOI: 10.2196/56250.Peer-Reviewed Original ResearchHIV prevention servicesTransgender womenFocus groupsPrEP uptakePreventive servicesCare servicesHIV preventionFG sessionsBarriers to PrEP uptakeUptake of HIV pre-exposure prophylaxisHIV pre-exposure prophylaxisTailored HIV preventionMobile appsReduce HIV vulnerabilityPre-exposure prophylaxisFocus group studyPrEP knowledgeTheater testingDedoose softwareMobile healthMultifaceted barriersDeliver interventionsHIV vulnerabilityPrEP barriersWomen's needsExploring Attitudes Toward Pre-Exposure Prophylaxis for HIV Prevention Prior to Implementation Among Female Sex Workers in Malaysia: Results from a Qualitative Study
Foley S, Keene D, Shrestha R, Brown S, Gautam K, Sutherland R, Maviglia F, Saifi R, Wickersham J. Exploring Attitudes Toward Pre-Exposure Prophylaxis for HIV Prevention Prior to Implementation Among Female Sex Workers in Malaysia: Results from a Qualitative Study. Patient Preference And Adherence 2024, 18: 797-807. PMID: 38595805, PMCID: PMC11003429, DOI: 10.2147/ppa.s413423.Peer-Reviewed Original ResearchFemale sex workersPre-exposure prophylaxisHIV preventionFSWs’ willingnessMethod of HIV preventionSex workersAcceptability of PrEPHIV prevention practicesPrevention of HIV transmissionGrounded theory approachSemi-structured interviewsCondom promotionPrEP usePrEP rolloutPrevention practicesTranslated interviewsEmpowerment componentsQualitative studyHarm reductionHIV transmissionOral PrEPPerceived challengesPrEPCondom useQualitative explorationTesting the Feasibility and Acceptability of Using an Artificial Intelligence Chatbot to Promote HIV Testing and Pre-Exposure Prophylaxis in Malaysia: Mixed Methods Study.
Cheah M, Gan Y, Altice F, Wickersham J, Shrestha R, Salleh N, Ng K, Azwa I, Balakrishnan V, Kamarulzaman A, Ni Z. Testing the Feasibility and Acceptability of Using an Artificial Intelligence Chatbot to Promote HIV Testing and Pre-Exposure Prophylaxis in Malaysia: Mixed Methods Study. JMIR Human Factors 2024, 11: e52055. PMID: 38277206, PMCID: PMC10858413, DOI: 10.2196/52055.Peer-Reviewed Original ResearchConceptsUptake of HIV testingHIV testingPre-exposure prophylaxisUnified Theory of AcceptanceFrequency of HIV testingTheory of AcceptanceAI chatbotsPromote HIV testingMental health supportHIV risk assessmentHIV prevention effortsHIV-related informationMixed methods studyPresence of stigmaUse of TechnologyConsequences of HIVEffort expectancySexually transmitted infectionsWeb-based surveyEngaging MSMArtificial intelligenceTranscribed verbatimPrEP uptakeHealth supportMental health
2023
Awareness and Uptake of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention Among Men who have Sex with Men in Nepal
Paudel K, Kanak M, Gautam K, Bhandari P, Dhakal M, Wickersham J, Valente P, Ha T, Shrestha R. Awareness and Uptake of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention Among Men who have Sex with Men in Nepal. Journal Of Community Health 2023, 49: 514-525. PMID: 38127298, DOI: 10.1007/s10900-023-01318-1.Peer-Reviewed Original ResearchPre-exposure prophylaxisPrEP awarenessBiomedical prevention strategiesHIV transmission riskUse of PrEPCross-sectional surveyHealth insurance coveragePrEP knowledgePrEP useHIV preventionStudy populationPrevention strategiesHealthcare providersBivariate analysisLogistic regressionTransmission riskPrEPMSMInsurance coverageProphylaxisHIVMenParticipantsInnovative strategiesInfectionCorrelates of never testing for HIV among men who have sex with men in Malaysia: A cross-sectional study
JadKarim L, Wickersham J, Gautam K, Azwa I, Saifi R, Khati A, Paudel K, Ha T, Shrestha R. Correlates of never testing for HIV among men who have sex with men in Malaysia: A cross-sectional study. PLOS ONE 2023, 18: e0294937. PMID: 38032958, PMCID: PMC10688714, DOI: 10.1371/journal.pone.0294937.Peer-Reviewed Original ResearchConceptsMalaysian MSMLogistic regressionCharacteristics of HIVFuture public health interventionsPre-exposure prophylaxisHIV testing uptakeHIV testing servicesMultivariable logistic regressionHIV prevention servicesCross-sectional studyDisproportionate HIV burdenLow testing ratesPublic health interventionsCross-sectional online surveySTI testing practicesHIV burdenPrior diagnosisSocio-demographic characteristicsTesting uptakeHigher oddsMSM communityLower oddsHIVPrevention servicesTesting ratesPre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment
Dubov A, Altice F, Gutierrez J, Wickersham J, Azwa I, Kamarulzaman A, Gautam K, Shrestha R. Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment. Scientific Reports 2023, 13: 14200. PMID: 37648731, PMCID: PMC10468492, DOI: 10.1038/s41598-023-41264-5.Peer-Reviewed Original ResearchConceptsInjectable PrEPPre-exposure prophylaxis servicesDaily oral PrEPPre-exposure prophylaxisMalaysian MSMPrEP deliveryOral PrEPPrEP uptakeMSMPrEPLatent class analysisDiscrete choice experimentMenDelivery preferencesDelivery programsSexGroupClass analysisType of programPreference groupsOnline surveyProphylaxisInitiation rateHIVDosingPredictors of PrEP awareness, PrEP discussion and interest in long‐acting injectable PrEP among Filipina transfeminine adults
Restar A, Quilantang M, Wickersham J, Adia A, Guigayoma J, Bermudez A, Galárraga O, Flores D, Cu‐Uvin S, Nazareno J, Operario D, Sison O. Predictors of PrEP awareness, PrEP discussion and interest in long‐acting injectable PrEP among Filipina transfeminine adults. Journal Of The International AIDS Society 2023, 26: e26080. PMID: 37306123, PMCID: PMC10258862, DOI: 10.1002/jia2.26080.Peer-Reviewed Original ResearchConceptsLAI-PrEPHIV servicesPrEP awarenessHigher HIV knowledgePre-exposure prophylaxisMultivariable logistic regressionInjectable PrEPPrEP discussionPrEP outcomesHealthcare discriminationHIV epidemicHIV knowledgeHealthcare accessSexual partnersOlder ageTransgender healthHealth inequitiesLogistic regressionHIVHealthcare settingsPrEPAdultsProvidersProphylaxisStructural driversBarriers and Facilitators to Pre-Exposure Prophylaxis by Men Who Have Sex with Men and Community Stakeholders in Malaysia
Rosen A, Wickersham J, Altice F, Khati A, Azwa I, Tee V, Jeri-Wahrhaftig A, Luces J, Ni Z, Kamarulzaman A, Saifi R, Shrestha R. Barriers and Facilitators to Pre-Exposure Prophylaxis by Men Who Have Sex with Men and Community Stakeholders in Malaysia. International Journal Of Environmental Research And Public Health 2023, 20: 5669. PMID: 37174187, PMCID: PMC10177799, DOI: 10.3390/ijerph20095669.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisPrEP providersNominal group techniqueMalaysian MSMEvidence-based HIV prevention strategiesPatient-centered decision aidAwareness of PrEPHIV prevention strategiesPotential new strategyPrEP deliveryPrEP carePrEP initiationPrEP servicesPrEP uptakeDecision aidPrevention strategiesUnderstanding of barriersComplex clinical protocolsClinical protocolsMSMQualitative focus groupsCommunity stakeholdersPrEPProphylaxisMenMapping Community-Engaged Implementation Strategies with Transgender Scientists, Stakeholders, and Trans-Led Community Organizations
Restar A, Minalga B, Quilantang M, Adamson T, Dusic E, van der Merwe L, Millet G, Rosadiño D, Laguing T, Lett E, Everhart A, Phillips G, Janamnuaysook R, Seekaew P, Baker K, Ashley F, Wickersham J, Wallace S, Operario D, Gamarel K. Mapping Community-Engaged Implementation Strategies with Transgender Scientists, Stakeholders, and Trans-Led Community Organizations. Current HIV/AIDS Reports 2023, 20: 160-169. PMID: 37012537, PMCID: PMC10071255, DOI: 10.1007/s11904-023-00656-y.Peer-Reviewed Original ResearchClinic-Integrated Smartphone App (JomPrEP) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Malaysia: Mixed Methods Evaluation of Usability and Acceptability
Shrestha R, Altice F, Khati A, Azwa I, Gautam K, Gupta S, Sullivan P, Ni Z, Kamarulzaman A, Phiphatkunarnon P, Wickersham J. Clinic-Integrated Smartphone App (JomPrEP) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Malaysia: Mixed Methods Evaluation of Usability and Acceptability. JMIR MHealth And UHealth 2023, 11: e44468. PMID: 36795465, PMCID: PMC9982718, DOI: 10.2196/44468.Peer-Reviewed Original ResearchConceptsHIV prevention servicesINTERNATIONAL REGISTERED REPORT IDENTIFIERPrevention servicesMean ageHIV preventionPre-exposure prophylaxisHIV prevention outcomesHIV self-testing (HIVST) kitsParticipants' mean ageSelf-testing kitsHealth care settingsMobile health platformMalaysian MSMMixed-methods evaluationHIV testingCare settingsLocal clinicSystem Usability ScalePrevention outcomesDays of testingMSMSmartphone appPrEPHIVMean scoreHigh Interest in Long-acting Injectable Pre-exposure Prophylaxis (LAI-PrEP) for HIV Prevention Among Men Who Have Sex With Men (MSM): Result From A Nationwide Survey in Malaysia
Paudel K, Gupta S, Gautam K, Wickersham J, Khati A, Azwa I, Ha T, Shrestha R. High Interest in Long-acting Injectable Pre-exposure Prophylaxis (LAI-PrEP) for HIV Prevention Among Men Who Have Sex With Men (MSM): Result From A Nationwide Survey in Malaysia. Journal Of Community Health 2023, 48: 513-521. PMID: 36732459, PMCID: PMC10200758, DOI: 10.1007/s10900-023-01195-8.Peer-Reviewed Original ResearchConceptsLAI-PrEPHIV preventionInjectable pre-exposure prophylaxisLong-term side effectsPre-exposure prophylaxisOnline cross-sectional surveyCross-sectional surveyInjectable cabotegravirInjectable PrEPMalaysian MSMPrEP modalitiesOral PrEPHIV testingMiddle-income countriesOral pillsPrior historySide effectsRecent approvalPrEP optionsStudy participantsMSMPrEPNationwide surveyConvenience samplingNationwide sample
2022
Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey
Maviglia F, Wickersham J, Azwa I, Copenhaver N, Kennedy O, Kern M, Khati A, Lim S, Gautam K, Shrestha R. Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey. International Journal Of Environmental Research And Public Health 2022, 20: 294. PMID: 36612617, PMCID: PMC9819808, DOI: 10.3390/ijerph20010294.Peer-Reviewed Original ResearchConceptsInjection drug useMalaysian MSMDrug useGamma hydroxybutyrateGreater HIV risk behaviorsHIV-positive sexual partnerPre-exposure prophylaxis knowledgeRecent injection drug usePre-exposure prophylaxisHIV risk factorsHIV-positive partnerMultivariable logistic regressionSevere depressive symptomsRecent STI diagnosisHIV risk behaviorsTransactional sexCross-sectional studyMental health servicesMultiple sex partnersDrug-related behaviorsChemsex engagementRecent sexual intercourseSTI diagnosisMultivariable analysisAssociated FactorsClinic-Integrated Mobile Health Intervention (“JomPrEP” App) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Malaysia: Protocol for an Intervention Development and Multiphase Trial
Shrestha R, Wickersham J, Khati A, Azwa I, Ni Z, Kamarulzaman A, Sullivan P, Jadkarim L, Eger W, Gautam K, Altice F. Clinic-Integrated Mobile Health Intervention (“JomPrEP” App) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Malaysia: Protocol for an Intervention Development and Multiphase Trial. JMIR Research Protocols 2022, 11: e43318. PMID: 36542425, PMCID: PMC9813821, DOI: 10.2196/43318.Peer-Reviewed Original ResearchINTERNATIONAL REGISTERED REPORT IDENTIFIERPre-exposure prophylaxisHIV prevention servicesHIV testingMalaysian MSMPhase IHIV preventionPrevention servicesLarge-scale efficacy trialsHIV prevention resourcesMobile health interventionsHIV prevention effortsCare delivery servicesHealth care delivery servicesMultiphase trialPrEP servicesMiddle-income countriesHIV epidemicEfficacy trialsTrial designPrevention strategiesEntrenched stigmaHealth outcomesReal-world settingHealth interventionsUsing nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder
Eger WH, Altice FL, Lee J, Vlahov D, Khati A, Osborne S, Wickersham JA, Bohonnon T, Powell L, Shrestha R. Using nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder. Harm Reduction Journal 2022, 19: 120. PMID: 36307817, PMCID: PMC9616614, DOI: 10.1186/s12954-022-00703-8.Peer-Reviewed Original ResearchConceptsSame-day prescriptionPre-exposure prophylaxisOpioid use disorderHIV transmissionUse disordersClinical stakeholdersAvailability of providersSystems of careHealth care systemCoordinated careNew practice modelClinical careMedicationsPharmacy deliveryMOUDNominal group techniqueLocal prescribersPWIDSexual riskPrEPCare systemHealth benefitsCareMultiple visitsProphylaxisExploring drivers of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia
Eger WH, Adaralegbe A, Khati A, Azwa I, Wickersham JA, Osborne S, Shrestha R. Exploring drivers of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia. International Journal Of STD & AIDS 2022, 33: 821-828. PMID: 35772943, PMCID: PMC10069270, DOI: 10.1177/09564624221106535.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisPrEP useHIV prevention strategiesMultivariable logistic modelHigh-risk behaviorsMalaysian MSMPrEP uptakeMultivariable analysisHIV epidemicHealthcare engagementPrevention strategiesHealth systemSexual intercourseRM 3000PrEPProphylaxisSexual behaviorHIVMenMonthly incomeMSMMonthsHigh awarenessSexLogistic model
2021
Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment
Ni Z, Altice FL, Wickersham JA, Copenhaver MM, DiDomizio EE, Nelson LE, Shrestha R. Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment. Drug And Alcohol Dependence 2021, 219: 108477. PMID: 33422864, PMCID: PMC7946167, DOI: 10.1016/j.drugalcdep.2020.108477.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsPre-exposure prophylaxisPrEP useHIV riskHealthcare providersSex-related risk behaviorsMultivariable logistic regression analysisAwareness of PrEPUrban methadone clinicMultiple logistic regressionDisproportionate HIV burdenLogistic regression analysisCross-sectional surveyHIV burdenHIV infectionHIV testingIndependent correlatesMethadone clinicsDrug treatmentRisk behaviorsLogistic regressionPrEPPrevious useHigher likelihoodProphylaxis
2020
Willingness to Use Pre-Exposure Prophylaxis (PrEP) for HIV Prevention and PrEP Implementation Preferences Among Transgender Women in Malaysia
Galka JM, Wang M, Azwa I, Gibson B, Lim SH, Shrestha R, Wickersham JA. Willingness to Use Pre-Exposure Prophylaxis (PrEP) for HIV Prevention and PrEP Implementation Preferences Among Transgender Women in Malaysia. Transgender Health 2020, 5: 258-266. PMID: 33644315, PMCID: PMC7906238, DOI: 10.1089/trgh.2020.0003.Peer-Reviewed Original ResearchPre-exposure prophylaxisHIV preventionTransgender womenWorld Health Organization indicationsEffective HIV prevention strategiesDelivery of PrEPHigh HIV burdenInjection drug useHIV prevention strategiesMalaysian adult populationProphylaxis useHIV burdenHormone usePrEP willingnessHigh school educationPrevention strategiesDrug useAdult populationOlder ageSubstance abusePrEPMultivariate modelChinese ethnicityMost participantsPreventionAwareness about and willingness to use long-acting injectable pre-exposure prophylaxis (LAI-PrEP) among people who use drugs
Shrestha R, DiDomizio EE, Kim RS, Altice FL, Wickersham JA, Copenhaver MM. Awareness about and willingness to use long-acting injectable pre-exposure prophylaxis (LAI-PrEP) among people who use drugs. Journal Of Substance Use And Addiction Treatment 2020, 117: 108058. PMID: 32811633, PMCID: PMC7438607, DOI: 10.1016/j.jsat.2020.108058.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisInjectable pre-exposure prophylaxisLAI-PrEPOral pre-exposure prophylaxisLong-term side effectsSelf-reported HIV risk behaviorsBangkok Tenofovir StudyEvidence-based HIVHigh-risk PWUDImportant key populationHIV-negative peopleOpioid use disorderHIV risk behaviorsHIV prevention effortsAddiction treatment programsDaily PrEPOral PrEPAdherence challengesIndependent correlatesFemale sexClinical trialsHIV preventionIndependent factorsSide effectsUse disorders
2017
Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey
Lim SH, Mburu G, Bourne A, Pang J, Wickersham JA, Wei CKT, Yee IA, Wang B, Cassolato M, Azwa I. Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey. PLOS ONE 2017, 12: e0182838. PMID: 28902857, PMCID: PMC5597127, DOI: 10.1371/journal.pone.0182838.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisHIV preventionLogistic regressionMale anal sex partnersAwareness of PrEPMultivariate logistic regressionSexual health servicesAnal sex partnersYears of ageDrug use behaviorsHalf of participantsPreventative medicationsMajority of participantsEligibility criteriaMalay menSex partnersGovernment hospitalsHealth servicesBivariate analysisPrEPMale partnersUnknown statusParticipant demographicsSafer sexMSM