2024
Testing 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
Correlates 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 ResearchMeSH KeywordsCross-Sectional StudiesHIV InfectionsHomosexuality, MaleHumansMalaysiaMalePre-Exposure ProphylaxisSexual and Gender MinoritiesSexual BehaviorSexually Transmitted DiseasesConceptsMalaysian 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 ResearchMeSH KeywordsBayes TheoremHomosexuality, MaleHumansMalaysiaMalePre-Exposure ProphylaxisSexual and Gender MinoritiesConceptsInjectable PrEPPre-exposure prophylaxis servicesDaily oral PrEPPre-exposure prophylaxisMalaysian MSMPrEP deliveryOral PrEPPrEP uptakeMSMPrEPLatent class analysisDiscrete choice experimentMenDelivery preferencesDelivery programsSexGroupClass analysisType of programPreference groupsOnline surveyProphylaxisInitiation rateHIVDosingApplication of the multiphase optimisation strategy (MOST) to optimise HIV prevention targeting people on medication for opioid use disorder (MOUD) who have cognitive dysfunction: protocol for a MOST study
Mistler C, Shrestha R, Gunstad J, Collins L, Madden L, Huedo-Medina T, Sibilio B, Copenhaver N, Copenhaver M. Application of the multiphase optimisation strategy (MOST) to optimise HIV prevention targeting people on medication for opioid use disorder (MOUD) who have cognitive dysfunction: protocol for a MOST study. BMJ Open 2023, 13: e071688. PMID: 37399447, PMCID: PMC10314648, DOI: 10.1136/bmjopen-2023-071688.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsCognitive DysfunctionHIV InfectionsHumansOpioid-Related DisordersPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsOpioid use disorderMultiphase optimization strategyCognitive dysfunctionHIV preventionUse disordersPromising biomedical interventionsPre-exposure prophylaxisHIV incidence ratesHIV risk reductionHIV prevention interventionsDrug treatment settingsInstitutional review boardInformed consent formPrEP adherenceHIV prevention contentHIV infectionPrEP uptakeStudy protocolIncidence rateRisk groupsPrevention interventionsPWIDTreatment settingsReview boardEffective interventionsBarriers 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 ResearchMeSH KeywordsAnti-HIV AgentsHIV InfectionsHomosexuality, MaleHumansMalaysiaMalePre-Exposure ProphylaxisSexual and Gender MinoritiesConceptsPre-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 stakeholdersPrEPProphylaxisMenClinic-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 ResearchMeSH KeywordsAdultHIV InfectionsHIV TestingHomosexuality, MaleHumansMalaysiaMaleMobile ApplicationsPre-Exposure ProphylaxisSexual and Gender MinoritiesConceptsHIV 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
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
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 ResearchMeSH KeywordsAnti-HIV AgentsHIV InfectionsHumansOpioid-Related DisordersPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsSame-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 ResearchMeSH KeywordsCoitusFemaleHIV InfectionsHomosexuality, MaleHumansMalaysiaMalePre-Exposure ProphylaxisSexual and Gender MinoritiesSexual BehaviorConceptsPre-exposure prophylaxisPrEP useHIV prevention strategiesMultivariable logistic modelHigh-risk behaviorsMalaysian MSMPrEP uptakeMultivariable analysisHIV epidemicHealthcare engagementPrevention strategiesHealth systemSexual intercourseRM 3000PrEPProphylaxisSexual behaviorHIVMenMonthly incomeMSMMonthsHigh awarenessSexLogistic model
2021
Limited Risk Compensation Among Women Who Inject Drugs: Results From the Project Sexual Health Equity Preexposure Prophylaxis Demonstration Study in Philadelphia
Tran NK, Van Der Pol B, Shrestha R, Bazzi AR, Bellamy SL, Sherman SG, Roth AM. Limited Risk Compensation Among Women Who Inject Drugs: Results From the Project Sexual Health Equity Preexposure Prophylaxis Demonstration Study in Philadelphia. Sexually Transmitted Diseases 2021, 49: e64-e66. PMID: 34694276, PMCID: PMC9018480, DOI: 10.1097/olq.0000000000001577.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHealth EquityHIV InfectionsHumansMalePhiladelphiaPre-Exposure ProphylaxisSexual BehaviorSubstance Abuse, IntravenousThe Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals
Mistler CB, Curley CM, Rosen AO, El-Krab R, Wickersham JA, Copenhaver MM, Khati A, Shrestha R. The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals. Journal Of Community Health 2021, 46: 960-966. PMID: 33770334, PMCID: PMC7996112, DOI: 10.1007/s10900-021-00979-0.Peer-Reviewed Original ResearchConceptsOpioid use disorderHIV prevention servicesSTI testingHIV counselorsPrEP prescriptionPrevention servicesCOVID-19Pre-exposure prophylaxis servicesOpioid use disorder treatmentCOVID-19 pandemicClean injection equipmentOpioid-dependent individualsOpioid-dependent peopleUse disorder treatmentInjection equipmentHIV testingInfection testingBlood testingHIV preventionUse disordersPWIDDisorder treatmentDoctor's appointmentAdverse effectsCase managersUse of Pre-exposure Prophylaxis Among People Who Inject Drugs: Exploratory Findings of the Interaction Between Race, Homelessness, and Trust
Zhou X, Altice FL, Chandra D, Didomizio E, Copenhaver MM, Shrestha R. Use of Pre-exposure Prophylaxis Among People Who Inject Drugs: Exploratory Findings of the Interaction Between Race, Homelessness, and Trust. AIDS And Behavior 2021, 25: 3743-3753. PMID: 33751313, DOI: 10.1007/s10461-021-03227-7.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsCross-Sectional StudiesHIV InfectionsHumansIll-Housed PersonsPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousTrustConceptsPre-exposure prophylaxisPrEP useProvider trustPatient-level factorsOpioid-dependent patientsLogistic regression analysisNon-homeless participantsHomeless participantsRace/ethnicityEligibility criteriaCross-sectional dataPrEPProphylaxisMethadoneRegression analysisDrugsExploratory findingsParticipantsPotential moderatorsPWIDPatientsSignificant moderatorWillingness 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
The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review
Mistler CB, Copenhaver MM, Shrestha R. The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review. AIDS And Behavior 2020, 25: 1490-1506. PMID: 32749627, PMCID: PMC7858689, DOI: 10.1007/s10461-020-02988-x.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsHIV InfectionsHumansPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsPre-exposure prophylaxisCare cascadeSystematic reviewInjection drug useTransmission of HIVKey risk factorsPrEP eligibilityPrEP carePrEP uptakeHIV incidenceHIV transmissionRisk factorsPRISMA guidelinesPrevention strategiesPWIDDrug useLiterature searchEfficacious strategyProphylaxisPrEPDrugsInterventionHigh awarenessHIVReviewAwareness 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 ResearchMeSH KeywordsAnti-HIV AgentsFemaleHIV InfectionsHomosexuality, MaleHumansMalePatient Acceptance of Health CarePharmaceutical PreparationsPre-Exposure ProphylaxisThailandConceptsPre-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
2019
Online HIV information seeking and pre-exposure prophylaxis awareness among people who use drugs
Ranjit YS, Shrestha R, Copenhaver M, Altice FL. Online HIV information seeking and pre-exposure prophylaxis awareness among people who use drugs. Journal Of Substance Use And Addiction Treatment 2019, 111: 16-22. PMID: 32087834, PMCID: PMC7039922, DOI: 10.1016/j.jsat.2019.12.010.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesHIV InfectionsHumansInformation Seeking BehaviorPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsHuman immunodeficiency virusHIV informationMethadone treatmentPre-exposure prophylaxis (PrEP) awarenessPre-exposure prophylaxisNew HIV diagnosesHIV-negative PWUDBehavior change continuumCross-sectional surveyMethods of preventionAddiction treatment programsHIV diagnosisImmunodeficiency virusInjection drugsHIV preventionHigh riskGeneral populationSex partnersOverall healthTreatment programPrEPDrugsPWUDChange continuumRiskRationale and design of an integrated bio-behavioral approach to improve adherence to pre-exposure prophylaxis and HIV risk reduction among opioid-dependent people who use drugs: The CHRP-BB study
Shrestha R, Altice FL, Sibilio B, Ssenyonjo J, Copenhaver MM. Rationale and design of an integrated bio-behavioral approach to improve adherence to pre-exposure prophylaxis and HIV risk reduction among opioid-dependent people who use drugs: The CHRP-BB study. Contemporary Clinical Trials 2019, 82: 77-84. PMID: 31229618, PMCID: PMC6639056, DOI: 10.1016/j.cct.2019.06.012.Peer-Reviewed Original ResearchConceptsBio-behavioral interventionHIV risk reductionOpioid-dependent peopleMethadone maintenance programPrEP adherenceHIV transmission risk reductionFirst prospective trialPre-exposure prophylaxisHIV prevention strategiesOngoing drug useRisk reductionBehavioral skills modelProspective trialSecondary outcomesPrimary outcomeRisk reduction outcomesHIV riskWeek 20Prevention strategiesUnmet needDrug useHybrid type IBio-behavioral approachProcess evaluationAdherence
2018
Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study
Shrestha R, Altice FL, Karki P, Copenhaver MM. Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study. AIDS And Behavior 2018, 22: 2640-2649. PMID: 29582199, PMCID: PMC6051885, DOI: 10.1007/s10461-018-2099-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidBiobehavioral SciencesCondomsFeasibility StudiesFemaleHIV InfectionsHumansMaleMedication AdherenceMethadoneMiddle AgedMotivationOpiate Substitution TreatmentOpioid-Related DisordersPatient Acceptance of Health CarePilot ProjectsPre-Exposure ProphylaxisProspective StudiesRisk Reduction BehaviorSexual BehaviorSexual PartnersSubstance Abuse, IntravenousConceptsPre-exposure prophylaxis adherenceSelf-reported PrEP adherenceSex-related risk behaviorsHIV risk reduction behaviorsBio-behavioral interventionPre-exposure prophylaxisProspective clinical trialsHigh-risk peopleHIV prevention interventionsHIV risk behaviorsPilot feasibility studyPost-intervention assessmentPrEP adherenceProphylaxis adherencePreliminary efficacyClinical trialsIntervention groupHIV riskPrevention interventionsRisk behaviorsBio-behavioral approachAdherenceInterventionHigh acceptabilityPrEP
2017
Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users
Shrestha R, Karki P, Altice FL, Dubov O, Fraenkel L, Huedo-Medina T, Copenhaver M. Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users. AIDS And Behavior 2017, 22: 1228-1238. PMID: 28695388, PMCID: PMC5762432, DOI: 10.1007/s10461-017-1851-1.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisSex-related risk behaviorsHigh-risk drug usersAcceptability of PrEPHigh-risk PWUDPrimary HIV preventionHIV prevention approachesDrug treatment settingsKey risk populationsHIV-negative PWUDHigh acceptabilityHIV clinicPrEP acceptabilityHIV testingPrEP uptakeMethadone clinicsHIV preventionRisk populationsSide effectsTreatment settingsDrug usersPrEP attributesRisk behaviorsPrEPUnderserved populationsIntent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis
Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis. Journal Of The Association Of Nurses In AIDS Care 2017, 28: 612-621. PMID: 28478870, PMCID: PMC7451137, DOI: 10.1016/j.jana.2017.04.005.Peer-Reviewed Original ResearchConceptsHIV risk behaviorsNeurocognitive impairmentRisk behaviorsPreexposure prophylaxisSelf-reported neurocognitive symptomsHigh-risk drug usersHigh-risk PWUDPrEP uptakeNeurocognitive symptomsHIV riskDrug usersSimilar outcomesUnderserved populationsSignificant correlatesProphylaxisImportant unanswered questionsPreliminary evidencePrEPDissemination effortsMediation analysisUnanswered questionsVariables of interestHIVSymptomsClinicians