2024
Transactional sex and its associated factors among gay, bisexual and other men who have sex with men in Nepal
Sujan M, Paudel K, Gautam K, Khati A, Wickersham J, Dhakal M, Ha T, Shrestha R. Transactional sex and its associated factors among gay, bisexual and other men who have sex with men in Nepal. Sexual Health 2024, 21 PMID: 39388431, DOI: 10.1071/sh24178.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCross-Sectional StudiesHomosexuality, MaleHumansMaleNepalPrevalenceSex WorkSexual and Gender MinoritiesSexual BehaviorYoung AdultConceptsTransactional sexPrevalence of transactional sexFactors associated with transactional sexExchange of sexReduce transactional sexPolice detentionMental health challengesEconomic vulnerabilityTransgender womenFinancial dependenceGBMSMCondomless sexSubstance useAssociated with adverse health outcomesNepalParticipants' sociodemographic characteristics,Cross-sectional surveyMultivariate logistic regression analysisAdverse health outcomesAge of participantsHealth outcomesSexually transmitted infectionsHigh-risk groupSociodemographic characteristicsLogistic regression analysisTesting 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 healthMediating role of food insecurity in the relationship between perceived MSM related stigma and depressive symptoms among men who have sex with men in Nepal
Paudel K, Bhandari P, Gautam K, Wickersham J, Ha T, Banik S, Shrestha R. Mediating role of food insecurity in the relationship between perceived MSM related stigma and depressive symptoms among men who have sex with men in Nepal. PLOS ONE 2024, 19: e0296097. PMID: 38166131, PMCID: PMC10760890, DOI: 10.1371/journal.pone.0296097.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesDepressionFemaleFood InsecurityHIV InfectionsHomosexuality, MaleHumansMaleNepalSexual and Gender MinoritiesSocial StigmaConceptsDepressive symptomsHigher ageCross-sectional studyHealth-related confoundersResource-limited countriesCondom-less sexMental health concernsRespondent-driven samplingPrEP uptakeFood insecurityDearth of evidenceUnadjusted modelsAdjusted modelSymptomsHealth concernMSMOutcome variablesConfidence intervalsMenMonthly incomeSexAssociationStigmaAgePrevious studies
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 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 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 rateHIVDosingBarriers 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
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 FactorsExploring Malaysian Physicians' Intention to Discriminate Against Gay, Bisexual, and Other Men Who Have Sex with Men Patients
Ni Z, Shrestha R, Earnshaw VA, Tee YC, Altice FL, Azwa I, Kamarulzaman A, Zhou X, Wickersham JA. Exploring Malaysian Physicians' Intention to Discriminate Against Gay, Bisexual, and Other Men Who Have Sex with Men Patients. LGBT Health 2022, 10: 169-175. PMID: 36251945, PMCID: PMC9986015, DOI: 10.1089/lgbt.2021.0452.Peer-Reviewed Original ResearchMobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey
Shrestha R, Maviglia F, Altice FL, DiDomizio E, Khati A, Mistler C, Azwa I, Kamarulzaman A, Halim MAA, Wickersham JA. Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey. Journal Of Medical Internet Research 2022, 24: e36917. PMID: 35877172, PMCID: PMC9361153, DOI: 10.2196/36917.Peer-Reviewed Original ResearchConceptsHIV prevention informationHIV preventionDrug usePrevention informationMalaysian menMHealth platformHIV risk-related behaviorsHIV prevention toolHIV prevention servicesSexual activityReceptive anal sexMobile health interventionsHIV prevention effortsUse of mHealthIllicit drug useSexualized drug useCross-sectional surveyAcceptability of mHealthHealth technology useSelf-administered questionnaireRespondent-driven samplingHealth-related informationSuboptimal engagementDearth of evidencePrevention servicesExploring 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
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
Using individual stated-preferences to optimize HIV self-testing service delivery among men who have sex with men (MSM) in Malaysia: results from a conjoint-based analysis
Shrestha R, Alias H, Wong LP, Altice FL, Lim SH. Using individual stated-preferences to optimize HIV self-testing service delivery among men who have sex with men (MSM) in Malaysia: results from a conjoint-based analysis. BMC Public Health 2020, 20: 1777. PMID: 33238941, PMCID: PMC7687720, DOI: 10.1186/s12889-020-09832-w.Peer-Reviewed Original ResearchConceptsClinic-based HIV testingHIV testing uptakeMethodsA cross-sectional online surveyCross-sectional online surveyNational AIDS ProgramAcceptability of HIVSTMalaysian MSMHIV testingTesting uptakeService delivery programsKey populationsHIVSTService delivery modelsAIDS ProgramMSMKit deliveryTelephone hotlineService delivery approachHigh acceptabilityDelivery programsMultiple barriersSafe useMean acceptabilityDelivery approachDelivery modelAwareness 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
2019
Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks
Shrestha R, Lim SH, Altice FL, Copenhaver M, Wickersham JA, Saifi R, Ab Halim MA, Naning H, Kamarulzaman A. Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks. Journal Of Community Health 2019, 45: 10-19. PMID: 31375976, PMCID: PMC6957731, DOI: 10.1007/s10900-019-00713-x.Peer-Reviewed Original ResearchConceptsSexual health informationHIV testingHealth informationOnline sexual health informationSexual partnersRecent HIV testingHigh-risk MSMHIV/STIsHIV risk behaviorsHIV prevention activitiesCross-sectional online surveyHealth Information OnlineMalaysian MSMSTI preventionIndependent correlatesGeosocial networking appsHIV riskMHealth interventionsMHealth strategiesMHealth toolsRisk behaviorsOlder ageLogistic regressionMSMPrevention activities
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 populationsAn explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru
Weikum D, Shrestha R, Ferro EG, Vagenas P, Copenhaver M, Spudich S, Alpert MD, Cabello R, Lama JR, Sanchez J, Altice FL. An explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru. AIDS Care 2017, 29: 1297-1301. PMID: 28449599, PMCID: PMC6337065, DOI: 10.1080/09540121.2017.1322681.Peer-Reviewed Original ResearchConceptsHIV-positive menNeuropsychological Impairment ScaleNeurocognitive impairmentTransgender womenAntiretroviral therapyHIV-positive MSMPoor clinical outcomeHIV risk behaviorsClinical care settingsHealth-related outcomesExploratory factor analysisART adherenceClinical outcomesPatient populationCare settingsImpairment ScaleRisk behaviorsImpairmentMenPrincipal axis factoringSelf-report scalesOrthogonal varimax rotationWomenBrief self-report scaleOutcomesCorrelates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment
Shrestha R, Karki P, Altice FL, Huedo-Medina TB, Meyer JP, Madden L, Copenhaver M. Correlates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment. Drug And Alcohol Dependence 2017, 173: 107-116. PMID: 28214391, PMCID: PMC5366273, DOI: 10.1016/j.drugalcdep.2016.12.023.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisHIV risk reductionDrug injectionHIV riskRisk behaviorsHigh-risk drug usersHigh-risk PWUDOpioid-dependent personsHIV prevention approachesRecent risk behaviorsCross-sectional studyConsistent condom useHigh-risk behaviorsRisk reductionCorrelates of willingnessPrEP deliveryMethadone treatmentIndependent correlatesMethadone programsSafe drugElevated riskCasual partnersNeurocognitive impairmentDrug usersKey populations