2024
User preferences for an mHealth app to support HIV testing and pre-exposure prophylaxis uptake among men who have sex with men in Malaysia
Palmer L, Wickersham J, Gautam K, Maviglia F, Bruno B, Azwa I, Khati A, Altice F, Paudel K, Pagoto S, Shrestha R. User preferences for an mHealth app to support HIV testing and pre-exposure prophylaxis uptake among men who have sex with men in Malaysia. PLOS Digital Health 2024, 3: e0000643. PMID: 39475851, PMCID: PMC11524455, DOI: 10.1371/journal.pdig.0000643.Peer-Reviewed Original ResearchHIV prevention servicesHIV testingPreventive servicesPre-exposure prophylaxis uptakeHIV prevention appIncrease HIV testingMobile appsPrevalence of HIVHard-to-reach populationsStudy assessed attitudesOnline focus groupsMalaysian MSMCost of servicesPrEP uptakeDedoose softwareMHealth appsPrevention appsFocus groupsIntervention modalitiesMSMEngagement strategiesHIVConfidentiality risksThematic contentMenAdaptation 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 needsTesting 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 ResearchConceptsDepressive 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
Pre-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 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 ResearchConceptsOpioid 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 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 stakeholdersPrEPProphylaxisMen
2022
Exploring 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
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 ResearchConceptsPre-exposure prophylaxisCare cascadeSystematic reviewInjection drug useTransmission of HIVKey risk factorsPrEP eligibilityPrEP carePrEP uptakeHIV incidenceHIV transmissionRisk factorsPRISMA guidelinesPrevention strategiesPWIDDrug useLiterature searchEfficacious strategyProphylaxisPrEPDrugsInterventionHigh awarenessHIVReview
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 populationsDeveloping an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research
Shrestha R, Altice F, Karki P, Copenhaver M. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research. Frontiers In Immunology 2017, 8: 561. PMID: 28553295, PMCID: PMC5425476, DOI: 10.3389/fimmu.2017.00561.Peer-Reviewed Original ResearchNeurocognitive impairmentHigh-risk drug usersBehavioral interventionsHigh-risk PWUDHIV prevention behavioral interventionBiobehavioral approachHIV risk reductionHIV prevention interventionsDrug treatment settingsFormative researchHIV prevention effortsTarget populationPrEP adherencePrEP uptakeRisk reduction outcomesHIV preventionDrug treatmentPrevention interventionsFocus groupsTreatment settingsDrug usersRecovery programStructured focus groupsRisk behaviorsTarget population membersIntent 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