Transcript Powerpoint

A Bio Behavioural and Prevalence study of HIV,
syphilis and Hepatitis B in high risk men who have
sex with men (MSM) in Kuala Lumpur, Malaysia
I. Azwa 1, E. Celaya 2, I. Yee 3, K. Baker 4, S.H. Lim 3, A. Ashraf 5,
F.T. Tai 2, M. Choo Kok Keong 3, D. Dangerfield 1
1 University Malaya, Department of Medicine, Kuala Lumpur,
Malaysia, 2 PT Foundation, Kuala Lumpur, Malaysia, 3 CERIA, Kuala
Lumpur, Malaysia, 4 London School of Hygiene and Tropical
Medicine, London, United Kingdom, 5 Terrence Higgins Trust,
London, United Kingdom
www.ias2013.org
Kuala Lumpur, Malaysia , 30 June - 3 July 2013
Objective and Methods
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The MSM community is a heterogeneous and hidden population in Malaysia due
to stigma, cultural and religious influences.
Previous studies looking at the HIV prevalence within the MSM population in Kuala
Lumpur such as the venue day time sampling ( Kanter et al, 2011) recorded
surprisingly low levels of HIV. (VDTS -3.9%)
The Objective of the study was to describe the risk behaviours and estimate the
prevalence and risk factors of HIV, syphilis and hepatitis B in high risk MSM
attending a voluntary counselling and testing (VCT) centre in Kuala Lumpur.
High risk behaviour was defined as MSM who engaged in unprotected anal
intercourse (UAI) in the previous 6 months
Clients completed a self- administered questionnaire on sexual behaviour, alcohol
and substance use and HIV/STI testing and knowledge
Each client was tested for HIV using a rapid test kit (Intec, Korea) and venous blood
was tested for syphilis (RPR and TPPA) and Hepatitis B (hepatitis B surface Antigen
and surface antibody)
www.ias2013.org
Kuala Lumpur, Malaysia , 30 June - 3 July 2013
Results
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Sociodemographics
229 men fulfilled inclusion
criteria
Mean age – 29 years
55% Chinese, 35% Malays
94% single, 4% married
72% university graduates
85% identified as
homosexual
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Prevalence (N=229)
Kuala Lumpur, Malaysia , 30 June - 3 July 2013
Results
Sexual Behaviour
Recreational Drug Use
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Kuala Lumpur, Malaysia , 30 June - 3 July 2013
Predictors of HIV and syphilis infection
Bivariate analysis
Variable
Variable
HIV Negative
Syphilis
Negative
HIV
Positive
Syphilis
Positive PPvalue
value
Ethnicity
Chinese
Education
Malays
<Indians/Others
Form 5
105 (83.3%)
65 (80.2%)
8 (53.3%)
19 (86.4%)
21 (16.7%)
16 (19.8%)
7
(46.7%)
3 (16.4%)
0.751
8 (53.3%)
181 (84.6%)
7 (46.7%)
33 (15.4%)
0.002
Form 5 or higher
Education
< Form 5
Form 5 and higher
184 (86%)
0.001
9 (14%)
STI symptoms in past 12 months
UAI during last sex with casual partners
No
138169
(89.1%)
No
(85.4%)
Yes
5454
Yes
20 (72.9%)
(64.5%)
17
(10.9%)
29 (14.7%)
20
(27.1%)
11 (35.5%)
Used drugs during group sex
No
Yes
172 (83.9%)
17 (70.8%)
33 (16.1%)
7 (29.2%)
0.110
Syphilis
Positive
Negative – previously infected
Negative – never infected
29 (78.4%)
8 (57.1%)
152 (85.4%)
8 (21.6%)
6 (42.9%)
26 (14.6%)
0.021
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0.002
0.005
Kuala Lumpur, Malaysia , 30 June - 3 July 2013
Conclusion
• Highest rates of HIV prevalence reported to date within high risk
MSM in Kuala Lumpur
• Syphilis prevalence very similar to that of HIV and may be fuelling
the HIV epidemic within the MSM population
• High levels of UAI and recreational drug use particularly for the
purposes of sex are prevalent within this population
• There is an urgent need to provide more effective and targeted HIV
prevention education and strategies to combat the spread of HIV
infection within the MSM community in Malaysia
• Future studies need to look at HIV incidence within established
MSM cohorts, the role of cultural and religious norms and
perceived stigma on risk behaviour, the impact of newer HIV
prevention strategies on HIV incidence and include online
recruitment given the high numbers that use the internet to solicit
partners for sex
www.ias2013.org
Kuala Lumpur, Malaysia , 30 June - 3 July 2013