Willingness to use HIV self-testing and associated factors among transgender women in Malaysia

Shrestha, Roman and Galka, Jonathan M. and Azwa, Iskandar and Lim, Sin How and Guadamuz, Thomas E. and Altice, Frederick L. and Wickersham, Jeffrey A. (2020) Willingness to use HIV self-testing and associated factors among transgender women in Malaysia. Transgender Health, 5 (3). pp. 182-190. ISSN 2688-4887, DOI https://doi.org/10.1089/trgh.2019.0085.

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Background: While global research on the implementation of HIV self-testing (HIVST) has increased exponentially, few studies have assessed information on HIVST uptake factors (i.e., willingness, preferences) in transgender women (TW) and none in the Malaysian context. We therefore sought to assess willingness to use HIVST among this understudied key population. Methods: A cross-sectional survey was conducted among 361 HIV-negative Malaysian TW in 2017. Participants were recruited using flyers, announcements through social media, and direct referral from staff members of the community-based organizations serving the TW communities. Multivariable logistic regression was used to identify correlates of willingness to use HIVST. Results: Nearly half of the participants (47.6%) reported that they would be willing to use HIVST. Multivariable analysis showed that willingness to use HIVST was positively associated with having experienced sexual assault in childhood (adjusted odds ratio aOR]=3.239, p<0.001), having ever used mobile phone or apps to find sex work clients (aOR=1.677, p=0.040), and having engaged in condomless sex in the past 6 months (aOR=1.886, p=0.018). In contrast, living in Kuala Lumpur (aOR=0.559, p=0.032), having higher number of sex work clients per day (aOR=0.927, p=0.004), and current depressive symptoms (aOR=0.576, p=0.026) were negatively associated with willingness to use HIVST. Conclusions: Findings in this study suggest that TW in our sample were moderately willing to use HIVST. Especially important here is the increased interest in HIVST among TW who are at higher risk for HIV infection. Overall, our findings underscore the need for additional research on how to most effectively implement HIVST for key populations, including TW, such that uptake and retention in regular HIV screening is sustained.

Item Type: Article
Funders: Yale Bates Summer Fellowship, Yale Global Health Seed Funding Award, Yale Global Health Studies Scholarship, United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Drug Abuse (NIDA) European Commission [Grant No: K01 DA038529 & R01 DA041271]
Uncontrolled Keywords: HIV; HIV self-testing; Transgender women; Malaysia
Subjects: B Philosophy. Psychology. Religion > BF Psychology
G Geography. Anthropology. Recreation > GE Environmental Sciences
Divisions: Faculty of Medicine
Depositing User: Mrs. Siti Mawarni Salim
Date Deposited: 18 Oct 2022 06:27
Last Modified: 18 Oct 2022 06:29
URI: http://eprints.um.edu.my/id/eprint/31671

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