Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention

Background: Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts. Methods: In June 2007, 102 HIV-infected male prisoners within 6 mont...

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Main Authors: Bachireddy, C., Bazazi, A.R., Kavasery, R., Govindasamy, S., Kamarulzaman, A., Altice, F.L.
Format: Article
Published: 2011
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Online Access:http://eprints.um.edu.my/4541/
http://www.ncbi.nlm.nih.gov/pubmed/21232882
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spelling my.um.eprints.45412013-01-16T02:13:40Z http://eprints.um.edu.my/4541/ Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention Bachireddy, C. Bazazi, A.R. Kavasery, R. Govindasamy, S. Kamarulzaman, A. Altice, F.L. R Medicine Background: Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts. Methods: In June 2007, 102 HIV-infected male prisoners within 6 months of community-release were anonymously surveyed in Kota Bharu, Malaysia. Results: Nearly all subjects (95) met criteria for opioid dependence. Overall, 66 of participants reported sharing needles, and 37 reported unprotected sex in the 30 days prior to incarceration. During this period, 77 reported injection drug use, with 71 injecting daily and 65 injecting more than one substance. Injection of buprenorphine (28), benzodiazepines (28) and methamphetamines (49) was reported. Nearly all (97) of those reporting unprotected sex did so with someone not known to be HIV-infected. While 51 believed that opioid substitution therapy COST) would be helpful, only 33 believed they needed it to prevent relapse after prison release. Most participants (70) expressed interest in learning more about OST. Those reporting the highest injection risks were more likely to believe OST would be helpful (p < 0.05), to believe that it was needed to prevent relapse post-release (p < 0.05), and to express interest in learning more about OST (p < 0.01). Conclusions: Secondary HIV prevention among prisoners in Malaysia is crucial to reduce community HIV transmission after release. Effectively reducing HIV risk associated with opioid injection will require OST expansion, including social marketing to improve its acceptability and careful monitoring. Access to sterile injection equipment, particularly for non-opioid injectors, and behavioral interventions that reduce sexual risk will also be required. (C) 2010 Elsevier Ireland Ltd. All rights reserved. 2011 Article PeerReviewed Bachireddy, C. and Bazazi, A.R. and Kavasery, R. and Govindasamy, S. and Kamarulzaman, A. and Altice, F.L. (2011) Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention. Drug and Alcohol Dependence, 116 (1-3). pp. 151-157. ISSN 0376-8716 http://www.ncbi.nlm.nih.gov/pubmed/21232882
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Bachireddy, C.
Bazazi, A.R.
Kavasery, R.
Govindasamy, S.
Kamarulzaman, A.
Altice, F.L.
Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
description Background: Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts. Methods: In June 2007, 102 HIV-infected male prisoners within 6 months of community-release were anonymously surveyed in Kota Bharu, Malaysia. Results: Nearly all subjects (95) met criteria for opioid dependence. Overall, 66 of participants reported sharing needles, and 37 reported unprotected sex in the 30 days prior to incarceration. During this period, 77 reported injection drug use, with 71 injecting daily and 65 injecting more than one substance. Injection of buprenorphine (28), benzodiazepines (28) and methamphetamines (49) was reported. Nearly all (97) of those reporting unprotected sex did so with someone not known to be HIV-infected. While 51 believed that opioid substitution therapy COST) would be helpful, only 33 believed they needed it to prevent relapse after prison release. Most participants (70) expressed interest in learning more about OST. Those reporting the highest injection risks were more likely to believe OST would be helpful (p < 0.05), to believe that it was needed to prevent relapse post-release (p < 0.05), and to express interest in learning more about OST (p < 0.01). Conclusions: Secondary HIV prevention among prisoners in Malaysia is crucial to reduce community HIV transmission after release. Effectively reducing HIV risk associated with opioid injection will require OST expansion, including social marketing to improve its acceptability and careful monitoring. Access to sterile injection equipment, particularly for non-opioid injectors, and behavioral interventions that reduce sexual risk will also be required. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
format Article
author Bachireddy, C.
Bazazi, A.R.
Kavasery, R.
Govindasamy, S.
Kamarulzaman, A.
Altice, F.L.
author_facet Bachireddy, C.
Bazazi, A.R.
Kavasery, R.
Govindasamy, S.
Kamarulzaman, A.
Altice, F.L.
author_sort Bachireddy, C.
title Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
title_short Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
title_full Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
title_fullStr Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
title_full_unstemmed Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
title_sort attitudes toward opioid substitution therapy and pre-incarceration hiv transmission behaviors among hiv-infected prisoners in malaysia: implications for secondary prevention
publishDate 2011
url http://eprints.um.edu.my/4541/
http://www.ncbi.nlm.nih.gov/pubmed/21232882
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