TY - JOUR
T1 - The association between psychosocial and structural-level stressors and HIV injection drug risk behavior among Malaysian fishermen
T2 - A cross-sectional study
AU - Michalopoulos, Lynn Murphy
AU - Jiwatram-Negrón, Tina
AU - Choo, Martin K.K.
AU - Kamarulzaman, Adeeba
AU - El-Bassel, Nabila
N1 - Funding Information:
NEB and AK received funding from the Malaysian Ministry of Higher Education High Impact Research Grant on Mitigating the Malaysian HIV Epidemic through a Comprehensive Research Programme (E-000001-20001) and the World Bank to conduct this study. TJN was supported by the Columbia Weatherhead East Asian Institute - Ryoichi Sasakawa Young Leaders Fellowship Award and by the Behavioral Sciences Training in Drug Abuse Research program at NDRI, with funding from the National Institute on Drug Abuse (T32 DA007233).
Publisher Copyright:
© 2016 Murphy Michalopoulos et al.
PY - 2016/6/2
Y1 - 2016/6/2
N2 - Background: Malaysian fishermen have been identified as a key-affected HIV population with HIV rates 10 times higher than national rates. A number of studies have identified that psychosocial and structural-level stressors increase HIV injection drug risk behaviors. The purpose of this paper is to examine psychosocial and structural-level stressors of injection drug use and HIV injection drug risk behaviors among Malaysian fishermen. Methods: The study employs a cross-sectional design using respondent driven sampling methods. The sample includes 406 fishermen from Pahang state, Malaysia. Using multivariate logistic regressions, we examined the relationship between individual (depression), social (adverse interactions with the police), and structural (poverty-related) stressors and injection drug use and risky injection drug use (e.g., receptive and non-receptive needle sharing, frontloading and back-loading, or sharing drugs from a common container). Results: Participants below the poverty line had significantly lower odds of injection drug use (OR 0.52, 95 % CI: 0.27-0.99, p = 0.047) and risky injection drug use behavior (OR 0.48, 95 % CI: 0.25-0.93, p = 0.030). In addition, participants with an arrest history had higher odds of injection use (OR 19.58, 95 % CI: 9.81-39.10, p < 0.001) and risky injection drug use (OR 16.25, 95 % CI: 4.73-55.85, p < 0.001). Participants with depression had significantly higher odds of engaging in risky injection drug use behavior (OR 3.26, 95 % 1.39-7.67, p = 0.007). Focusing on participants with a history of injection drug use, we found that participants with depression were significantly more likely to engage in risky drug use compared to participants below the depression cutoff (OR 3.45, 95 % CI: 1.23-9.66, p < 0.02). Conclusions: Findings underscore the need to address psychosocial and structural-level stressors among Malaysian fishermen to reduce HIV injection drug risk behaviors.
AB - Background: Malaysian fishermen have been identified as a key-affected HIV population with HIV rates 10 times higher than national rates. A number of studies have identified that psychosocial and structural-level stressors increase HIV injection drug risk behaviors. The purpose of this paper is to examine psychosocial and structural-level stressors of injection drug use and HIV injection drug risk behaviors among Malaysian fishermen. Methods: The study employs a cross-sectional design using respondent driven sampling methods. The sample includes 406 fishermen from Pahang state, Malaysia. Using multivariate logistic regressions, we examined the relationship between individual (depression), social (adverse interactions with the police), and structural (poverty-related) stressors and injection drug use and risky injection drug use (e.g., receptive and non-receptive needle sharing, frontloading and back-loading, or sharing drugs from a common container). Results: Participants below the poverty line had significantly lower odds of injection drug use (OR 0.52, 95 % CI: 0.27-0.99, p = 0.047) and risky injection drug use behavior (OR 0.48, 95 % CI: 0.25-0.93, p = 0.030). In addition, participants with an arrest history had higher odds of injection use (OR 19.58, 95 % CI: 9.81-39.10, p < 0.001) and risky injection drug use (OR 16.25, 95 % CI: 4.73-55.85, p < 0.001). Participants with depression had significantly higher odds of engaging in risky injection drug use behavior (OR 3.26, 95 % 1.39-7.67, p = 0.007). Focusing on participants with a history of injection drug use, we found that participants with depression were significantly more likely to engage in risky drug use compared to participants below the depression cutoff (OR 3.45, 95 % CI: 1.23-9.66, p < 0.02). Conclusions: Findings underscore the need to address psychosocial and structural-level stressors among Malaysian fishermen to reduce HIV injection drug risk behaviors.
KW - Depression
KW - Fishermen
KW - HIV risk
KW - Injection drug use
KW - Malaysia
KW - Policing
UR - http://www.scopus.com/inward/record.url?scp=84978204214&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978204214&partnerID=8YFLogxK
U2 - 10.1186/s12889-016-3125-7
DO - 10.1186/s12889-016-3125-7
M3 - Article
C2 - 27250497
AN - SCOPUS:84978204214
SN - 1471-2458
VL - 16
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 464
ER -