國立虎尾科技大學 |

Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia.

Record Type:	Language materials, manuscript : Monograph/item
Title/Author:	Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia./
Author:	Rankin, Kelsey A.
Description:	1 online resource (49 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 85-01, Section: B.
Contained By:	Dissertations Abstracts International85-01B.
Subject:	Medicine. -
Online resource:	click for full text (PQDT)
ISBN:	9798379795009

Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia.
Rankin, Kelsey A.

Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia. - 1 online resource (49 pages)

Source: Dissertations Abstracts International, Volume: 85-01, Section: B.

Thesis (M.D.)--Yale University, 2023.

Includes bibliographical references

Pre-exposure prophylaxis (PrEP) is highly effective in human immunodeficiency virus (HIV) prevention for key populations, including men who have sex with men (MSM). In Malaysia, human immunodeficiency virus (HIV) prevalence among MSM is 22%, and is even higher in key urban areas, including Kuala Lumpur. Despite nationwide campaigns committed to address HIV, scale-up of PrEP for MSM in Malaysia has been suboptimal. This limitation can be attributed partially to concerns that PrEP will lead to increased sexual risk behaviors, based on the controversial theory of risk compensation. A 2018 PrEP demonstration study of MSM in Malaysia (n=150) was used to assess changes in sexual risk behaviors after PrEP initiation, exploring risk compensation. Changes in sexual risk behaviors between baseline and follow-up (months 3, 6, 9, and 12) were tested using Wilcoxon signed-rank and McNemer's tests for non-parametric continuous and paired binary variables, respectively. Generalized estimating equations were used to model risk outcome behaviors. Significance was set at p<0.05 for all analyses. Participants were mostly single (62.0%), gay (92.0%), young (mean age: 31.33 + 7.36), and employed full-time (81.3%). Participants reported a small but statistically significant increase in sexual partners compared to baseline at all timepoints (all p<0.001), peaking at month 6, and then decreasing significantly thereafter (9 months: p=0.002; 12 months: p=0.001). There was no change in the risk behaviors of condomless anal sex (CAS) or CAS with an HIV+ partner at any timepoint. Baseline HIV risk perception could not predict any change in any risk behavior. Increased number of missed pills was significantly associated with decreased CAS (p=0.003).Lack of associations between baseline HIV risk perception and changes in any sexual risk behavior, as well as lack of changes in CAS and CAS with an HIV+ partner, undermines the notion of risk compensation in MSM while using PrEP. We advocate for the Malaysian government's endorsement, subsidization, and increased utilization of PrEP in the MSM community.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2024

Mode of access: World Wide Web

ISBN: 9798379795009Subjects--Topical Terms:

644133
Medicine.
Subjects--Index Terms:

HIVIndex Terms--Genre/Form:

554714
Electronic books.

Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia.
LDR:03598ntm a2200409K 4500 001 1141229
005 20240311061547.5
006 m o d
007 cr mn ---uuuuu
008 250605s2023 xx obm 000 0 eng d
020 $a 9798379795009
035 $a (MiAaPQ)AAI30311534
035 $a AAI30311534
040 $a MiAaPQ $b eng $c MiAaPQ $d NTU
100 1 $a Rankin, Kelsey A. $3 1464898
245 1 0 $a Is Risk Compensation Real? The Effect of Perceived Level of HIV Acquisition on Risk Behavior in a Pilot Pre-exposure Prophylaxis Demonstration Project in Men Who Have Sex With Men in Malaysia.
264 0 $c 2023
300 $a 1 online resource (49 pages)
336 $a text $b txt $2 rdacontent
337 $a computer $b c $2 rdamedia
338 $a online resource $b cr $2 rdacarrier
500 $a Source: Dissertations Abstracts International, Volume: 85-01, Section: B.
500 $a Advisor: Herzog, Erica.
502 $a Thesis (M.D.)--Yale University, 2023.
504 $a Includes bibliographical references
520 $a Pre-exposure prophylaxis (PrEP) is highly effective in human immunodeficiency virus (HIV) prevention for key populations, including men who have sex with men (MSM). In Malaysia, human immunodeficiency virus (HIV) prevalence among MSM is 22%, and is even higher in key urban areas, including Kuala Lumpur. Despite nationwide campaigns committed to address HIV, scale-up of PrEP for MSM in Malaysia has been suboptimal. This limitation can be attributed partially to concerns that PrEP will lead to increased sexual risk behaviors, based on the controversial theory of risk compensation. A 2018 PrEP demonstration study of MSM in Malaysia (n=150) was used to assess changes in sexual risk behaviors after PrEP initiation, exploring risk compensation. Changes in sexual risk behaviors between baseline and follow-up (months 3, 6, 9, and 12) were tested using Wilcoxon signed-rank and McNemer's tests for non-parametric continuous and paired binary variables, respectively. Generalized estimating equations were used to model risk outcome behaviors. Significance was set at p<0.05 for all analyses. Participants were mostly single (62.0%), gay (92.0%), young (mean age: 31.33 + 7.36), and employed full-time (81.3%). Participants reported a small but statistically significant increase in sexual partners compared to baseline at all timepoints (all p<0.001), peaking at month 6, and then decreasing significantly thereafter (9 months: p=0.002; 12 months: p=0.001). There was no change in the risk behaviors of condomless anal sex (CAS) or CAS with an HIV+ partner at any timepoint. Baseline HIV risk perception could not predict any change in any risk behavior. Increased number of missed pills was significantly associated with decreased CAS (p=0.003).Lack of associations between baseline HIV risk perception and changes in any sexual risk behavior, as well as lack of changes in CAS and CAS with an HIV+ partner, undermines the notion of risk compensation in MSM while using PrEP. We advocate for the Malaysian government's endorsement, subsidization, and increased utilization of PrEP in the MSM community.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2024
538 $a Mode of access: World Wide Web
650 4 $a Medicine. $3 644133
650 4 $a Public health. $3 560998
650 4 $a Pathology. $3 668553
650 4 $a Biostatistics. $3 783654
653 $a HIV
653 $a Pre-exposure prophylaxis
653 $a MSM community
653 $a Sexual risk behaviors
653 $a Malaysia
655 7 $a Electronic books. $2 local $3 554714
690 $a 0564
690 $a 0308
690 $a 0573
690 $a 0571
710 2 $a ProQuest Information and Learning Co. $3 1178819
710 2 $a Yale University. $b Yale School of Medicine. $3 1464899
773 0 $t Dissertations Abstracts International $g 85-01B.
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30311534 $z click for full text (PQDT)