A Qualitative Study of HIV “Test-and-Treat” Experience Among Men Who Have Sex With Men in Malaysia

Abstract

This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.

A socio-ecological analysis of factors influencing HIV treatment initiation and adherence among key populations in Papua New Guinea

“…Passing as HIV negative was probably not as important for some as it was passing as cis-gender. Similar findings have been noted in other studies in PNG [ 36 , 37 ] and among key populations in LMICs [ 27 , 34 ]. Friendly, non-judgmental and supportive patient-provider relationships that assisted participants navigate HIV services after diagnosis and ensured early ART initiation enabled HIV care [ 11 , 12 , 24 , 27 , 34 ].…”

“…Similar findings have been noted in other studies in PNG [ 36 , 37 ] and among key populations in LMICs [ 27 , 34 ]. Friendly, non-judgmental and supportive patient-provider relationships that assisted participants navigate HIV services after diagnosis and ensured early ART initiation enabled HIV care [ 11 , 12 , 24 , 27 , 34 ]. Different experiences of intersecting socio-ecological influences made accessing HIV treatment and remaining adherent to ART less challenging for some participants.…”

“…Lack of family support after the HIV-positive diagnosis and fear of shame, gossip and even physical violence if seen in the location of HIV services prevented some FSW from accessing HIV services. Negative interactions with healthcare workers, lack of anonymity within HIV services, and perceived or actual experiences of HIV-related stigma and discrimination inhibited participant’s willingness to remain engaged in HIV care [ 11 , 24 – 27 , 39 ]. It was the absence of these barriers that participants in the qualitative study identified as important in influencing their participation in the larger biobehavioural survey – Kauntim mi tu [ 33 ].…”

Methodologies of Stigma-Related Research Amongst Men Who Have Sex With Men (MSM) and Transgender People in Asia and the Pacific Low/Middle Income Countries (LMICs): A Scoping Review

“…Most of these were conducted at health care settings or at places where consultation, testing, and treatment was available (27)(28)(29)(30)(31)(32). This method was widely used as random sampling was not usually feasible (8,(33)(34)(35)(36)(37) and some helped by non-governmental organizations (NGOs)/community-based organizations (CBOs) staff (12,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Limitations associated with the use of convenience/consecutive sampling recruitment included that the sampling may not reach all subpopulations and the study may lack the intended diversity (21,49).…”

Current Research Involving LGBTQ People in Malaysia: A Scoping Review Informed by a Health Equity Lens

“…LGBTQ people reported high levels of distrust towards health professionals in providing confidential care (Gibson et al, 2016;Lim et al, 2019). Furthermore, there was a preference among LGBTQ people to utilize HIV self-testing kits and virtual platforms for counseling as these alternatives could warrant anonymity (Shrestha, Alias, et al, 2020;.…”