Prevalence and correlates of psychological distress among drug users in Phnom Penh, Cambodia

Background: Compared to the general population, drug users are at increased risk of both poor mental health and HIV infection. The aim of this study was to determine the prevalence and correlates of high psychological distress among drug users in Cambodia. Methods: In April 2014, a two-stage cluster sampling method was used to randomly select 169 drug users from hotspots in Phnom Penh. Psychological distress was measured using General Health Questionnaire (GHQ-12). Bivariate and multivariable analyses were conducted to identify factors associated with levels of psychological distress among this population.Results: Our study found high prevalence of attempted suicide (15.3%), drug related arrests (46.2%), and incarceration (31.4%). Of the 169 participants, 42.0% were found to have high levels of psychological distress, indicating poor mental health. After adjustment, high levels of psychological distress were independently associated with suicidal ideation (p< 0.001), higher frequency of drug use (p= 0.02), sharing of needles or syringes (p= 0.005), and having been sent to a rehabilitation centre (p= 0.02). In addition, participants who perceived their overall health as being poor or very poor were more likely to have high levels of psychological distress (p= 0.002).Conclusions: Integration of mental health within HIV and needle and syringe exchange programmes is required to address psychological distress among drug users in Cambodia. Health system interventions, such as screening, referral, and training of health providers, need to be strengthened. In addition, interventions addressing social determinants of mental health and mitigation of frequent arrests and improving conditions in rehabilitation centres are required

Improving prevention and care for HIV and sexually transmitted infections among men who have sex with men in Cambodia: the sustainable action against HIV and AIDS in communities (SAHACOM)

Abstract Background The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia. Methods We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang and Siem Reap provinces. A two-stage cluster sampling method was employed to select the study sample for structured interviews. Results The midterm and endline samples were similar. The average number of sexual partners in the past three months decreased significantly from 6.2 to 4.0 (p = 0.03). The proportion of MSM who reported paying for sex with men in the past three months also decreased significantly from 19.0 % to 9.7 % (OR = 2.0, 95 % CI = 1.3-3.0). No significant change was found in condom and lubricant use in all types of relationships. Regarding STIs, 28.1 % of MSM at midterm reported having at least one STI symptom in the past three months compared to 6.1 % at endline (OR = 4.6, 95 % CI = 2.9–7.4); out of them, 14.1 % of MSM at midterm sought treatment compared to 20.7 % at endline (OR = 2.6, 95 % CI = 1.1–6.9). The proportion of MSM who reported using illicit drugs in the past three months also decreased significantly from 12.2 % to 5.1 % (OR = 2.4, 95 % CI = 1.4–4.2). However, the proportion of MSM who reported having been tested for HIV in the past six months decreased significantly from 94.1 % to 77.1 % (OR = 2.9, 95 % CI = 1.8–3.6). Conclusions Findings from this study indicate that the SAHACOM was effective in improving sexual behaviors and related health outcomes among MSM under the project. However, it could not increase condom use and HIV testing rates among this key population. Tailored intervention programs are needed to improve condom use and HIV testing among MSM in Cambodia

Prevalence of HIV and Risk Behaviors among Female Entertainment Workers in Cambodia: A National Biological and Behavioral Survey

10.12691/ajphr-7-3-2American Journal of Public Health Research7394-10

Assessing and evaluating community organizations' capacity for working in HIV|AIDS responses in India, Ecuador and Cambodia

Civil society programmes and funding mechanisms need tools to assess capacities of organizations to identify credible partners and further build their capacity to absorb funds and implement programmes. However, for all the investment in capacity building, results and impact are often difficult to evaluate, although most programmes monitor process indicators. The International HIV|AIDS Alliance is running a multi-country prevention programme with over 60 community organizations where participatory analysis of partners' capacities at the beginning of a programme will accelerate capacity building and provide baseline data to evaluate increases in capacity and impacts on programme outcomes. The work has contributed to a new printed toolkit for analysing NGO capacity. Unlike many assessment tools, the toolkit provides participatory training hand-in-hand with participatory appraisal methods, to enable organisations to critically reflect and motivate for change internally. The scope of the toolkit goes beyond traditional organisational development, to look at other areas of capacity instrumental for organisations providing services and working for change related to HIV|AIDS. The toolkit is freely available from the organisation's website ( www.aidsalliance.org ). Copyright © 2006 John Wiley & Sons, Ltd.

Prevalence and correlates of psychological distress among drug users in Phnom Penh, Cambodia

10.1016/j.drugpo.2016.06.002INTERNATIONAL JOURNAL OF DRUG POLICY3625-3

Mental health among men who have sex with men in Cambodia:implications for integration of mental health services within HIV programmes

Background: Poor mental health contributes to poor HIV prevention, treatment and care outcomes. This paper documents factors associated with psychological distress among men who have sex with men (MSM) in Cambodia and discusses potential ways in which routine mental health management could be integrated into HIV services.Methods: A cross-sectional study was conducted in 2014 among 394 MSM randomly selected from two provinces using a two-stage cluster sampling method. A structured questionnaire was used to assess psychological distress, sexual behaviors, substance use, adverse childhood experiences and family dysfunction. Multivariate logistic regression analysis was performed to explore factors associated with levels of psychological distress.Results: In total, 10.7 % of the respondents reported having suicidal thoughts and 6.6 % reported having attempted to commit suicide in the past three months, while 38.8 % had a higher level of psychological distress (GHQ-12 > 3), which indicates poor mental health. Higher levels of psychological distress were independently associated with older age (AOR = 1.09, 95 % CI 1.03–1.14), alcohol use (AOR = 3.3, 95 % CI 1.36–7.83), illicit drug use (AOR = 3.53, 95 % CI 1.12– 11.18), poor self-reported quality of life (AOR = 7.45, 95 % CI 1.79–3.04), and reduced condom use at last sex (AOR = 0.40, 95 % CI 0.21–0.73). MSM with higher levels of psychological distress were significantly more likely to report that a family member said hurtful things to them (AOR = 1.80, 95 % CI 1.10–2.97), a parent or guardian had been physically abused (AOR = 3.51, 95 % CI 1.86–6.62), and a family member had been mentally ill (AOR = 4.01, 95 % CI 2.06–7.81) when they were growing up.Conclusions: In order to mitigate psychological distress among MSM in Cambodia, integration of mental health interventions within HIV programmes should be strengthened. To achieve optimal impact, these interventions should also address alcohol and other substance use, and low condom use among distressed MSM. In addition, training of clinical and non-clinical HIV service providers to screen for mental health symptoms, and subsequent provision of peer-based outreach and social support for MSM identified with psychological distress is required

Improving prevention and care for HIV and sexually transmitted infections among men who have sex with men in Cambodia: the sustainable action against HIV and AIDS in communities (SAHACOM)

10.1186/s12913-016-1857-9BMC HEALTH SERVICES RESEARCH16

Barriers in access to services and information gaps by genders and key populations in the national tuberculosis programme in Cambodia

Global Public Health1781743-175