Assessment of HIV testing among young methamphetamine users in Muse, Northern Shan State, Myanmar

Background Methamphetamine (MA) use has a strong correlation with risky sexual behaviors, and thus may be triggering the growing HIV epidemic in Myanmar. Although methamphetamine use is a serious public health concern, only a few studies have examined HIV testing among young drug users. This study aimed to examine how predisposing, enabling and need factors affect HIV testing among young MA users. Methods A cross-sectional study was conducted from January to March 2013 in Muse city in the Northern Shan State of Myanmar. Using a respondent-driven sampling method, 776 MA users aged 18-24 years were recruited. The main outcome of interest was whether participants had ever been tested for HIV. Descriptive statistics and multivariate logistic regression were applied in this study. Results Approximately 14.7% of young MA users had ever been tested for HIV. Significant positive predictors of HIV testing included predisposing factors such as being a female MA user, having had higher education, and currently living with one’s spouse/sexual partner. Significant enabling factors included being employed and having ever visited NGO clinics or met NGO workers. Significant need factors were having ever been diagnosed with an STI and having ever wanted to receive help to stop drug use. Conclusions Predisposing, enabling and need factors were significant contributors affecting uptake of HIV testing among young MA users. Integrating HIV testing into STI treatment programs, alongside general expansion of HIV testing services may be effective in increasing HIV testing uptake among young MA users

What are the Factors Associated With HIV Testing Among Male Injecting An Non-Injecting Drug Users In Lashio, Myanmnar: A Cross-Sectional Study

Objectives: HIV testing is an effective intervention for reducing HIV risk and providing information on HIV status. However, uptake of HIV testing is a major challenge within the drug-using population due to the stigma and discrimination associated with their illegal drug use behaviours. This study thus aimed to identify factors associated with HIV testing among injecting drug users (IDUs) and non-injecting drug users (NIDUs) in Lashio, Myanmar. Design: A cross-sectional study was conducted from January 2010 to February 2010. Setting: This study was carried out in Lashio city, Northern Shan State, Myanmar. Participants: In total, 158 male IDUs and 210 male NIDUs were recruited using a respondent-driven sampling method. Primary outcome measures: Proportion of both drug users who were ever tested for HIV and factors associated with HIV testing. Results: Approximately 77% of IDUs and 46% of NIDUs were ever tested for HIV. The multivariate analysis revealed that having ever received drug treatment was positively associated with HIV testing among both IDUs (adjusted OR (AOR) 13.07; 95% CI 3.38 to 50.53) and NIDUs (AOR 3.58; 95% CI 1.38 to 9.24). IDUs who were married (AOR 0.24; 95% CI 0.06 to 0.94) and who injected at least twice daily (AOR 0.30; 95% CI 0.09 to 0.97) were less likely to undergo HIV testing. Among NIDUs, those who belonged to Shan (AOR 0.30; 95% CI 0.11 to 0.84) or Kachin (AOR 0.30; 95% CI 0.10 to 0.87) ethnicities were less likely to test for HIV. Conclusions: IDUs and NIDUs who have received drug treatment are more likely to test for HIV. Integrating HIV testing into drug treatment programmes alongside general expansion of HIV testing services may be effective in increasing HIV testing uptake among both IDUs and NIDUs in the Northern Shan State of Myanmar

Barriers between mothers and their adolescent daughters with regards to sexual and reproductive health communication in Taunggyi Township, Myanmar: What factors play important roles?

BACKGROUND:Parents play critical roles in adolescents' sexual and reproductive health (SRH) and discussions between parents and adolescents on this topic are fundamental in reducing adolescents' risky sexual behaviors. However, SRH communication is a challenging issue in Myanmar due to socio-cultural taboos. This study assessed the communication barriers towards SRH issues among mothers and their adolescent girls. METHODS:A community-based, cross-sectional study was conducted from January to December 2017 in Taunggyi Township, Southern Shan State, Myanmar. In total, 112 pairs of mothers and adolescent daughters were recruited using a face-to-face interview method with semi-structured questionnaires. Logistic regression analysis was applied to examine communication barriers on SRH issues between mothers and their adolescent girls. RESULTS:More than half of both mother and adolescent girls had negative perceptions of communication on SRH issues. Only 2.7% of girls discussed SRH issues with their mothers more than four times in the last six months. The factors found to create SRH communication barriers were higher family incomes (adjusted odd ration [AOR] 2.5, 95% confidence interval [CI] 1.0, 6.2), good knowledge of puberty (AOR 4.5, 95% CI 1.6, 12.5), good knowledge of sexual and reproductive health issues (AOR 4.5, 95% CI 1.8, 11.5), and positive perception of communication (AOR 6.7, 95% CI 2.5, 17.9) among mothers, and good knowledge of contraception (AOR 5.7, 95% CI 1.5, 21.4) and good knowledge of sexually transmitted infections (AOR 2.5, 95% CI 1.0, 6.4) among adolescent girls. CONCLUSION:Mothers and adolescent girls communicated on SRHs was narrow, occurring infrequently and late, with only limited topics discussed. Having higher levels of SRH knowledge were more likely to create communication barriers among mother and adolescent girls. Policy makers need to consider targeted sexual and reproductive health education programs that can be implemented at the school and community levels to increase parent-adolescent communication

Gender difference in early initiation of methamphetamine use among current methamphetamine users in Muse, Northern Shan State, Myanmar

Abstract Background Globally, methamphetamine (MA) use is a significant public health concern due to unprecedented health effects of its use. However, gender similarities and differences in early age of MA initiation and its risk factors among current MA users have been understudied in a developing country setting. Methods A community-based, cross-sectional study was conducted using a computer assisted self-interviewing program from January to March 2013 in Muse, Northern Shan State, Myanmar. A total of 1362 (775 male and 587 female) self-reported current MA users aged between 18 and 35 years were recruited using respondent-driven sampling. Two gender-stratified multiple logistic regression models (models I and II) were done for analysis. Results For similarities, 73.0% of males and 60.5% of females initiated MA before their 18th birthday. The early age of MA initiation was positively associated with the reasons and places of the first time MA use among both genders. For differences, males [hazard ratio 1.35; 95% confidence interval, 1.18–1.54] had a significantly higher risk than females to initiate MA at earlier age. Among male users, participants who had bisexual/homosexual preferences were more likely to initiate MA use earlier. In contrast, female users who exchanged sex for money and/or drugs were more likely to initiate MA in earlier age. Conclusions More than 60.0% of male and female participants initiated MA use early; however, males initiated use earlier than females. Although similarities were found among both genders, differences found in key risk factors for early age MA initiation suggest that gender-specific, MA prevention programs are urgently needed in Myanmar

Assessment of HIV testing among young methamphetamine users in Muse, Northern Shan State, Myanmar

Background Methamphetamine (MA) use has a strong correlation with risky sexual behaviors, and thus may be triggering the growing HIV epidemic in Myanmar. Although methamphetamine use is a serious public health concern, only a few studies have examined HIV testing among young drug users. This study aimed to examine how predisposing, enabling and need factors affect HIV testing among young MA users. Methods A cross-sectional study was conducted from January to March 2013 in Muse city in the Northern Shan State of Myanmar. Using a respondent-driven sampling method, 776 MA users aged 18-24 years were recruited. The main outcome of interest was whether participants had ever been tested for HIV. Descriptive statistics and multivariate logistic regression were applied in this study. Results Approximately 14.7% of young MA users had ever been tested for HIV. Significant positive predictors of HIV testing included predisposing factors such as being a female MA user, having had higher education, and currently living with one’s spouse/sexual partner. Significant enabling factors included being employed and having ever visited NGO clinics or met NGO workers. Significant need factors were having ever been diagnosed with an STI and having ever wanted to receive help to stop drug use. Conclusions Predisposing, enabling and need factors were significant contributors affecting uptake of HIV testing among young MA users. Integrating HIV testing into STI treatment programs, alongside general expansion of HIV testing services may be effective in increasing HIV testing uptake among young MA users

Prevalence of alcohol consumption and its risk factors among university students: A cross-sectional study across six universities in Myanmar.

BACKGROUND:Globally, alcohol consumption is a significant public health concern and it is one of the most important risk behaviours among university students. Alcohol consumption can lead to poor academic performance, injuries, fights, use of other substances, and risky sexual behaviours among students. However, the study explored the prevalence of alcohol consumption and the associated risk factors among university students since these have not been fully examined in previous research. Therefore, the aim of this study was to explore the prevalence of alcohol consumption and the associated risk factors among university students in Myanmar. METHODS:The present cross-sectional study was conducted using a sample of 15-24-year-old university students who were selected from six universities in Mandalay, Myanmar, in August 2018. In total, 3,456 students (males: 1,301 and females: 2,155) were recruited and asked to respond to a self-administered questionnaire. Multiple logistic regression analysis was used to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for alcohol consumption among university students. RESULTS:The prevalence of alcohol consumption in the previous 30 days was 20.3% (males: 36.0%, females: 10.8%). The alcohol consumption was significantly higher among males (AOR = 2.3, 95% CI; 1.9-2.9), truant students (AOR = 2.1, 95% CI; 1.3-3.3), smokers (AOR = 7.0, 95% CI; 5.1-9.7), students who reported feeling of hopelessness or sadness (AOR = 1.4, 95% CI; 1.2-1.8), peers' alcohol consumption (AOR = 7.5, 95% CI; 4.8-11.7). CONCLUSION:The present study revealed that males, smokers, peer alcohol consumption, and truant students had higher odds of alcohol consumption among the students. Therefore, effective campus-based counselling, peer education, and national surveillance systems that can monitor risky drinking behaviours among university students should be implemented. Further, government regulations that control the production, sale, promotion, advertising, and restriction of alcohol should be well developed and strengthened, as in the case of other Southeast Asian countries

Assessment of quality of life among elderly in urban and peri-urban areas, Yangon Region, Myanmar.

BackgroundIn the context of an aging population, quality of life (QOL) is an important consideration for the well-being of the elderly. However, there is limited information on the QOL of the elderly in Myanmar. This study aimed to explore the risk factors for low QOL among the elderly in urban and peri-urban areas of the Yangon Region, Myanmar.MethodsA community-based, cross-sectional study was conducted among the elderly aged 60 years or older in two urban and two peri-urban townships in the Yangon Region from July to September 2019. A multi-stage sampling method was used to recruit study participants using a pre-tested questionnaire. A total of 616 (305 males and 311 females) elderly people were interviewed using a face-to-face interview technique. Multiple linear regression analysis was performed on the four domains (physical health, psychological health, social relationship, and environment) of QOL measured with the WHOQOL-BREF.ResultsIncome level and having intimate friends influenced the QOL scores of the elderly in all domains, while education level and marital status influenced psychological health, social relationship, and environment domains. Social interaction with neighbors increased the QOL scores for physical health, social relationship, and environment domains. Living in peri-urban areas was associated with lower QOL scores for physical health, psychological health, and environment, while participation in group activities increased QOL scores in these domains. Having comorbidities affected the QOL for psychological health and environment domains, while the frequency of going out affected physical health, and the frequency of religious performance affected social relationship.ConclusionResidential location, education level, marital status, income, comorbidities, social interactions with neighbors and friends, participation in group activities, and frequencies of going out and religious activities should be considered in planning and implementing programs for the elderly in Myanmar. Peri-urban development, strengthening healthcare and social security systems, and encouraging social interaction and participation in group activities play critical roles in improving the QOL for elderly residing in Myanmar

Survival rate and mortality risk factors among TB–HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study

Background: Myanmar is listed as one of the countries with the highest burden of tuberculosis and HIV infections (TB–HIV) in the world. However, the survival rate and risk factors for mortality among TB–HIV co-infected patients in the country remain unstudied. Therefore, the purpose of this study was to examine these factors. Methods: A 12-year retrospective follow-up study was conducted among 3598 TB–HIV co-infected patients (2452 male and 1146 female) aged 15 years and above, enrolled on antiretroviral therapy (ART) from July 1, 2005 to December 31, 2016. Hazard ratios (HR) were estimated using the Cox proportional hazards model. Survival rates at the beginning of ART were calculated using the Kaplan–Meier method. Results: A total of 494 (13.7%) patients died during this period. The survival rate of TB–HIV co-infected patients was 82.0% at 5 years and 58.1% at 10 years. The risk factors for mortality were being bedridden (adjusted hazard ratio (aHR) 2.70, 95% confidence interval (CI) 2.13–3.42), having a low baseline CD4 count (aHR 1.53, 95% CI 1.25–1.87), and being on a second-line ART regimen (aHR 8.12, 95% CI 3.56–18.54). Conclusions: Two out of five TB–HIV patients died within 10 years after ART initiation. Current HIV prevention and treatment programs should focus more on bedridden patients, those on second-line ART, and those with low baseline CD4 counts. Keywords: Survival, TB–HIV, Antiretroviral therapy, Mortality, Myanma