HIV Testing and awareness of HIV status among people who inject drugs in greater Kuala Lumpur, Malaysia

HIV testing services are the gateway into HIV treatment and are critical for monitoring the epidemic. HIV testing is recommended at least annually in high-risk populations, including people who inject drugs (PWID). In Malaysia, the HIV epidemic is concentrated among PWID, but their adherence to test...

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Bibliographic Details
Published in:AIDS care 2018-01, Vol.30 (1), p.59-64
Main Authors: Bazazi, Alexander R., Vijay, Aishwarya, Crawford, Forrest W., Heimer, Robert, Kamarulzaman, Adeeba, Altice, Frederick L.
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Awareness
Correctional institutions
Crime
Criminal justice
Detention centers
Drug Users - psychology
Drugs
Epidemics
Female
Health Knowledge, Attitudes, Practice
High risk
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Infections - psychology
HIV testing
HIV treatment cascade
Human immunodeficiency virus
Human rights
Humans
Involuntary
Judicial system
Malaysia
Malaysia - epidemiology
Male
Mandatory testing
Mass Screening
Medical tests
Middle Aged
people who inject drugs
Prisons
Risk Factors
Sampling
Serologic Tests
Substance Abuse, Intravenous - diagnosis
Substance Abuse, Intravenous - epidemiology
Substance Abuse, Intravenous - psychology
Tests
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Summary:HIV testing services are the gateway into HIV treatment and are critical for monitoring the epidemic. HIV testing is recommended at least annually in high-risk populations, including people who inject drugs (PWID). In Malaysia, the HIV epidemic is concentrated among PWID, but their adherence to testing recommendations and the proportion of HIV-positive PWID who are aware of their status remain unknown. We recruited 460 PWID in Greater Kuala Lumpur using respondent-driven sampling and conducted HIV testing. We examined past testing behaviors, estimating testing frequency, correlates of testing in the past 12 months, and the proportion of those living with HIV who were aware of their status. Results showed that most PWID living with HIV (90.4%, 95% CI: 83.6%-95.9%) were aware of their status. Among those never previously diagnosed with HIV, few had accessed HIV testing in the past 12 months (14.3%, 95% CI: 11.1%-18.0%). Prison (57.0%) and compulsory drug detention centers (36.1%) were the primary locations where PWID reported ever being HIV tested, and the main correlate of recent testing in regression was recent criminal justice involvement. Although awareness of HIV status may be high among PWID living with HIV in Kuala Lumpur, testing occurs primarily in prisons and compulsory drug detention centers, where it is involuntary and linkage to care is limited. A shift in HIV testing policy is needed to align health and human rights objectives, replacing mandatory testing with voluntary testing in settings where individuals can be rapidly linked to HIV care.
ISSN:0954-0121
1360-0451
DOI:10.1080/09540121.2017.1363852