Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Gregg Gonsalves

Abstract

Background: Men who have sex with men (MSM) now account for nearly half of all new HIV cases in Malaysia. There has been little research, however, characterizing the HIV care continuum among MSM living with HIV in Malaysia. This study describes the HIV care continuum and examines factors associated with HIV viral non-suppression among newly diagnosed MSM living with HIV in Kuala Lumpur, Malaysia.

Methods: We enrolled 163 MSM living with HIV who were in care at a major university hospital in Kuala Lumpur, Malaysia. Participants completed a self-administered questionnaire. Electronic medical chart review also provided data on engagement in the care continuum, including CD4 counts and HIV viral loads. Bivariate and multivariable logistic regression was used to identify correlates of HIV viral non-suppression.

Results: 94.4% of this sample is currently on ART while 79.7% self-reported 100% adherence to medication. Nearly 80% of this population were optimally virally suppressed at <20 copies/mL. In the multivariable model, not having a full-time job (aOR = 6.25; 95% CI = 1.53 – 25.49; p = 0.011) and being single (aOR = 9.15; CI = 1.07 – 78.21; p = 0.043) were associated with viral non-suppression (viral load of 200 copies/mL or more). 9.8% of all participants reported active (last 30 days) chemsex participation while nearly 40% indicated severe depression symptoms.

Conclusions: This is the first study to describe the HIV care continuum on MSM from Malaysia. Though many MSM in this sample were able to achieve viral suppression, others continue to face socioeconomic barriers to treatment and retention in care. Future studies should recruit from a wider range of venues and include those disengaged from care.

Comments

This is an Open Access Thesis.

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