International Public Health Commons^™

Access To Community-Based Hiv Services Among Transgender Women In Cambodia: Findings From A National Survey., Siyan Yi, Say Sok, Srean Chhim, Pheak Chhoun, Navy Chann, Sovannary Tuot, Phalkun Mun, Marija Pantelic

BACKGROUND: Globally, the prevalence of HIV among transgender women is more than 40 times higher than the prevalence in the general reproductive-age adults. They also face intersecting barriers to health, social, and legal services due to their hidden and stigmatized nature. Despite the particular needs, data regarding the access to services among transgender populations is scant globally. This study aims to identify characteristics of transgender women in Cambodia that may determine their accessibility to community-based HIV services.

METHODS: In the National Biological and Behavioral Survey 2016, a structured questionnaire was used for face-to-face interviews with 1375 sexually active transgender women …

Factors Associated With Condom Use With Non-Commercial Partners Among Sexually-Active Transgender Women In Cambodia: Findings From A National Survey Using Respondent-Driven Sampling., Siyan Yi, Amelia Plant, Sovannary Tuot, Phalkun Mun, Srean Chhim, Navy Chann, Pheak Chhoun, Carinne M. Brody

BACKGROUND: Globally, the prevalence of HIV among transgender women is much higher than that of the general adult population. This can be explained by the persistently low rate of consistent condom use among this population. This study was therefore conducted to explore factors associated with consistent condom use among sexually-active transgender women in Cambodia, specifically with their non-commercial partners.

METHODS: Data used for this study were collected as part of the National Integrated Biological and Behavioral Survey 2016. Participants were recruited from the capital city of Phnom Penh and 12 other provinces with high burden of HIV using the Respondent-Driven …

Factors Associated With Viral Non-Suppression Among Adolescents Living With Hiv In Cambodia: A Cross-Sectional Study, Kolab Chhim, Gitau Mburu, Sovannary Tuot, Ratana Sopha, Vohith Khol, Pheak Chhoun, Siyan Yi

Background

Adolescents living with HIV on antiretroviral therapy (ART) have worse treatment adherence, viral suppression, and mortality rates compared to adults. This study investigated factors associated with viral non-suppression among adolescents living with HIV in Cambodia.

Methods

A cross-sectional study was conducted in August 2016 among 328 adolescents living with HIV aged 15–17 years who were randomly selected from 11 ART clinics in the capital city of Phnom Penh and 10 other provinces. Clinical and immunological data, including CD4 count and viral load, were obtained from medical records at ART clinics. Adolescents were categorized as having achieved viral suppression if …

Hiv Prevalence, Risky Behaviors, And Discrimination Experiences Among Transgender Women In Cambodia: Descriptive Findings From A National Integrated Biological And Behavioral Survey, Siyan Yi, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Srean Chhim, Khuondyla Pal, Gitau Mburu

Background: Transgender people are disproportionately affected by HIV. Despite their high vulnerability to HIV, lack of adequate epidemiological and surveillance data related to this population in many countries prevents provision of appropriate services. This paper summarizes descriptive findings from a national integrated biological and behavioral survey and discusses policy implications of the findings on HIV prevention among transgender women in Cambodia.

Methods: This cross-sectional study was conducted between December 2015 and February 2016. Participants were recruited from 20 sites in the capital city and 12 provinces of Cambodia using Respondent Driven Sampling (RDS) method. Behavioral data were collected …

Awareness And Willingness To Use Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Siyan Yi, Sovannary Tuot, Grace W. Mwai, Chanrith Ngin, Kolab Chhim, Khuondyla Pal, Gitau Mburu

Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC.

Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …

Non-Communicable Diseases And Related Risk Behaviors Among Men And Women Living With Hiv In Cambodia: Findings From A Cross-Sectional Study, Pheak Chhoun, Chanrith Ngin, Martin Steel, Jennifer Dionisio, Hattie Pearson, Carinne M. Brody, Siyan Yi

Background: There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia.

Methods: This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, …

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

High Prevalence Of Non-Communicable Diseases And Associated Risk Factors Amongst Adults Living With Hiv In Cambodia, Pheak Chhoun, Sovannary Tuot, Anthony D. Harries, Nang Thu Thu Kyaw, Khuondyla Pal, Carinne M. Brody, Siyan Yi

BACKGROUND:

With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambodia.

METHODS:

This cross-sectional study was conducted in five provinces of Cambodia from May-June 2015. Information was obtained on socio-demographic and clinical characteristics through face-to-face interviews using …

Determinants Of Inconsistent Condom Use Among Hiv Serodiscordant Couples In Cambodia, Sovannary Tuot, Khuondyla Pal, Kouland Thin, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Siyan Yi

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and …

Acceptability Study On Hiv Self-Testing Among Transgender Women, Men Who Have Sex With Men, And Female Entertainment Workers In Cambodia: A Qualitative Analysis, Khuondyla Pal, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Cheaty Ly, Srean Chhim, Siyan Yi

Background: In Cambodia, HIV prevalence is high while HIV testing rates remain low among transgender women (TG women), men who have sex with men (MSM), and female entertainment workers (FEW). Introducing self-testing for HIV to these key populations (KPs) could potentially overcome the under-diagnosis of HIV and significantly increase testing rates and receipt of the results, and thus could decrease transmission. Therefore, this study aimed to determine the acceptability of HIV self-testing (HIVST) among these three categories of KPs.

Methods: This study was conducted through focus group discussions (FGDs) with TG women, MSM, and FEW in Phnom Penh …

Health And Socio-Economic Impacts Of Livelihoods Programs Among People Living With Hiv In Cambodia: A Case-Control Study, Sovannary Tuot, Kouland Thin, Mayumi Shimizu, Samedy Suong, Samithrea Sron, Pheak Chhoun, Siyan Yi

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in …

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

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), Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Sok Chamreun Choub, Carinne M. Brody

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 …

Men Who Have Sex With Men In Cambodia: Population Size, Hiv Risky Behaviors, And Hiv Prevalence, Siyan Yi, Srean Chhim, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Chanrith Ngin

Background: Men who have sex with men (MSM) constitute a significant proportion of HIV key populations in Cambodia. We conducted this study to estimate the national population size, assess HIV-related risk behaviors, and determine HIV prevalence among MSM in Cambodia. Methods: This research was conducted in 2014 in 12 study sites in Cambodia. MSM size estimation was performed using capture-recapture method with data collected in two time points within an 18-day interval. To assess HIV risk behaviors, a total of 838 MSM were randomly selected for face-to-face interviews during the capture round. A separate survey using a time …

Improving Education Opportunity, Health, And Quality Of Life Of Orphans And Vulnerable Children: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Sovannary Tuot

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia.

Study Design: Operational intervention study.

Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014.

Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data …

Aids-Related Stigma And Mental Disorders Among People Living With Hiv: A Cross-Sectional Study In Cambodia, Siyan Yi, Pheak Chhoun, Samedy Suong, Carinne M. Brody, Sovannary Tuot

Background: AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.

Methods: A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.

Results: The reported experiences of discrimination in communities …

The Sustainable Action Against Hiv And Aids In Communities (Sahacom): Impacts On Health And Quality Of Life Of People Living With Hiv In Cambodia, Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Samedy Suong, Kouland Thin, Sovannary Tuot

This study evaluated the impacts of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) Project on health and quality of life of people living with HIV (PLHIV). Outcome indicators from baseline documentation (2010) were compared to those obtained at midterm (2012) and end line (2014). Results showed that HIV prevalence among pregnant women aged 15–24 attending antenatal care decreased from 0.5% at baseline to 0.3% at midterm and end line. Proportion of PLHIV who were on antiretroviral therapy (ART) 12 months after the initiation of the treatment increased from 85% at baseline and midterm to 89.5% at end …