Exploring Factors for Future HIV Prevention in Malaysia

描述(由申请人提供)：拟议的探索性/发展性研究将调查在马来西亚被污名化的高危群体中影响艾滋病毒相关危险行为的同性恋恐惧症/跨性别恐惧症和其他社会文化因素：男男性行为者(MSM)和男女变性人女性(Mak Nyah)。在马来西亚，国家宗教是伊斯兰教；同性恋、变性人和饮酒在穆斯林中受到惩罚；非法吸毒可能会受到法律的严厉惩罚。通过马来西亚和美国的研究人员与艾滋病服务组织(ASOS)服务提供者的共同努力，我们将进行一项探索性研究，以准备未来的干预研究，以减少马来西亚MSM和Mak nyah中的药物滥用和HIV危险行为。我们的研究团队由经验丰富的研究人员组成，在为马来西亚、其他亚洲国家和美国的MSM和变性人进行艾滋病毒预防研究方面拥有丰富的经验。这项研究将为了解同性恋恐惧症、跨性别恐惧症和其他与药物使用和艾滋病毒危险行为有关的重要和有意义的社会文化因素奠定坚实的基础，并将使我们更好地了解马来西亚MSM和Mak nyah的生活。根据研究结果，我们的研究团队将能够在未来开发药物滥用和艾滋病毒预防干预研究，并与ASOS合作建议马来西亚的政策变化。本研究的具体目的是：1)从背景变量的角度探讨和描述马来西亚男男性同性恋者和蒙古族人群的物质使用和HIV相关的性行为；2)从背景变量的角度探讨和描述影响MSM和蒙古族人群的物质使用和HIV危险行为的同性恋恐惧症和跨性别恐惧症等社会文化因素；3)探索和确定针对MSM和蒙古族的未来物质滥用和HIV预防干预研究的理论模型；4)培养和维持马来西亚和美国在马来西亚ASOS的研究人员和服务提供商之间的合作努力和能力建设，并为未来的药物滥用和艾滋病毒预防干预研究和计划奠定基础；5)根据关键线人访谈，描述马来西亚关于药物滥用和艾滋病毒预防的政策和法规，总结研究结果，并建议未来的政策变化。在有目的抽样的基础上，将招募24名男男性接触者和24名男男性接触者进行定性访谈。在定性分析完成后，我们将招募200名男男性行为者和200名男男性行为者，以受访者驱动抽样(RDS)的方法进行调查访谈。基于混合方法，我们将检验假设和概念模型。为了了解马来西亚未来在药物滥用和艾滋病毒预防方面的政策变化，我们还将对20名关键线人进行定性访谈。我们将与ASOS合作，继续努力预防艾滋病毒，促进健康，改善男男性接触者和男性接触者的人权状况。

DESCRIPTION (provided by applicant): The proposed exploratory/developmental study will investigate homophobia/transphobia and other sociocultural factors that influence HIV-related risk behaviors among stigmatized high-risk groups in Malaysia: men who have sex with men (MSM) and male-to-female transgender women (mak nyah). In Malaysia, where the national religion is Islam; homosexuality, transgenderism, and alcohol use are punished among Muslims; and illicit drug use risks severe punishment by law. Through the collaborative efforts among researchers in Malaysia and the U.S. and service providers at the AIDS service organizations (ASOs), we will conduct an exploratory study to prepare future intervention studies to reduce substance abuse and HIV risk behaviors among MSM and mak nyah in Malaysia. Our study team which consists of experienced researchers has ample experience in conducting HIV prevention research for MSM and transgender populations in Malaysia, other Asian countries, and the U.S. The study will provide a solid foundation for understanding homophobia, transphobia, and other significant and meaningful sociocultural factors in relation to substance use and HIV risk behaviors, and will provide a better understanding of the lives of MSM and mak nyah in Malaysia. Based on study findings, our study team will be able to develop substance abuse and HIV prevention intervention studies in the future and recommend policy changes in Malaysia in collaboration with ASOs. The specific aims of the study are: 1) To explore and describe substance use and HIV-related sexual risk behaviors among MSM and mak nyah in Malaysia in relation to background variables; 2) To explore and describe homophobia and transphobia and other sociocultural factors which influence substance use and HIV risk behaviors among MSM and mak nyah in relation to background variables; 3) To explore and determine the theoretical models for future substance abuse and HIV prevention intervention studies specific to MSM and mak nyah; 4) To nurture and sustain the collaborative efforts and build capacity among Malaysian and the U.S. researchers and service providers at ASOs in Malaysia and to lay the groundwork for future substance abuse and HIV prevention intervention studies and programs; 5) To describe the policies and regulations regarding substance abuse and HIV prevention in Malaysia based on key informant interviews, summarize study findings, and recommend future policy changes. Based on purposive sampling, 24 MSM and 24 mak nyah will be recruited for the qualitative interviews. After completion of qualitative analysis, we will recruit 200 MSM and 200 mak nyah for survey interviews based on respondent driven sampling (RDS) methods. Based on mixed methods, we will test the hypotheses and conceptual models. In order to inform future policy changes in substance abuse and HIV prevention in Malaysia, we will also conduct qualitative interviews with 20 key informants. We will sustain our efforts in HIV prevention, health promotion, and human rights improvement for MSM and mak nyah in collaboration with ASOs.