Exploring Factors for Future HIV Prevention in Malaysia

描述（由申请人提供）：拟议的探索性/发展性研究将调查同性恋恐惧症/跨性别恐惧症和其他社会文化因素，这些因素会影响马来西亚被污名化的高风险群体中的艾滋病毒相关风险行为：与男性发生性关系的男性（MSM）和男性对女性的跨性别女性（mak nyah）。在马来西亚，国教是伊斯兰教;同性恋、变性和酗酒在穆斯林中受到惩罚;非法使用毒品可能受到法律的严厉惩罚。通过马来西亚和美国的研究人员以及艾滋病服务组织（ASO）的服务提供者之间的合作努力，我们将进行一项探索性研究，为未来的干预研究做准备，以减少马来西亚MSM和mak nyah中的药物滥用和艾滋病毒风险行为。我们的研究团队由经验丰富的研究人员组成，在马来西亚，其他亚洲国家和美国对MSM和变性人群进行艾滋病毒预防研究方面拥有丰富的经验。这项研究将为理解同性恋恐惧症，变性恐惧症以及其他与药物使用和艾滋病毒风险行为有关的重要和有意义的社会文化因素提供坚实的基础，并将提供一个更好的了解生活的男男性接触者和mak nyah在马来西亚。根据研究结果，我们的研究小组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ASO合作建议马来西亚的政策变化。本研究的具体目的是：1）探讨和描述马来西亚MSM和mak nyah人群的物质使用和HIV相关性风险行为与背景变量的关系; 2）探讨和描述影响MSM和mak nyah人群物质使用和HIV相关性风险行为与背景变量的关系的同性恋恐惧症和跨性别恐惧症以及其他社会文化因素; 3）探索和确定未来针对MSM和mak nyah的药物滥用和艾滋病预防干预研究的理论模型;四、培养和维持马来西亚和美国研究人员和马来西亚ASO服务提供者之间的合作努力和能力建设，并为未来奠定基础。药物滥用和艾滋病预防干预研究和方案; 5）根据主要知情人访谈，描述马来西亚有关药物滥用和艾滋病预防的政策和法规，总结研究结果，并建议未来的政策变化。采用立意抽样的方法，选取男男性接触者24名，女男性接触者24名进行质性访谈。在完成定性分析后，我们将招募200名男男性接触者和200名女男性接触者进行调查访问，基于受访者驱动抽样（RDS）方法。基于混合方法，我们将测试假设和概念模型。为了告知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名主要知情人进行定性访谈。我们将与艾滋病服务组织合作，继续努力预防艾滋病毒，促进健康，改善男男性接触者和妇女的人权。

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.