The Role of Education and Demographic Factors in Condom Use among Male Drug Users in Malaysia
Main Article Content
Abstract
Introduction: The rising prevalence of human immunodeficiency virus (HIV) among people who inject drugs is a major public health issue. This study intends to explore education and demographic correlates of use of condoms among male drug users in Malaysia. Methods: Data were extracted from the Integrated Biological and Behavioral Surveillance Survey 2017. Pearson’s chi-square tests and a logistic regression were used to examine the associations between condom use and education, and demographic factors. Results: Only a small proportion of drug users used condoms (25.7%). Educational backgrounds, age, ethnicity and marital status were associated with condom use. The likelihood of using condoms was lower among less educated drug users (aOR: 0.308–0.339). There was an in- teraction effect of education and age on condom use (aOR: 0.116–0.308). Chinese (aOR: 3.117) and those of other ethnicities (aOR: 2.934) were more likely to use condoms when compared with Malays. Being married (aOR: 0.291) or divorced/widowed (aOR: 0.346) was associated with reduced odds of using condoms. Conclusion: Education and demographic factors play an important role in influencing the decisions of Malaysian drug users to use condoms. Therefore, HIV-preventive measures targeting drug users could benefit by paying special attention to these factors.
Downloads
Article Details
References
World Health Organization. HIV/AIDS [Internet]. [cited 2021 November 29]. Available from: https:// www.who.int/news-room/fact-sheets/detail/hiv- aids
Ministry of Health Malaysia. Country progress report on HIV/AIDS 2019: Malaysia. Putrajaya: Ministry of Health Malaysia; 2019.
Pinkerton SD, Abramson PR. Effectiveness of condoms in preventing HIV transmission. Soc Sci Med. 1997;44(9):1303-1312. doi: 10.1016/S0277- 9536(96)00258-4
Chawarski MC, Mazlan M, Schottenfeld RS. Heroin dependence and HIV infection in Malaysia. Drug Alcohol Depend. 2006;82(S1):S39-S42. doi: 10.1016/S0376-8716(06)80007-4
Kapadia F, Latka MH, Hudson SM, Golub ET, Campbell JV, Bailey S, et al. Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities. Drug Alcohol Depend. 2007;91S:S56-S63. doi: 10.1016/j. drugalcdep.2007.01.004
Hiebert L, Azzeri A, Dahlui M, Hecht R, Mohamed R, Shabaruddin FH, et al. Estimating the population size of people who inject drugs in Malaysia for 2014 and 2017 using the benchmark-multiplier method. Subst Use Misuse. 2020;55(6):871-877. doi: 10.1080/10826084.2019.1708943
Sherman SG, Latkin CA. Intimate relationship characteristics associated with condom use among drug users and their sex partners: a multilevel analysis. Drug Alcohol Depend. 2001;64:97-104. doi: 10.1016/s0376-8716(00)00236-2
Rosengard C, Anderson BJ, Stein MD. Correlates of condom use and reasons for condom non-use among drug users. Am J Drug Alcohol Abuse. 2006;32:637- 644. doi: 10.1080/00952990600919047
Kumar MS, Virk HK, Chaudhuri A, Mittal A, Lewis
G. A rapid situation and response assessment of the female regular sex partners of male drug users in South Asia: factors associated with condom use during the last sexual intercourse. Int J Drug Policy. 2008;19:148-158. doi: 10.1016/j. drugpo.2007.12.003
Cawley J, Ruhm CJ. The economics of risky behaviors. In Pauly MV, Mcguire TG, and Barros PP, editor. Handbook of Health Economics (Vol. 2). New York: Elsevier, 2012;95-199. doi: 10.1016/ B978-0-444-53592-4.00003-7
Van Der Pol M. Health, education and time preference. Health Econ. 2011;20(8):917-929. doi: 10.1002/hec.1655
Lau JTF, Tsui HY, Siah PC, Zhang KL. A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history. AIDS Care. 2002;14(2):219-233. doi: 10.1080/09540120220104721
Lau JTF, Zhang J, Zhang L, Wang N, Cheng F, Zhang Y, et al. Comparing prevalence of condom use among 15379 female sex workers injecting or not injecting drugs in China. Sex Transm Dis. 2007;34(11):908-916. doi: 10.1097/ OLQ.0b013e3180e904b4
Allen CF, Simon Y, Edwards J, Simeon DT. Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean. AIDS Care. 2010;22(11):1386-1394. doi: 10.1080/09540121003720978
Costa Andrade SS, Zaccara AAL, Leite KNS, Brito KKG, Soares MJGO, Costa MML, et al. Knowledge, attitude and practice of condom use by women of an impoverished urban area. Rev Esc Enferm. 2015;49(3):364-371. doi: 10.1590/S0080- 623420150000300002
Zhao Q, Mao Y, Sun M, Li X. Sexual risk behaviours and correlates of condom use with casual sex partners among drug users in Jiangsu, China. Drug Alcohol Depend. 2019;26(5):422-428. doi: 10.1080/09687637.2018.1463356
Anderson JE, Wilson R, Doll L, Jones S, Barker P. Condom use and HIV risk behaviors among U.S. adults: data from a national survey. Fam Plann Perspect. 1999;31(1):24-28.
Semple SJ, Patterson TL, Grant I. Determinants of condom use stage of change among heterosexually- identified methamphetamine users. AIDS Behav. 2004;8(4):391-400. doi: 10.1007/s10461-004- 7323-4
Lagarde E, Carael M, Glynn JR, Kanhonou L, Abega SC, Kahindo M, et al. Educational level is associated with condom use within non-spousal partnership in four cities of sub-Saharan Africa. AIDS. 2001;15:1399-1408. doi: 10.1097/00002030- 200107270-00009
Burt RD, Thiede H, Barash ET, Sabin K. Recent condom use by arrested injection drug users in King County, Washington, USA. Int J Drug Policy. 2006;17:222-229. doi: 10.1016/j. drugpo.2006.03.007
Ministry of Health Malaysia. Integrated Biological and Behavioral Surveillance Survey 2017. Putrajaya: Ministry of Health Malaysia; 2019.
Lin G, Wang Q. Predictors of non-use of condoms among drug users in China: implications for HIV harm reduction. Drug Edu Prev Policy. 2003;10(2):141- 146. doi: 10.1080/0968763031000071342
Chen JJ. Communicating complex information: the interpretation of statistical interaction in multiple logistic regression analysis. Am J Public Health. 2003;93(9):1376-1377. doi: 10.2105/ ajph.93.9.1376-a.
Hosmer DW, Hosmer T, Le Cessie S, Lemeshow SA. Comparison of goodness-of-fit tests for the logistic regression model. Stat Med. 1997;16(9):965-980. doi: 10.1002/ (sici)1097-0258(19970515)16:9<965::aid-
sim509>3.0.co;2-o
Pregibon D. Goodness of link tests for generalized linear models. J Roy Stat Soc. 1980;29:15-23. doi: 10.2307/2346405
StataCorp. Stata statistical software: Release 16.1. Texas: Stata Corporation; 2019.
Wooldridge JM. Introductory Econometrics: A Modern Approach, 6th edn. Boston: Cengage Learning; 2016.
Emerson AM, Carroll HF, Ramaswamy M. Education level as a predictor of condom use in jail-incarcerated women, with fundamental-cause analysis. Public Health Nurs. 2018;35(4):273-280. doi: 10.1111/phn.12514
Barmania S, Aljunid SM. Navigating HIV prevention policy and Islam in Malaysia: contention, compatibility or reconciliation? Findings from in- depth interviews among key stakeholders. BMC Public Health. 2016;16:524. doi: 10.1186/s12889- 016-3247-y
Perloff JM. Microeconomics, 8th ed. London: Pearson; 2018.