Framework of analysisA descriptive analysis was carried out on the data from the survey to assess the needs ofPLHIV communities as a whole, and to determine any specific needs of focal groups,namely, DU, SWs, infected women partners, MSM and heterosexual men.Ethical reviewThe study project proposal was submitted to the University Malaya Medical CentreEthical Review Board for review. Ethical approval was obtained prior to commencingthe study (Annex VI). Prior to starting each FGD, participants were:1. informed of the background and purpose of the research2. reminded that participation was voluntary3. assured that data from the discussions and questionnaires would be kept strictlyprivate and confidential for use only by the research team4. assured that participants’ identities would not be recorded (anonymous)5. explained that discussions would be audio-taped and that tapes would bedestroyed after transcribing6. explained that there were no right or no answers and that each had the right not torespond or discuss issues with which they were not comfortableWhen participants had affirmed that they understood, consent was obtained from themverbally at the outset of each FGD. For the needs assessment questionnaire, a cover letterwas attached explaining the background and purpose of the survey. No names orpersonal identifiers were obtained from participants.Problems and constraintsExcept for DU men, a major problem in the qualitative study was getting participantsespecially among sex workers, MSM and heterosexual men groups. Without exception,all the NGOs that were approached to recruit participants and facilitate the organising ofvenue and refreshments were extremely helpful, for which the project team would like torecord their sincere acknowledgement of thanks.Overall, IDU men proved to be the easiest to recruit and the most vocal duringdiscussions. The reasons for <strong>this</strong> can only be speculated. A possible factor is that theirinvolvement with the specific NGO (PENGASIH) has nurtured a sense of empowermentand coping with the infection, resulting in a willingness to talk and share. It may also berelated to their drug-using history and consequent acceptance of self-blame for beinginfected. Another factor may be that they are male, who may be more easily forgiven, orexcused, than women for undesirable social behaviours, such as drug use. In contrast,women partners were less vocal in the FGDs compared to men. In fact, for one group inKita Baru, the feelings of shock and dismay, arising from their being infected by theirown husbands whom they loved and trusted, were still palpable with most womenbreaking down emotionally regardless of how long ago they were diagnosed.28
In Kuching, there were logistic problems in recruitment as some patients who werecontacted to participate in <strong>this</strong> study lived long distances away from the FGD venue. Sexworkers in Sabah also needed a lot of persuasion to come forward as they were no longerdoing commercial sex work and wanted to leave that past behind.At the outset, a Family care-givers group was included for the FGDs. The criterion for<strong>this</strong> group was a main care-provider for a HIV-positive person (or child) who is not HIVpositive.The premise was that HIV-positive persons who are care-givers to other HIVpositivefamily members, notably children, would be captured in one of the other groups.This was intended to recruit family members, including grandparents or adoptive parents,or friends who have taken on the care of one or more HIV-positive person(s) whose usualcare-giver has, or care-givers have, died or abandoned them. It was particularly aimed atcare-givers of HIV-positive children. Since such participants may not be clients ofNGOs which provide services to PLHIV, the approach was through doctors of HIVpatients. However, despite trying for several weeks, there were no participants who fitthe criterion and who were willing to take part in a discussion.Another problem that arose for the FGDs was the selection criteria. Despite specifyingthe criteria to contact recruiters, a few participants who turned up did not meet all thecriteria, e.g., duration since diagnosis and age. It was desirable to have an age ceiling of50 years so as to minimise the confounding effects of age on the various dimensions ofimpact, notably, physical health. However, several who turned up for the FGDs wereslightly above <strong>this</strong> age-group. Possibly, <strong>this</strong> older group is the one who has more freetime or more flexible hours. The criterion of more than six months since diagnosis, asmentioned earlier, was to avoid those in the early stages of HIV diagnosis and itsassociated experiences and emotional state. In terms of eligibility, the research team alsomet with two participants who had speech impediments; one due to stroke and anotherdue to a problem with her tongue. Since the team relied upon contact persons to recruitparticipants, and in turn, since contact persons do not have full control over who finallyattends, these situations were difficult to control.There were frequent problems of literacy and, in particular, the ability of participants tocomplete the short needs assessment questionnaire. Although initially designed to beself-administered, many PLHIV could not fill out the questionnaire on their needswithout assistance from project team members.The survey on needs was intended to be disseminated to all the organisations whichprovide services to PLHIV communities. The Malaysian <strong>AIDS</strong> Council was contacted togain access to their partner organisations for which they were very helpful. However,while there was interest in carrying out the survey, manpower limitations prevented manyorganisations from participating. Although the survey was intended to be selfadministered,service providers found that they had to assist respondents. Hence, thesurvey did not capture as many respondents as planned, i.e., all clients at participatingservice providers for a one month period.Summary profile of study participantsBy end of September, a total of 19 FGDs were conducted with 93 participants fromPLHIV communities. The FGD participants also filled out a needs assessmentquestionnaire. In addition, four FGDs were conducted with men and women from an29
- Page 2 and 3: Table of ContentsPROJECT TEAM 5ACKN
- Page 4 and 5: Information received at the time of
- Page 6 and 7: AcknowledgementsThis research is fu
- Page 9: The main findings from the qualitat
- Page 14 and 15: school or work, transport costs for
- Page 16 and 17: is that the large majority of women
- Page 18 and 19: In fact, special surveys conducted
- Page 20 and 21: ObjectivesThe specific objectives o
- Page 22 and 23: have been rejected by their immedia
- Page 24 and 25: eport) that his/her healthcare (or
- Page 26 and 27: CommunityKnowledge/awareness of HIV
- Page 30 and 31: urban and a rural community. In all
- Page 32 and 33: medication, the physical health com
- Page 34 and 35: husbands working in other places wh
- Page 36 and 37: (“And then, this doctor, he/she v
- Page 38 and 39: their food. Nurses and their attend
- Page 40 and 41: “Because we take drugs….no time
- Page 42 and 43: The same claim to 100% condom use w
- Page 44 and 45: in asking them to use condoms, even
- Page 46 and 47: “Normally…..normally, memang ma
- Page 48 and 49: (“But I continued using at that t
- Page 50 and 51: “Buat pada permulaannya, saya mem
- Page 52 and 53: However, not all experiences with d
- Page 54 and 55: yang amat sangat. Tak pernah I rasa
- Page 56 and 57: long term fears and anxieties. The
- Page 58 and 59: “The first time I heard from the
- Page 60 and 61: handset, I too, have handset. Some
- Page 62 and 63: have been turning to God since and
- Page 64 and 65: felt I’m indecent. But, at one ti
- Page 66 and 67: would certainly want to continue wo
- Page 68 and 69: (Transgender, 53 yrs, Upper seconda
- Page 70 and 71: “Sometimes I didn’t get enough
- Page 72 and 73: positively portray people living wi
- Page 74 and 75: “After my diagnosis...I’ll pay
- Page 76 and 77: not know or might not want to be bo
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(UNAIDS 2005).(UNAIDS 2000):The fac
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“…bawak saya pergi hospital. An
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erpindah ke tempat lain makin lama.
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pada HIV itu, dia nampak penagih. S
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(Male, 49yrs, University education,
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However this association with the n
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“…..depends on who is the perso
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(“I …my experience society will
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(“Can…can marry, no problem. Bu
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Harm Reduction programmeSome urban
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(“In my opinion such campaign sta
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Table 2aDistribution of Respondents
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female sex workers (seven out of 13
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NO. OF LIVING PARENTSNobody 7 1 1 2
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tested in drug rehabilitation cente
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GroupsDUHetero-SexuallyInfectedMenT
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y the Ministry of Health (74.2%) or
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Child CareYes, often 0 0 0 1 0 1 0
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GroupsDUHetero-SexuallyInfectedMenT
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Figure 5: Percentage of Respondents
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GroupsTable 12aEmotional Problems E
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Stigmatization and how it has affec
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GroupsTable 15How They Cope With Th
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Table 18Percentage Of Respondents W
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esponsible for their families. As m
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In this study, it took more effort
- Page 131 and 132:
eing transgender and sex worker whe
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denies them social and economic opp
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working towards their future, who c
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ReferencesAidsmeds.com (2006). Curr
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Sen G, George A, Ostlin P (2002). E
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Annex II: FGD Guide for PLHIV Group
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♦ Spouse: marital/sexual relation
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I. Attitudes and Perceptions relate
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I. HIV/AIDS Knowledge‣ What did y
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Annex V: Rapid Needs Assessment Que
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Types of support or responsibilityM
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Please tick (√)one onlyIf yes,ple
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more help would be useful for you i
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Annex VI: Ethics Approval Letter157