Betel quid chewing and its prevalence and determinants: data from Myanmar Demographic Health and Survey of 2015-2016.

BACKGROUND: Although betel quid chewing with tobacco use is one of the major behavioral risk factors for chronic diseases, the prevalence is rather on the increase in Myanmar. This study determined prevalence of betel quid chewing at the national and subnational levels and its associations with tobacco and sociodemographic factors. METHODS: This study is a secondary data analysis of Myanmar demographic health survey 2015-2016 with a total of 11 773 women and 4251 men aged 18-49 years. Chi-square tests and multivariable logistic regression tests were performed. RESULTS: Prevalence of betel quid chewing was 61.8% in men and 19.5% in women and by regions it ranged from 34 to 82.2% and from 5-8 to 52.9%, respectively. The prevalence of the concurrent use with tobacco was 25.8 and 2.3%, respectively. Women with older age, low education and low wealth and occupation and living with spouse were associated with betel quid chewing, while low education, living with spouse and Myanmar speaker were associated with men. Tobacco use was inversely and positively associated with betel quid chewing in men and women, respectively (P-interaction <0.0001). CONCLUSION: Implementation of culturally sensitive intervention and policies including effective community awareness campaigns for anti-betel quid chewing is strongly recommended in Myanmar.

Substance abuse in early adolescents and HIV preventive behaviors: findings from a school-based cross-sectional survey for the period from 2009 to 2013, Bangkok Thailand.

This study is first of its kind in Bangkok, and is a five-year (2009-2013) cross-sectional web-based survey to examine HIV preventive behaviors related to substance abuse among adolescents (N = 16,913). The questionnaire was self-administered. Logistic regression was used to analyze the data. The relationship between different types of substance abuse with risky and preventive behaviors was assessed. Male participants reported more substance abuse as compared to females. The risk behaviors observed among the substance abusers include increased sexual experience, multiple sex partners, no use of condoms, and injection drug use. The preventive behaviors include having a high self-risk assessment, going for HIV testing (highest in methamphetamine users), and screening for sexually transmitted infection. Logistic regression suggests that risky behaviors (e.g., sexual experience, injection drug use) are more common in substance abusers. Adolescents are clearly at a high risk. Behavioral preventive measures are needed to reduce or delay premature substance exposure to prevent a wide range of health problems and risks such as HIV and AIDS, injection drug use and unprotected sex.

The role of AIDS volunteers in developing community-based care for people with AIDS in Thailand.

The present study analyses the effectiveness of AIDS volunteers in mitigating the stigma attached to People With AIDS (PWAs) within the context of developing community-based care (CBC) in Thailand. A total of 86 trained village health volunteers (T-VHVs) and 99 non-trained village health volunteers (N-VHVs) were enrolled in the study. In addition, 58 villagers in the T-VHV's intervention area and 72 villagers in the non-intervention area were also enrolled. Both T-VHVs and N-VHVs as well as villagers were assessed to determine their level of knowledge with respect to HIV/AIDS and attitudes toward PWAs. Furthermore, we also determined the village health volunteers' level of activity in distributing knowledge of HIV/AIDS in order to prevent and reduce stigma in the community. Although T-VHVs showed a greater depth of knowledge of HIV/AIDS than N-VHVs (p < 0.05), positive attitudes toward PWAs and the level of practice of village health volunteers did not differ significantly between T-VHVs and N-VHVs. While the level of health knowledge of villagers did not differ significantly between the T-VHV's intervention and control areas, a significant difference was observed between the two areas in terms of the villagers' attitudes towards PWAs (p < 0.01). Villagers in the intervention area attached less stigma to PWAs; therefore, T-VHVs played a role in providing basic information on AIDS to the villagers and in mitigating the stigma attached to PWAs. However, these volunteers need to undergo further training through a well-organized training programme in order to obtain a greater depth of knowledge. This is essential for the development of community-based care for PWAs.