Publication: Development and effectiveness of mydrcare4u online HIV health education module in increasing HIV knowledge, reducing HIV stigma and increasing accessibility to healthcare services for transgender
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Date
2022-05
Authors
Baharuddin, Mohd Hazwan
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Abstract
Background: Transgender populations hugely affected by HIV infection due to unsafe sexual behaviour. The contrary of gender value to socio-cultural expectation among transgender in Malay-Muslim community strongly hindrances to access the facility-based healthcare services. Lacking of supportive environment on conventional HIV health education significantly reduce their motivation to actively involved in current engagement strategy. This complex health disparities lead to inadequate level of HIV knowledge which was the uttermost important element in decreasing risk of the infection. Acknowledging these issues, a structured online HIV health education module named MyDrCare4u has been developed by integrating the advancement of digital communication with the theory-based health education which tailored with the cultural needs of transgender. Objective: The current study was aimed to develop MyDrCare4u Online HIV health education and to evaluate the effectiveness of this module on level of HIV knowledge, level of HIV stigma and accessibility to healthcare services for transgender. Methodology: This study comprised of two phases which are development of HIV health education module in Phase I and quasi-experimental study in Phase II. The newly developed MyDrCare4u online HIV health education module was based on enriched consensus of relevant stakeholders systematically from Health Belief Model (HBM) theory by using modified delphie technique. This module has been delivered to intervention group in Kelantan while control group in Pahang received HIV health education at healthcare facility. Repeated Measures Analysis of Variances (RM ANOVA), Chi-Square test, Independent T-test and Fisher's exact test were applied. Result: In Phase I, the content validation, face validation and usability assessment of newly developed module was rated excellent and verified by specific raters on each stage. In Phase II, there was an overall statistically significant difference in mean HIV knowledge scores between intervention and control group, regardless of time [F(1,58) =5.98, p<0.001; effect size (ηp2) =0.093]. There was an overall statistically significant difference in mean HIV stigma scores between intervention and control group, regardless of time [F(1,58) =10.97, p=0.002; effect size (ηp2) =0.159].The intervention group had statistically significant increment of mean HIV knowledge score from baseline to one-month and three-months follow up [Huynh-Feldt:F(1.7,49.8) =38.86, p<0.001; effect size (η2) =0.573]. There was a statistically significant reduction of mean HIV stigma score from baseline to one-month and three-months follow up in intervention group [F(0.96; df = 2; p=0.619)]. There was a statistically significant increment of proportion of HIV screening test in intervention group from baseline to three-months follow up (p<0.001). Conclusion: The newly developed online HIV health education module effectively increase HIV knowledge, reduce HIV stigma and increase proportion of HIV screening among transgender population. Our findings shed light for future implementation of this module through collaborative efforts of relevant stakeholders towards ending AIDS in Malaysia by 2030
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Keywords
HIV/AIDS , Online HIV health education module