Publications by authors named "Kamal Gautam"

Recent estimates report a high incidence and prevalence of HIV among men who have sex with men (MSM) in Malaysia. Mobile apps are a promising and cost-effective intervention modality to reach stigmatized and hard-to-reach populations to link them to HIV prevention services (e.g.

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Introduction: From 1996 to 2006, Nepal experienced a decade-long armed conflict that adversely impacted survivors of torture. The conflict posed threats to various facets of their lives, such as men-tal health, socio-economic status, human rights, and the process of reintegration into their original communities. This study was done with the survivors of torture from the armed conflict.

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  • The study addresses the high rates of HIV among men who have sex with men (MSM) in Malaysia by developing a web-based platform called "CINTAI," which offers an HIV self-testing (HIVST) kit and real-time e-counseling to enhance access to HIV care services.
  • The research follows SPIRIT guidelines, with two phases: the first focuses on adapting existing web platforms, and the second involves a pilot randomized controlled trial to evaluate the feasibility and effectiveness of "CINTAI" over 6 months with 78 MSM participants.
  • The study aims to improve HIV testing rates and linkages to care for MSM by combining self-testing with expert support, while also
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  • Transactional sex, the exchange of sex for money or goods, poses health risks such as HIV and mental health issues, particularly among gay, bisexual, and other men who have sex with men (GBMSM) in Nepal, an area previously under-researched.
  • A study conducted with 250 GBMSM in Kathmandu Valley revealed that 16.4% had engaged in transactional sex in the past 6 months, with financial dependence and experiences of police detention being significant risk factors.
  • The findings highlight the need for targeted interventions to address social and legal challenges faced by GBMSM to reduce the prevalence of transactional sex and its health risks.
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Background: Globally, transgender women have been disproportionately affected by the HIV epidemic, including in Malaysia, where an estimated 11% of transgender women are living with HIV. Available interventions designed specifically to meet transgender women's needs for HIV prevention are limited. Mobile health, particularly smartphone mobile apps, is an innovative and cost-effective strategy for reaching transgender women and delivering interventions to reduce HIV vulnerability.

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Limited health literacy is linked to unhealthy behaviors, adverse health outcomes, poor quality of life and financial burdens on society. However, little is known about the level of health literacy, especially among school-going children. This cross-sectional study assesses health literacy levels and their determinants in 354 school children from Kathmandu Metropolitan City, utilizing a multi-stage cluster sampling method.

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Background: Depression and anxiety are significant contributors to the global burden of disease among young people. Accurate data on the prevalence of these conditions are crucial for the equitable distribution of resources for planning and implementing effective programs. This study aimed to culturally adapt and validate data collection tools for measuring depression and anxiety at the population level.

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  • This study investigates the prevalence and symptoms of depression in primary healthcare settings in Jhapa, Nepal, aiming to fill the gap in data regarding mental health in low- and middle-income countries.
  • Among 1,897 adult patients, 14.5% were identified as depressed using the PHQ-9, with key symptoms including loss of energy and sleep difficulties.
  • The findings highlight the need for mobile app-based clinical guidelines to enhance the detection and management of depression in primary care.
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Introduction: Pre-exposure prophylaxis (PrEP) is an effective method for prevention of HIV transmission. Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population, yet little is known about this population's current HIV prevention practices or acceptance of PrEP. This study aims to inform the culturally relevant implementation of PrEP through the qualitative exploration of (1) the potential need for PrEP in this population and (2) the factors that determine FSW willingness to use oral PrEP.

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  • - The study highlights the significant mental health challenges faced by men who have sex with men (MSM) in Nepal, where issues like anxiety, depression, and suicidal thoughts are prevalent due to factors such as family rejection and discrimination.
  • - Focus group discussions with 28 participants in Kathmandu revealed barriers to accessing mental health care, including cost and the lack of LGBTIQA+ friendly services, alongside suggestions for interventions like a smartphone app for mental health support.
  • - Findings suggest that creating resources focused on confidentiality and peer support could improve mental health access for MSM, with the potential applicability of these solutions to similar low-resource contexts.
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Mobile technology growth in Nepal offers promising opportunities for using mobile health (mHealth) interventions to facilitate HIV prevention efforts. However, little is known about access and utilization of communication technology and their willingness to use mHealth for HIV prevention services in Nepal. We conducted a cross-sectional respondent-driven sampling survey of 250 MSM in Kathmandu Valley of Nepal from October to December 2022.

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Background: Previous studies have indicated the association between stigma and depressive symptoms among frequently stigmatized groups, such as men who have sex with men (MSM). While this association has been suggested in the literature, there is a dearth of evidence that examines whether food insecurity statistically mediates the relationship between stigma and depressive symptoms.

Methods: This cross-sectional study conducted between October and December 2022 among a sample of 250 MSM in Kathmandu, Nepal, recruited through respondent-driven sampling.

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This paper describes the development process of a mobile app-based version of the World Health Organization mental health Gap Action Programme Intervention Guide, testing of the app prototypes, and its functionality in the assessment and management of people with mental health conditions in Nepal. Health workers' perception of feasibility and acceptability of using mobile technology in mental health care was assessed during the inspiration phase ( 43); the ideation phase involved the creation of prototypes; and prototype testing was conducted over multiple rounds with 15 healthcare providers. The app provides provisional diagnoses and treatment options based on reported symptoms.

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This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training.

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Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention strategy that remarkably reduces HIV transmission risk. Although PrEP has been available in Nepal since 2019, very little is known about PrEP use among MSM in Nepal. This study aimed to examine PrEP awareness and its use among Nepali MSM and the factors influencing its adoption.

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Aims: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live.

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  • HIV testing rates are low among men who have sex with men (MSM) in Malaysia, prompting a study to analyze factors influencing never-testing.
  • A survey of 1,799 MSM showed that 33.8% had never tested for HIV, with various reasons such as lack of awareness about PrEP and higher risks due to relationships with HIV-positive partners.
  • The study emphasizes the need for targeted public health interventions to promote HIV testing among this subgroup, particularly focusing on increasing knowledge and accessibility of testing services.
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  • The study investigates the prevalence and health-related factors of active amphetamine-type stimulant (ATS) use among transgender women in Malaysia, revealing that 10.2% reported current use.
  • It highlights that those undergoing hormone therapy were less likely to use ATS, while a history of drug-related arrests was associated with higher ATS usage.
  • The findings suggest a significant connection between health factors and ATS use, indicating the need for targeted prevention strategies to reduce ATS use within this population.
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The monkeypox virus (MPOX) poses a major threat to the health of people, particularly among men who have sex with men (MSM). However, the knowledge regarding MPOX among MSM in Nepal is poorly understood. Therefore, the present study aimed to assess the knowledge of human monkeypox among Nepalese MSM.

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Men who have sex with men (MSM) in Malaysia are disproportionately affected by HIV. As pre-exposure prophylaxis (PrEP) is being introduced, we assessed population-based PrEP delivery preferences among MSM in Malaysia. We conducted a discrete choice experiment through an online survey among 718 MSM.

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Background: Mental wellbeing encompasses life satisfaction, social connectedness, agency and resilience. In adolescence, mental wellbeing reduces sexual health risk behaviours, substance use and violence; improves educational outcomes; and protects mental health in adulthood. Mental health promotion seeks to improve mental wellbeing and can include activities to engage participants in sport.

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