Introduction: Nonadherence to antihypertensive medications has been found increasingly prevalent in Thailand, yet the critical cultural resources of Islamic belief systems and family support are seldom mobilized to support adherence. Our study aimed to develop, implement, and evaluate an Islamic-based intervention program to promote medication adherence among Muslim older adults with uncontrolled hypertension in southern Thailand. Method: An action research with codesign and family participation principles was utilized. Within action research cycles, interviews with Thai-Muslim older adults, family primary caregivers, and health care professionals were undertaken alongside participant observations. Results: A qualitative audit demonstrated an improved medication adherence with all stakeholders expressing their desire to further engage and maintain the new intervention program. Discussion: Engaging with Islamic doctrine and concepts of family participation could support an improvement in antihypertensive medication adherence for Muslim older adults. Codesigning enables recognition of community belief systems, forming an important step toward improving community-based medication adherence.
Sexual risks for HIV transmission among injection drug users (IDUs) in Thailand are not well characterized. We surveyed 272 male IDUs about their background, sexual behaviors, and drug use at drug treatment clinics in southern Thailand. HIV seroprevalence was determined using enzyme immunoassay. Fifty-six percent of participants were sexually active, of whom 88% had sex mostly with a noninjecting regular partner (wife or steady girlfriend), reporting low rates (34%) of condom use. Among sexually active IDUs, 43% were HIV infected and only a few were aware of their HIV serostatus. Condom use was associated with history of HIV voluntary counseling and testing (VCT) and poor perceived health status in multivariate analysis. Unprotected sex with regular sexual partners is frequent among IDUs in southern Thailand, where most IDUs have not sought VCT services. AIDS prevention efforts should address access to VCT and condom promotion to sexually active couples to prevent sexual transmission of HIV.
Our data suggest that AIDS prevention efforts should focus on approaches to reduce needle sharing. Needle exchange programs, HIV counseling and testing and bleach distribution may reduce levels of needle-sharing risks.
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