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Singh D, Mamat RB, Narayanan S, Vicknasingam B. Prevalence of Amphetamine-Type Stimulants (ATS) use among clients in primary and private Methadone Maintenance Treatment (MMT) program in Kuantan, Malaysia. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1642409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | | | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia
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Chen X, Zhu L, Zhou YH, Liu FL, Li H, Yao ZH, Duo L, Pang W, Ye M, Zheng YT. Factors associated with needle sharing among people who inject drugs in Yunnan, China: a combined network and regression analysis. Infect Dis Poverty 2016; 5:73. [PMID: 27502491 PMCID: PMC4977866 DOI: 10.1186/s40249-016-0169-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 07/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background Network analyses have been widely utilized to evaluate large datasets, but have not yet been used to explore factors associated with risk behaviours. In combination with traditional regression analysis, network analyses may provide useful information and highlight key factors for reducing needle sharing behaviours among people who inject drugs (PWID). Methods Sociodemographic data, and information on injection behaviour and sexual practices were collected from a cross-sectional survey that was conducted with PWID in five prefectures of Yunnan province, China. A combination of logistic regression and correlation network analyses were used to explore key factors for reducing needle-sharing behaviours among PWID. Results In a total of 1 049 PWID, 37.5 % had a history of needle or syringe sharing. The logistic analysis showed that Zhaotong, Qujing, Dehong, or Lincang residents, diazepam use, longer injection duration, needle reuse, and infection with HIV, viral hepatitis, tuberculosis and/or malaria were independently associated with needle sharing. The correlation network analyses showed that, compared to PWID who had never shared needles, PWID who did share needles would achieve harm reduction goals faster and more permanently. HIV serostatus and marital status were found to be closely associated with other risk factors. By combining regression analyses with network analyses, it was shown that PWID who are HIV seropositive will be an ideal target group for harm reduction programs. Conclusion Needle-sharing behaviours are common among PWID in Yunnan, and harm reduction programs may help PWID who are HIV seropositive reduce risk behaviours and prevent blood borne diseases. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0169-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xin Chen
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650204, China
| | - Lin Zhu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650204, China
| | - Yan-Heng Zhou
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,College of Life Sciences, Yan'an University, Yan'an, Shaanxi, 716000, China
| | - Feng-Liang Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Hong Li
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, 650022, China
| | - Zhi-Hong Yao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Lin Duo
- The Second People's Hospital of Yunnan Province, Kunming, Yunnan, 650021, China
| | - Wei Pang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Mei Ye
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650204, China
| | - Yong-Tang Zheng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.
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Wang LJ, Lin SK, Chiang SC, Su LW, Chen CK. Risk factors for HIV, viral hepatitis, and syphilis among heroin users in northern Taiwan. Subst Use Misuse 2013; 48:89-98. [PMID: 23077983 DOI: 10.3109/10826084.2012.731131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A total of 125 heroin users were recruited from a detention center and two psychiatric hospitals in northern Taiwan during 2006 in order to investigate the prevalence and correlates of blood-borne infections among heroin users. The seroprevalence rates of the human immunodeficiency virus (HIV), hepatitis C virus (HCV), HBV, HDV, and syphilis were 15.2%, 74.4%, 15.2%, 6.4%, and 8%, respectively. Injection risk behaviors were associated with HIV, HCV, and syphilis infections, but not with HBV infections. Meanwhile, HCV and HBV infections were correlated with the duration of heroin use and age of the subjects, respectively. The results of this study suggest that a comprehensive public health program is needed to prevent transmission of these blood-borne infections. The study's limitations are noted.
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Affiliation(s)
- Liang-Jen Wang
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan
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Meade CS, Watt MH, Sikkema KJ, Deng LX, Ranby KW, Skinner D, Pieterse D, Kalichmann SC. Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa. Drug Alcohol Depend 2012; 126:232-9. [PMID: 22717338 PMCID: PMC3465508 DOI: 10.1016/j.drugalcdep.2012.05.024] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 05/10/2012] [Accepted: 05/18/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("meth") use over the past decade. There is concern that meth may further fuel the HIV epidemic in this country because of its association with risky sexual behaviors. This study describes the prevalence of meth use and its relation to HIV sexual risk behaviors among patrons of alcohol-serving venues. METHODS Participants (N=3328) were surveyed in 12 venues in a mixed race township. Logistic regression models were used to examine the relations between meth use and sexual risk behaviors, and structural equation models were used to test whether meth use mediates the relationship between childhood sexual abuse and current sexual risk. RESULTS Meth use in the past 4 months was more common among Coloured than Black persons (10.5% vs. 3.5%). Meth users were more likely than non users to use marijuana, inhalants, and injection drugs, have a history of childhood sexual and/or physical abuse, and experience and/or perpetrate intimate partner violence. Among both men and women, meth use was associated with greater odds of engaging in sexual risk behaviors, and meth use partially mediated the relationships between childhood sexual abuse and all sexual risk behaviors. CONCLUSIONS Meth users in this setting are at increased risk for HIV due to their greater likelihood of engaging in sexual risk behaviors and being in violent relationships. There is an urgent need to provide targeted HIV prevention and substance abuse treatment to meth users living in townships in Cape Town.
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Robertson AM, Rangel MG, Lozada R, Vera A, Ojeda VD. Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico. Drug Alcohol Depend 2012; 120:142-8. [PMID: 21835559 PMCID: PMC3245754 DOI: 10.1016/j.drugalcdep.2011.07.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/30/2011] [Accepted: 07/16/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Among male injection drug users (IDUs) in Tijuana, Mexico, U.S. deportation is associated with HIV transmission. Changing drug use behaviors following deportation, including the use of new drugs, may increase HIV risk but are understudied. We identify correlates of trying new drugs following male IDUs' most recent U.S. deportation to Mexico. METHODS In 2010, we recruited 328 deported male IDUs in Tijuana, Mexico. Questionnaires collected retrospective data on drug use and other HIV risk behaviors throughout migratory events. Logistic regression identified correlates of trying new drugs/combinations following their most recent deportations. Informed consent was obtained from all participants. RESULTS Nearly one in six men (n=52, 16%) tried new drugs following their most recent deportation, including heroin (n=31), methamphetamine (n=5), and heroin/methamphetamine combined (n=17). Trying new drugs following deportation was independently associated with U.S. incarceration (adjusted odds ratio [AOR]=3.96; 95% confidence interval [C.I.] 1.78, 8.84), increasing numbers of U.S. deportations (AOR=1.11 per deportation; C.I. 1.03, 1.20), feeling sad following deportation (AOR 2.69; C.I. 1.41, 5.14), and perceiving that one's current lifestyle increases HIV/AIDS risk (AOR 3.91; C.I. 2.05, 7.44). CONCLUSIONS Trying new drugs following U.S. deportation may be related to the unique contexts and stressors experienced by drug-abusing migrants as they attempt to reestablish their lives in Mexico. Findings imply an unmet need for health and social programs to alleviate pre- and post-deportation stressors faced by undocumented and return migrants in the U.S.-Mexico context.
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Affiliation(s)
- Angela M. Robertson
- San Diego State University/University of California, San Diego; Institute of the Americas, 10111 N. Torrey Pines Road, Mail Code 0507, La Jolla, CA 92093-0507
| | - M. Gudelia Rangel
- El Colegio de la Frontera Norte; Carretera Escénica Tijuana - Ensenada, Km. 18.5, San Antonio del Mar, Tijuana, Mexico; y Secretaría de Salud de México, Distrito Federal, México
| | - Remedios Lozada
- Patronato Pro-COMUSIDA; Ave. Baja California 7580, Zona Norte, Tijuana, Mexico
| | - Alicia Vera
- University of California, San Diego; Institute of the Americas, 10111 N. Torrey Pines Rd., Mail Code 0507, La Jolla, CA 92093-0507
| | - Victoria D. Ojeda
- University of California, San Diego; Institute of the Americas, 10111 N. Torrey Pines Rd., Mail Code 0507, La Jolla, CA 92093-0507
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Role of social network dimensions in the transition to injection drug use: actions speak louder than words. AIDS Behav 2011; 15:1579-88. [PMID: 21431412 DOI: 10.1007/s10461-011-9930-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to examine the influences of social network factors, particularly social support and norms, in the transition from non-injection heroin and/or opiate use to heroin-injection, which is one of the leading causes of the spread of HIV/AIDS in China. Respondent-driven sampling was used to recruit young heroin and/or opiate users in an egocentric network study in Yunnan, China. Multivariate logistic regression using hierarchical combinations of candidate variables was used to analyze network factors for the injection transition. A total of 3,121 social network alters were reported by 403 egos with an average network size of eight. Fifty-eight percent of egos transitioned to heroin-injection from non-injection. This transition was associated with having a larger sex network size, a larger number of heroin injectors in one's network, and a higher network density. The findings enhance our understanding of the influence of social network dimensions on the transition to injection drug use. Accordingly, the development of interventions for heroin and/or opiate users in China should consider social network characteristics.
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Meth/amphetamine use and associated HIV: Implications for global policy and public health. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2010; 21:347-58. [PMID: 20117923 DOI: 10.1016/j.drugpo.2009.11.007] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 10/30/2009] [Accepted: 11/24/2009] [Indexed: 11/24/2022]
Abstract
Amphetamine type stimulants (ATS) have become the focus of increasing attention worldwide. There are understandable concerns over potential harms including the transmission of HIV. However, there have been no previous global reviews of the extent to which these drugs are injected or levels of HIV among users. A comprehensive search of the international peer-reviewed and grey literature was undertaken. Multiple electronic databases were searched and documents and datasets were provided by UN agencies and key experts from around the world in response to requests for information on the epidemiology of use. Amphetamine or methamphetamine (meth/amphetamine, M/A) use was documented in 110 countries, and injection in 60 of those. Use may be more prevalent in East and South East Asia, North America, South Africa, New Zealand, Australia and a number of European countries. In countries where the crystalline form is available, evidence suggests users are more likely to smoke or inject the drug; in such countries, higher levels of dependence may be occurring. Equivocal evidence exists as to whether people who inject M/A are at differing risk of HIV infection than other drug injectors; few countries document HIV prevalence/incidence among M/A injectors. High risk sexual behaviour among M/A users may contribute to increased risk of HIV infection, but available evidence is not sufficient to determine if the association is causal. A range of possible responses to M/A use and harm are discussed, ranging from supply and precursor control, to demand and harm reduction. Evidence suggests that complex issues surround M/A, requiring novel and sophisticated approaches, which have not yet been met with sufficient investment of time or resources to address them. Significant levels of M/A in many countries require a response to reduce harms that in many cases remain poorly understood. More active models of engagement with M/A users and provision of services that meet their specific needs are required.
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Du WJ, Xiang YT, Wang ZM, Chi Y, Zheng Y, Luo XN, Cai ZJ, Ungvari GS, Gerevich J. Socio-demographic and clinical characteristics of 3129 heroin users in the first methadone maintenance treatment clinic in China. Drug Alcohol Depend 2008; 94:158-64. [PMID: 18164146 DOI: 10.1016/j.drugalcdep.2007.11.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 11/13/2007] [Accepted: 11/13/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to determine the characteristics of heroin users in the first methadone maintenance treatment (MMT) clinic in China. METHODS In a retrospective chart review, the notes of 3127 heroin users who received both detoxification and MMT at the clinic were analyzed. Their socio-demographic and clinical data were collected, and the frequency of human immunodeficiency virus (HIV), Hepatitis C virus (HCV), and syphilis infections was investigated. RESULTS The main findings are as follows: (1) 66.5% of the patients were younger than 35 years; (2) 55.1% were married at admission; (3) 32% were non-local residents; (4) the majority had high school level education, a history of smoking and alcohol consumption prior to the initial heroin use, and did not have stable jobs; (5) 28.4% were self-employed; (6) 5.4% of the sample had total hearing loss coupled with loss of speech; (7) 83.4% sniffed heroin or injected it intravenously at the time of admission, but 87.2% had smoked the drug when they first began abusing it; (8) a significant proportion of the patients were infected with HIV, HCV, and syphilis. CONCLUSIONS Some of the above findings are not consistent with the results of previous studies conducted in Western countries and China. The unique socio-cultural and clinical characteristics of heroin abusers in different regions of China should be considered when MMT services are planned.
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Affiliation(s)
- Wan-Jun Du
- Chinese National Drug Dependence Treatment Center affiliated with Beijing Anding Hospital, Capital Medical University, Beijing, China
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Tran TMT, Nguyen HT, Yatsuya H, Hamajima N, Nishimura A, Ito K. HIV prevalence and factors associated with HIV infection among male injection drug users under 30: a cross-sectional study in Long An, Vietnam. BMC Public Health 2006; 6:248. [PMID: 17029648 PMCID: PMC1633741 DOI: 10.1186/1471-2458-6-248] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 10/10/2006] [Indexed: 02/25/2023] Open
Abstract
Background Sufficient targeted HIV prevention activities aiming at reducing HIV transmission within and from an extremely marginalized population of injection drug users (IDUs) must urgently and efficiently be implemented in Vietnam. This study was conducted to facilitate the development of such activities by describing transmission risks of young IDUs and evaluating factors in association with HIV infection. Methods Thirty clusters were selected from 29 hotspot communes in Long An province by probability proportional to size (PPS) sampling method. The snowball technique was used for enrolling participants in each cluster. The cross-sectional association of factors obtained during direct structured interviews to 248 male IDUs aged 14 to 29 years old and with their HIV test results were examined. Results The HIV prevalence among the studied IDUs was 32%. Age range of 18–20 years old, low educational level, sharing injection equipment or injection drug use in the other cities were independently associated with HIV serostatus in the multivariate analysis. Sexual behaviors did not differ between HIV-positive and -negative IDUs. Among HIV seropositive IDUs who had sexual contact with primary (n = 37), casual (n = 6), and commercial (n = 15) partners, only 5.4% (n = 2), 33.3% (n = 2), and 46.7% (n = 7), respectively, responded that they had used condoms every time. Conclusion About one-third of young IDUs aged less than 30 identified in the hotspot communes in Long An, Vietnam was found to be infected with HIV, and socio-demographic and injection-related factors might account for the infection risk. Prevailing risky sexual behavior of this extremely marginalized population highlights the need to reduce their high transmission risks as a public health priority.
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Affiliation(s)
- Thu Minh T Tran
- Planning Department, National Institute of Hygiene and Epidemiology, 1 Yersin Hai Ba Trung, Hanoi, Vietnam.
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Cheng Y, Sherman SG, Srirat N, Vongchak T, Kawichai S, Jittiwutikarn J, Suriyanon V, Razak MH, Sripaipan T, Celentano DD. Risk factors associated with injection initiation among drug users in Northern Thailand. Harm Reduct J 2006; 3:10. [PMID: 16536869 PMCID: PMC1450277 DOI: 10.1186/1477-7517-3-10] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 03/14/2006] [Indexed: 11/10/2022] Open
Abstract
Background Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand. Methods A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection. Results After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation. Conclusion Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.
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Affiliation(s)
- Yingkai Cheng
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Susan G Sherman
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Namtip Srirat
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Tasanai Vongchak
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Surinda Kawichai
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Jaroon Jittiwutikarn
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Vinai Suriyanon
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Myat Htoo Razak
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - Teerada Sripaipan
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
| | - David D Celentano
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand
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