Bridging The Science-Practice Gap In Malaysia’s Journey Towards Ending HIV/AIDS — ERASE
By CodeBlue | 14 March 2023
Public stigma towards HIV can lead to a lack of treatment and prevention initiatives, perpetuating the cycle of infection.
Around 30 years ago, several celebrities and public figures made headlines with a shocking revelation — that they had contracted HIV. At a time when HIV was widely considered taboo, this news rocked the world, as it involved Magic Johnson and Freddie Mercury, who were at the peak of their careers and were globally celebrated personalities.
Both their careers were derailed; Magic Johnson faced opposition to continuing his basketball career after revealing his HIV diagnosis. However, he received support from influential figures, including President George HW Bush, and was able to play in the Barcelona 1992 Olympics with the ‘Dream Team’. Ultimately, he still retired due to controversy and opposition surrounding his HIV-positive status.
While all this was happening on the other side of the Pacific Ocean, the plight of people living with HIV in Malaysia is no different, if not worse.
Stigma In Malaysia
A recent survey by the Ministry of Health (MOH) found that one in four respondents believed that children living with HIV should not attend school with other children, and one in three respondents said they would not buy vegetables from a seller with HIV.
The same survey also revealed that young people between 15 and 19 years old are particularly vulnerable to stigmatisation, which is perhaps the most worrying trend of all.
Public stigma towards HIV can lead to a lack of treatment and prevention initiatives, perpetuating the cycle of infection. Therefore, it is important to understand the truths about HIV/AIDS and the situation at hand to reduce the stigma and discrimination towards people living with HIV.
How Bad Is HIV/AIDS In Malaysia Currently?
Globally, around 650,000 people lost their lives to AIDS in 2021, making it the 14th leading cause of death worldwide and the 13th leading cause of death in Malaysia.
Furthermore, more than 15 per cent of the deaths worldwide are from children under the age of 15. Since the start of the epidemic, Malaysia has had over 120,000 people diagnosed with HIV/AIDS and approximately 45,000 deaths.
Although the incidence of new infections is on a gradual decline, 44 per cent of newly diagnosed infections occur in the 20 to 29-year age group.
Sexual transmission, including both heterosexual and men who have sex with men (MSM), has become the primary mode of transmission of the HIV virus since 2010, overtaking intravenous drug use.
Other significant risk factors of transmission include mother-to-child transmission, and transfusion/medical injections.
How Is Malaysia Doing In The Fight Against HIV/AIDS?
According to the MOH’s Global Monitoring Report 2021, there are approximately 92,063 people living with HIV.
As of 2020, Malaysia fell short of attaining the UNAIDS 90-90-90 goal, where 90 per cent of people should be aware of their status, receiving antiretroviral therapy, and of those in treatment, became virally suppressed. We were only able to reach 87-58-85 respectively.
The numbers may not portray the situation in a positive light, but if these numbers were from 10 years ago, they would be considered as nothing short of a miracle.
It is important to note that we are well on the path of progress, with new HIV cases showing a decline of more than 50 per cent in just under two decades, decreasing from 6,978 in 2002 to 3,146 in 2020.
This success was achieved via a variety of different initiatives, such as the needle syringe exchange programme, the methadone maintenance therapy, and the prevention of mother to child transmissions therapy, most of which faced staunch opposition when it was first implemented but has since been proven to be highly effective.
What Are Some Of Malaysia’s Current Initiatives?
1. Undetectable = Untransmittable (U=U) Awareness Campaign
In 2016, a health equity programme launched the U=U campaign, which was subsequently adopted by the World Health Organization in 2017.
The campaign aimed to spread the word to the world that a person living with HIV receiving treatment and attaining and maintaining a suppressed viral load would not be able to transmit the HIV virus sexually.
This statement is supported by more than a decade of data from thousands of couples, one partner of which was living with HIV and the other was not.
There has not been a single reported case of transmission recorded in various similar studies. This meant that we could prevent the transmission of HIV with treatment.
2. Pre-Exposure Prophylaxis (PrEP)
Pre-exposure prophylaxis (PrEP), a medication taken to prevent getting HIV, has been shown to reduce the risk of getting HIV from sex by about 99 per cent when taken as prescribed.
At the end of 2022, the MOH launched a pilot project to dispense free PrEP at public clinics. However, since the launch of this project, the MOH has faced much scrutiny from certain groups, who are equating the dispensing of PrEP to encouraging “deviant sexual activity”.
This has unveiled a lot of judgemental and stigmatising comments, potentially hindering those who need PrEP from coming forward.
Despite the pushback from these groups, the scientific evidence supporting the use of PrEP in preventing HIV is undeniable.
Using PrEP to prevent HIV transmission would lighten the health and economic burden of the country, such as how other harm reduction programs have done between 2006 and 2013, saving more than RM 47 million in treatment costs in that time frame.
What We Are Doing
The world has come a long way since the 1980s, when HIV first became a concern, and was not well-understood. But until now, there remains a gap between the science and the beliefs of the public.
Eradicate AIDS and Stigma for Equality (ERASE) 2022/2023, a community-based project run by students from the Faculty of Medicine, University of Malaya, aims to bridge this gap.
We aim to raise awareness of the new scientific developments in the field of HIV/AIDS, as well as advocating for equal health care access for all patients, including those who are at risk of HIV and living with HIV.
We have been running an online campaign for the past three months promoting well-researched and accurate facts and information on HIV/AIDS.
ERASE will be holding an event on March 18, 2023, 9.30am to 4.00pm, at Perdanasiswa Complex, University of Malaya. There will be a keynote speech delivered by Assoc Prof Dr Raja Iskandar Shah Raja Azwa, an infectious disease consultant from the Department of Medicine, Faculty of Medicine, University of Malaya, and the president of the Malaysian AIDS Council.
Refreshments will be provided, and we will be offering free health screenings, free HIV and syphilis screenings, as well as interactive sessions to help you learn more about HIV/AIDS. This event is open to the public. Register now to show your support and help is in the fight to end AIDS. You can also find ERASE on Instagram at @erasecampaignofficial.
Sources
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
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CodeBlue
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Source: https://codeblue.galencentre.org/2023/03/14/bridging-the-science-practice-gap-in-malaysias-journey-towards-ending-hiv-aids-erase/
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