Success in fighting HIV among drug users

MAC secretary Hisham Hussein (left) and PT Foundation COO Raymond Tai (right).

PETALING JAYA: The Malaysia AIDS Council (MAC) has reported significant success in its fight against HIV through its programme to prevent drug addicts from using contaminated needles and syringes.

MAC secretary Hisham Hussein told FMT only 377 people contracted HIV last year as a result of sharing needles. This compares with the annual average of 4,307 between 2006 and 2006, the year the needle exchange programme was initiated. The numbers have been declining since. For example, between 2010 and 2016, the annual average was 920.

“Of the 3,397 people with HIV last year, only 11% were drug addicts,” Hisham said. “This proves that the system works and the programme has managed to stop the spread of HIV by needle transmission.”

The programme is supported by the health ministry and the police.

Hisham said the public should be reminded that government hospitals provide HIV patients with free treatment and medication. “All you need is RM3 for registration,” he added.

He said the health ministry and MAC were training MAC’s partner NGOs to do community-based testing, which will see the NGOs reach out to their respective communities as a proactive measure to get people tested.

PT Foundation COO Raymond Tai commended the health ministry for working with NGOs to provide training for healthcare providers in the treatment of people living with HIV.

Tai, whose organisation provides HIV/AIDS education, care and support programmes, expanded on Hisham’s statement about the reduction in infection rates among drug addicts.

“In the past, many drug users contracted HIV because they shared needles,” he said. “In those days, heroin was the main drug of choice and using needles was the most effective way of getting it into your system.”

Nowadays, he said, there were many different types of drugs and various ways of consuming them.

He noted that sexual transmission of HIV had been on the rise since 2012, involving both heterosexuals and homosexuals.

According to a recent United Nations report, Malaysia is one of 10 countries which together account for more than 95% of all new HIV infections in the Asia-Pacific region.

In Malaysia over the past three years, an average of nine people a day are diagnosed as having contracted HIV.

The health ministry uses statistics obtained from MAC. According to these, 10,244 people were diagnosed with HIV between 2014 and 2016. Malaysian citizens accounted for 95% of the cases. Of these, 85% were men. About 54% were Malays, 20% Chinese and 7% Indians. About 69% were aged between 20 and 40.

The states recording the highest number of cases were Selangor, Johor, Kuala Lumpur, Sabah and Sarawak. Terengganu, Pahang and Kelantan have seen a reduction in recent years.

Tai said the main concern was with people who got the disease through sex but didn’t get themselves tested.

“The figures come from reported cases registered with the health ministry,” he said. “So the actual number may be higher. If people don’t get tested, we may not know the real numbers. More worrying is that if these people don’t know they have HIV, they may be continuing with unsafe sex practices.”

He said a big challenge in promoting safe sex and getting people tested was social stigma and existing laws. “The best way to prevent contracting HIV remains the use of condoms,” he said. “But many people are uncomfortable buying condoms.

“Then, there is also the stigma of getting tested. People are afraid of being judged or being seen going for testing. The same goes for seeking treatment. Many are afraid someone they know will see them at the hospital or clinic.”

Another problem is the fear of arrest among sex workers and owners of brothels. Tai said this fear made some venue owners refuse to let NGOs distribute condoms in their premises and sex workers to reject free condoms.

Key solution

He said the key solution was to create a “more enabling” environment so that people could get access to information and safe-sex materials such as condoms as well as access to treatment without fear of stigmatisation.

“The very successful needle exchange programme didn’t happen by chance. The government took a calculated risk, even though its critics said it was unlawful to use needles to harm one’s body.

“This is the kind of measure we need to resort to because just telling people not to have pre-marital or extra-marital sex, be it heterosexual or homosexual, just isn’t going to work.”

Both Tai and Hisham said their organisations were against any form of mandatory testing as it would only make the issue of stigmatisation worse.

Parents Action Group for Education chairperson Noor Azimah Abd Rahim.

At present, only Muslim couples seeking to get married have to be tested for HIV.

Parents Action Group for Education chairperson Noor Azimah Abd Rahim said the root of the problem was the poor quality of education.

“It’s not even about sex education, which should be implemented in the syllabus, but the quality of education in general,” she said. “If you have a good educational background, you will get jobs that will naturally take you away from prostitution and drugs. You surely wouldn’t want to jeopardise your job by going down the wrong path.”

Mohamad Ali Hasan, president of the National Parent-Teacher Associations Consultative Council.

Mohamad Ali Hasan, president of the National Parent-Teacher Associations Consultative Council, said the battle against HIV needed constancy of effort from the government, NGOs and the media.

He said social ills had contributed to HIV cases in the country and there was a need for efforts to prevent such ills.

He added that sex education in schools should stress the dangers of pre-marital sex and that condoms shouldn’t be too readily available because they “promote free sex”.

*Ivy Chong, Nurul Azwa and Afiqah Farieza contributed to this article.