HIV/AIDS in Malaysia

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The first HIV/AIDS case in Malaysia made its debut in 1986. Since then, HIV/AIDS has become one of the country's most serious health and development challenges. [1] As of 2020, the Ministry of Health estimated that 87 per cent of an estimated 92,063 people living with HIV (PLHIV) in Malaysia were aware of their status, 58 per cent of reported PLHIV received antiretroviral therapy, and 85 per cent of those on antiretroviral treatment became virally suppressed. Despite making positive progress, Malaysia still fell short of meeting the global 2020 HIV goals of 90-90-90, with a scorecard of 87-58-85. [2]

Contents

Malaysia is ranked seventh highest in adult prevalence of HIV/AIDS in Asia after Thailand, Papua New Guinea, Burma, Cambodia, Vietnam and Indonesia with a 0.45% prevalence rate. [3] According to the United Nations, Malaysia is one of the ten countries which together accounted for over 95% of all new HIV infections in the region of Asia-Pacific in 2016. [4]

In 2020, Malaysia recorded an incidence rate of 8.5 cases per 100,000 population, a 70 percent drop from 28.5 cases per 100,000 people in 2002. [5]

Prevalence

Total Number of new HIV infections and AIDS death for each year between 1986 and 2010, by gender NO. OF NEW HIV INFECTIONS AND AIDS DEATHS BY GENDER PER YEAR REPORTED IN MALAYSIA (from 1986 until 2010).png
Total Number of new HIV infections and AIDS death for each year between 1986 and 2010, by gender
Number of new infections and percentage of new infections per State population in 2006, 2007 and 2008 Percentage of new hiv infection per state in 2006-2008.jpg
Number of new infections and percentage of new infections per State population in 2006, 2007 and 2008

Malaysian HIV/AIDS cases have been reported since 1986 by the Ministry of Health. Since then, the national surveillance system had reported a cumulative of 105,189 HIV cases, 21,384 AIDS and 17,096 deaths related to HIV/AIDS giving total reported PLHIV of 88,093 cases or 96% of estimated PLHIV. [6]

Males still make up the majority of HIV cases (89%), but the number of women with positive status of HIV has been increasing. This is shown by the decreasing trend of male:female ratio of 10:1 in 2002 to 4:1 in 2014. [7] 42% of HIV transmission by age group occurred in 30–39 bracket. [7]

Between January and June 2014, 1,676 cases of HIV and 598 cases of AIDS with 402 deaths were recorded. [8] Out of this new infection, 79.7% are men.

Reported New HIV Infections in Malaysia by Ethnic Groups (2016) [9]
Percentage%
Malay
57.5
Chinese
20.9
Indian
6.9
Foreigner
1.8
Others
12.9

Means of Transmission

In 2013, heterosexuals transmission recorded the highest (51%), followed by Injecting Drug User (22%) and Homo/Bisexual transmission (22%). The scenario shifted gradually whereby in 2016, the means of transmission of new HIV cases were highest among Homo/Bisexual (46%), followed by Heterosexual (39%), Injecting Drug User (11%), Others (4%) and Mother-to-Child (1%). [9]

In October 2018, Malaysia becomes the first country in the Western Pacific region to eliminate mother-to-child transmission of both HIV and syphilis, officially validated by the World Health Organization (WHO). [10]

HIV transmission by risk factor in 2016
(% of 3,397 new infections) [9]

  Homosexual/Bisexual (46%)
  Heterosexual (39%)
  Injecting Drug User (PWID) (11%)
  Others (4%)
  Mother-to-Child (1%)

HIV transmission by age group in 2016
(% of 3,397 new infections) [9]

  20–29 (40%)
  30–39 (31%)
  40–49 (16%)
  > 50 (9%)
  13–19 (3%)
  < 13 (1%)

Incidence & Mortality Rate

Incidence & Mortality Rate, 2016 (per 100,000 population) [11]
DiseaseIncidence RateMortality Rate
HIV10.730.53
AIDS3.862.34

At-risk group

The HIV epidemic in Malaysia is concentrated in these key populations; [7]

Sex workers

Sex worker accounts for 0.6% of total reported cases thus far. However, the number of cases reported among sex workers are grossly under reported. [1] In 2014, Integrated Bio-Behavioral Surveillance (IBBS) in female sex workers shows an increase of sex workers living with HIV to 7.3% from 4.2% in 2012. [6]

Transgender

An IBBS done in 2009 found HIV prevalence among the group at 9.3%, and was decreased to 4.8% in 2012. [6] However, in 2014, the IBBS shows an increase of HIV prevalence to 5.6%. [6]

Injecting Drug Users

At the beginning of the epidemic, injecting drug user (PWID) accounted for 70–80% of all new reported cases. This has started to decline since 2004. In 2011, PWID accounts for 39% of new reported cases. [1] In 2014, 16.3% of the PWID are reported living with HIV. [6]

Men who have sex with men (MSM)

IBBS conducted in 2012 shows 7.1% of MSMs is living with HIV. In 2014, the figure has increased to 8.9%. [6]

Laws and regulations

In 2001, the Department of Occupational Safety and Health developed a non-compulsory ‘Code of Practice on Prevention and Management of HIV and AIDS' which supports the creation of a non-judgemental and non-discriminatory work environment. [12]

During the 2011 Nineteenth ASEAN Summit, Malaysia together with other ASEAN nations, adopted the "ASEAN Declaration of Commitment: Getting To Zero New HIV Infections, Zero Discrimination, Zero AIDS-Related Deaths, Bali, Indonesia, 17 November 2011" to reaffirm their commitment in working towards realizing an ASEAN community with Zero HIV Infections, Zero Discrimination and Zero AIDS-related Deaths. [13]

On 13 October 2017, the then-Ministry of Human Resources Minister, Datuk Seri Dr Richard Riot Jaem announced that the government wants to draft a new regulation in an effort to eliminate discrimination against people living with HIV or AIDS at the workplace. The ministry plans to legislate the HIV and AIDS in Workplace Policy by 2020. [14] In October 2018, it is reported that the Malaysian AIDS Council (MAC) is currently working with the Ministry of Human Resources on a policy to ensure that people with HIV/AIDS including those receiving treatment are not discriminated when it comes to employment. [15]

Mandatory pre-marital HIV test

Mandatory pre-marital HIV screening for Muslim couples was made mandatory by the Religious Department of State Government in nine states, beginning in November 2001 in Johor, followed by Perak, Perlis, Kelantan, Terengganu, Kedah, Pahang, Selangor, and possibly Melaka. Beginning January 2009, Muslim couples in the entire country are required to submit to premarital HIV testing. [16]

In 2018, the Ministry of Women, Family and Community Development mulls to make HIV testing mandatory for non-Muslim couples seeking marriage as well. [17] The proposal is strongly opposed by NGOs such as the Malaysian AIDS Council and the Sarawak AIDS Concern Society (SACS) citing the stance of World Health Organization (WHO) and UNAIDS that do not support compulsory screening of individuals for HIV. [18]

Treatment

The first line of highly active antiretroviral therapy is provided for free in Malaysia by the Ministry of Health since 2006. [19] By the end of 2020, 58 per cent of reported PLHIV received antiretroviral therapy, and 85 per cent of those on antiretroviral treatment became virally suppressed. [2]

In September 2018, "HIV Connect", a self–paced, online learning platform that is designed for primary care physicians and other healthcare practitioners in Malaysia was launched. The online learning platform is a joint effort between the Malaysian AIDS Foundation (MAF) and the Malaysian Society for HIV Medicine (MASHM) to educate doctors regarding care and management of HIV/AIDS patients. [20]

Local support

The Malaysian AIDS Council MajlisAIDSMalaysia.jpg
The Malaysian AIDS Council

External sources

Related Research Articles

HIV/AIDS has been a public health concern for Latin America due to a remaining prevalence of the disease. In 2018 an estimated 2.2 million people had HIV in Latin America and the Caribbean, making the HIV prevalence rate approximately 0.4% in Latin America.

<span class="mw-page-title-main">Epidemiology of HIV/AIDS</span> Epidemic of HIV/AIDS

The global epidemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), as of 2021, HIV/AIDS has killed approximately 40.1 million people, and approximately 38.4 million people are infected with HIV globally. Of these 38.4 million people, 75% are receiving antiretroviral treatment. There were about 770,000 deaths from HIV/AIDS in 2018, and 650,000 deaths in 2021. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.

<span class="mw-page-title-main">HIV/AIDS in India</span>

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<span class="mw-page-title-main">HIV/AIDS in Zimbabwe</span> Major public health issue

HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.

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<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

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HIV/AIDS infection in the Philippines might be low but growing fast. The Philippines has one of the lowest rates of infection, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

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The Dominican Republic has a 0.7 percent prevalence rate of HIV/AIDS, among the lowest percentage-wise in the Caribbean region. However, it has the second most cases in the Caribbean region in total, with an estimated 46,000 HIV/AIDS-positive Dominicans as of 2013.

HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive. El Salvador therefore is a low-HIV-prevalence country. The virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

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Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.

<span class="mw-page-title-main">India HIV/AIDS Alliance</span> Indian non-governmental organisation

Founded in 1999, Alliance India is a non-governmental organisation operating in partnership with civil society, government and communities to support sustained responses to HIV in India that protect rights and improve health. Complementing the Indian national programme, we build capacity, provide technical support and advocate to strengthen the delivery of effective, innovative, community-based HIV programmes to vulnerable populations: sex workers, men who have sex with men (MSM), transgender people, hijras, people who inject drugs (PWID), and people living with HIV.

<span class="mw-page-title-main">HIV/AIDS in Armenia</span>

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References

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