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HEALTH-MALAYSIA: Divided Over HIV Testing
By Baradan Kuppusamy
KUALA LUMPUR, Jan 5, 2009 (IPS) - A raging debate over mandatory HIV screening has exposed fear and ignorance within
government, despite years of awareness campaigns to eradicate prejudice against people
living with the virus and acquired immune deficiency syndrome (AIDS).
Some high officials have suggested that those with HIV be quarantined at specially
constructed camps, or even isolated on islands, to safeguard the general population.
Others are calling for new mandatory rules forcing all Muslim couples, about to tie the
knot, to be tested for HIV status before being allowed to marry. They also want rules to
bar infected couples from having sex or having babies.
There have even been calls for mandatory screenings for all Malaysians, irrespective of
race of religion.
Muslim clerics have already announced that limited mandatory testing for HIV would be
extended nationally to cover all Muslim couples from Jan. 1, 2009.
Despite protests from HIV/AIDS experts and civil rights activists who say mandatory
screening is a serious violation of individual rights and does not prevent spread of the
disease, the government intends to widen the mandatory screening rule to all Malaysian
couples.
This is because numerous non-Muslim organisations, individuals and religious bodies
argue that the spread of the HIV infection can be curbed only if mandatory testing is
extended to all couples.
Deputy Prime Minister Najib Razak, who announced last month that all Muslim couples
would have to undergo mandatory HIV screening before they are allowed to marry, is in
favour of extending the measure to non-Muslims on a voluntary basis.
Najib received strong official and public support for ordering mandatory testing, including
from a senior opposition leader who went further to say couples having HIV should not be
allowed to marry or have children.
"I think it is a gross error to allow somebody very sick like that, an HIV carrier, to marry,"
said Mohammad Nizar of the pro-Islamic PAS party who is chief minister of northern Perak
state.
"If there's any breeding - sorry for having to use that word - the embryo will also carry
the same virus. It's very unjust to the child," Nizar told local newspapers, demanding
immediate mandatory testing.
The issue has revealed a deep gulf in thinking in this multiracial nation of about 27 million
people. AIDS activists have slammed official attitudes that they say are stigmatising and
isolating people with the HIV/AIDS.
"They are being treated like people with the plague…it is tragic that despite so much
public campaigning about HIV and against discrimination, officials and ordinary people
remain ignorant," said civil rights activist Irene Fernandez who runs an HIV/AIDS helpline.
"Fear and ignorance are driving the demands to isolate, to quarantine and to order
mandatory testing," Fernandez told IPS. "The government should not be making such
choices for people."
"After so many years of HIV/AIDS education people have such views and attitudes," she
said, adding that such views were frightening.
Ironically, the debate comes as Malaysian officials report a halving of HIV infections in
recent years after introducing ‘harm reduction’ methadone treatment and launching a
campaign to curb needle sharing by distributing free needles.
Due to strong protests from clerics both methods were introduced in a controlled manner
and its application limited.
However, those gains were offset by a significant 35 percent rise in infections among
married women between the ages 21 to 35 - a new trend that has alarmed the
government.
A newly released report brought out by the Ministry of Health (MoH) and the United
Nations Children’s Fund (UNICEF), ‘Women and Girls Confronting HIV and AIDS in
Malaysia’, reveals that infections among married women through sex increased from five
percent of total cases in 1997 to 16 percent in 2007.
Kedah, Terengganu and Kelantan, on the eastern coast of the peninsula and
overwhelmingly Muslim-Malay, recorded the highest numbers of infected housewives.
While the government has ordered an in-depth study into the new trend, experts are
attributing it to husbands catching the infection through unsafe sex with sex-workers and
passing it on to their wives.
They blame an uncontrolled and unrestricted proliferation of massage parlours, which are
undisguised fronts for prostitution, as a key reason.
According to United Nations figures, more than 82,500 Malaysians have been infected with
the virus since records began in 1986 and, while precise data is hard to obtain, around
80,000 people are currently living with HIV/AIDS.
The number of new HIV infections is falling, however.
Last year, 5,400 new cases were reported compared to 6,900 the year before, the MoH
says - a figure expected to drop further in 2009 to nearly 3,500.
Malaysian AIDS Council president Prof. Adeeba Kamarulzaman opposes any move to
introduce mandatory testing, saying such methods reflect ignorance and lack of
understanding of the disease and its effect on individuals.
She has written extensively in the local media opposing mandatory testing and
condemning quarantine and isolation and giving facts and reasons why people with HIV
can live a normal life despite carrying the virus.
"People should not fear those living with HIV. They are normal and live normal lives, have
careers and must be allowed to marry and have safe sex," the physician told IPS. "The
reactions and proposals show there is a lack of education about the latest developments in
treating HIV/AIDS.’’
"People with HIV and their families see infection as a death sentence," said a medical
expert doing research on HIV infection among rural farmers who asked not to be named.
"There is a lot of ignorance. People see having HIV as an immediate death sentence. They
don’t know that with proper treatment and monitoring an infected person can live a
normal life."
"In the West attitudes have changed with new knowledge…even our neighbour, Thailand,
has progressed but we have not," he said, blaming lack of open discussions, religious
inhibition and official denial as reasons for the "abysmal attitudes" towards people with
HIV/AIDS.
According to the MoH-UNICEF report, in 2006, when a survey on knowledge, attitudes
and risk behaviour was conducted respondents seemed to understand the nature of HIV
and AIDS and the common routes of HIV transmission.
But, the report said, there were difficulties in translating this knowledge into behavioural
change with socio-cultural and religious factors coming into play.
(END)
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