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So how to optimise the strategies to Overcome Stigma & Discrimination in #HIV?
As we know Malaysia is a high middle-income, multi-cultural country with 31 million people. HIV epidemic in this country originated in People Who Inject Drugs (PWID), but now is growing more in Men Who Have Sex with Men (MSM) and other Key Populations - including sexual partners.
HIV prevalence can be seen at 0.4% in adults, but concentrated in Key Populations.
Simply put;
-MSM: 21.6% (KL) & 8.9% (nationally)
-PWID: 19.8% (KL) & 16.9% (nationally)
-Transgender women (TGW): 12.4%
-Cisgender Female Sex Workers (FSW): 11.1%
All of these behaviours are ...
Simply put;
-MSM: 21.6% (KL) & 8.9% (nationally)
-PWID: 19.8% (KL) & 16.9% (nationally)
-Transgender women (TGW): 12.4%
-Cisgender Female Sex Workers (FSW): 11.1%
All of these behaviours are ...
... being criminalised in Malaysia. All the stigma and discrimination. You name it.
Malaysia is by far considered one of only FOUR countries in the Asia Region where HIV incidence and mortality are increasing.
So what’s hindering these Key Populations to get tested earlier before the virus turns into AIDS? What’s stopping them from going to clinics to get treatment? Yes! STIGMA & DISCRIMINATION. The real human killer.
Speaking of criminalisation laws and HIV prevalence.
Laws targeting people at highest risk for HIV in Malaysia include:
1- People who Use Drugs (Imprisonment)
2- MSM (both secular & Shariah law)
3- Transgenders (Shariah law)
4- Sex workers (Shariah law)
& HIV prevalence
Laws targeting people at highest risk for HIV in Malaysia include:
1- People who Use Drugs (Imprisonment)
2- MSM (both secular & Shariah law)
3- Transgenders (Shariah law)
4- Sex workers (Shariah law)
& HIV prevalence
These laws give birth to public shaming and perpetuating stigma towards these vulnerable populations thus hindering them from getting the right healthcare. Pergi klinik even some nurse sendiri kutuk. Macam mana nak dapatkan a good healthcare system?
So there are people working hard to stop the spread of Stigma and Discrimination in HIV, these people are working hard for Intervention and addressing these points:
1. medical school curriculum changes
2. implementation science strategies to have better facilitation with addiction treatment to improve HIV treatment parity
3. drug policy reform - drug decriminalisation
2. implementation science strategies to have better facilitation with addiction treatment to improve HIV treatment parity
3. drug policy reform - drug decriminalisation
4. jump-starting the HIV treatment (ART) and prevention (PrEP) cascade (mHealth)
5. self-testing for HIV ( http://JomTest.com by MAC)
6. prison transitional programs
5. self-testing for HIV ( http://JomTest.com by MAC)
6. prison transitional programs
Why mHealth strategies are urgently needed?
1. MSM account for the most new infections in Malaysia.
2. Lifetime HIV testing is LOW and recommended HIV testing (every 3 to 6 months for at risk MSM) is even lower
1. MSM account for the most new infections in Malaysia.
2. Lifetime HIV testing is LOW and recommended HIV testing (every 3 to 6 months for at risk MSM) is even lower
3. HIV testing is the FIRST step in the HIV treatment (ART) and prevention (PrEP) cascade.
So what gets in the way of starting PrEP in MSM?
1. Fear of HIV testing
- not wanting to be seen in person
- not wanting to openly disclose their risk
- having to come back for results
2. Fear of Discussing HIV risk to a prescriber
1. Fear of HIV testing
- not wanting to be seen in person
- not wanting to openly disclose their risk
- having to come back for results
2. Fear of Discussing HIV risk to a prescriber
3. Cost
-for medication (some get it for free now!)
-for testings for STIs frequently (some are free, some are not)
4. Side Effects
-for medication (some get it for free now!)
-for testings for STIs frequently (some are free, some are not)
4. Side Effects
So now we have a clear picture of how the affected people are facing due to stigma and discrimination. Their healthcare is being affected by these. Imprisonments, petty issues being exaggerated by authorities thus giving birth to stigma from the general public. It is sick.
People should not be hindered from healthcare systems due to other people’s perceptions. We as the general public need to EDUCATE OURSELVES and not just blindly follow our ancestors ideas.
Healthcare is a complete different topic from religious views. EVERYONE DESERVES A GOOD HEALTHCARE SYSTEM FREE FROM STIGMA AND DISCRIMINATION REGARDLESS OF HIS OR HER “MAQAM” DI MATA PARA AHLI SYURGA DUNIA. Sekian.
Sources: A personal collection of slideshow presentation by Prof. Frederick L. Altice, M.D., M.A. from @Yale University, a professor of Medicine and Public Health. He is also an Academic Icon Professor at the University of Malaya @unimalaya .
