Advocacy groups against call to stop vulnerable segment getting HIV prevention drug

PETALING JAYA: Several organisations have come out against the call to prevent sexually active gay men in the country from accessing the pre-exposure prophylaxis (PrEP) HIV prevention drug.

Six professors from local universities want the Health Ministry to review its plans to scale up the use of PrEP to curb HIV transmission but instead adopt an abstinence approach to deal with the issue.

"The Malaysian AIDS Foundation (MAF), Malaysian AIDS Council (MAC) and Malaysian Society for HIV Medicine (MASHM) disagree with the position taken by Dr Rafidah Hanim Mokhtar and her colleagues that effectively discriminates against the men who have sex with men (MSM) community from accessing PrEP for HIV prevention," said MAF chairman Prof Datuk Dr Adeeba Kamarulzaman (pic) in a joint statement issued on Wednesday (Dec 7)

She noted the objection to PrEP for this group does not reflect the current reality of the HIV epidemic in Malaysia.

"Last year, 96% of new HIV cases were caused by sexual transmission, concentrated largely among the MSM group.

"Despite the weight of their vulnerability to HIV, they are also among the hardest to reach with HIV prevention services," she said, adding that this was due to the legal system that criminalises their behaviour.

She cited a recent study in Australia involving 10,000 PrEP users which showed that the new rate of HIV transmission decreased by almost 90%.

The group noted that MAC faced similar objections from detractors a decade ago when pushing for the Needle Syringe Exchange Programme (NSEP) under the Harm Reduction initiative.

"A study conducted by the Centre of Excellence for Research in AIDS (Ceria) revealed that more than 13,000 new HIV infections were prevented in the first eight years of NSEP (2006-2013) which helped save some RM47mil in healthcare costs," the joint statement read.

“ We need to treat HIV prevention and care as a health-related issue, not a moralistic one, and recognise that history is repeating itself here with previous discussions around condoms and antiretroviral treatment and risk compensation,” said MAC president Associate Prof Dr Raja Iskandar Raja Azwa.

MASHM president Datuk Dr Chow Ting Soo said proper counselling on other methods of prevention of sexually transmitted diseases must be given on top of PrEP use.

"We should not regard this as a tool to promote sexual activities but rather as part of a prevention tool for HIV transmission,” added Dr Chow.

The AIDS-related groups were responding to a joint statement issued by several university professors published in a health portal on Tuesday (Dec 6).

The professors expressed concern that scaling up the use of PrEP among the MSM community would not only disrupt the moral fabric of Malaysian society but also result in high economic cost.

PrEP is an oral medicine taken daily to prevent transmission of HIV and is proposed to be dispensed at public health clinics in Selangor, the Klang Valley, Johor, Penang and Sabah.

"Abstinence Is the only key message that we should repeatedly promote to prevent HIV infection among the MSM community," the group advocated.

Apart from Dr Rafidah Hanim of Universiti Sains Islam Malaysia (USIM), the statement was also supported by Prof Dr Samsul Draman from the International Islamic University Malaysia (IIUM), Prof Dr Anis Safura Ramli from Universiti Teknologi MARA (UiTM), Prof Dr Harmy Mohamed Yusof from Universiti Sultan Zainal Abidin (UniSZA), Assoc Prof Dr Rosediani Muhamad from Universiti Sains Malaysia (USM) and Assoc Prof Dr Ani Amelia Dato Zainuddin from Universiti Kebangsaan Malaysia (UKM).

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