See HIV/AIDS complications first before issuing advisory, Selangor Mufti Dept told


PETALING JAYA: Religious and non-medical experts are urged to go to hospitals and see the ordeal of youths suffering from HIV and AIDS for themselves.

Dr Ummu Afeera Zainulabid took to Twitter to comment on the Selangor Mufti Department’s advisory for HIV prevention drug pre-exposure prophylaxis (PrEP), to not be administered to homosexuals.

Dr Ummu’s tweets had also been retweeted by several prominent doctors, who took a similar stand.

"A week or two of clinical attachments is insufficient. Come and see the complications from cytomegalovirus (CMV) talaromycosis, cryptococcal meningitis, pneumocystis pneumonia, toxoplasmosis, histoplasmosis and other opportunistic infections," said the internal medicine specialist.

"Also watch these kids die due to complications from cancer and other reasons linked to HIV/ AIDS. Understand the reason behind prevention vs cure," she added.

She said sex addiction was not simple and it took a long time to treat, adding that PrEP did not help with addiction.

"In the process of helping these youth, let us give them PrEP so that they do not get infected," she said, adding that time was part of the treatment.

"We believe that with continuous education from good doctors, they will return to the path of God without being infected. They will then help their friends," she added.

She said there were no Muslims doctors endorsing LGBT. However, they received patients from different backgrounds whom they had to treat.

"Let us attend to them and educate them," she said.

She said the PrEP issue opens up room for larger engagements for inclusive healthcare for high risk groups.

Dr Ummu also said while she respected religious leaders who cared about issues related to the "ummah", she added that advisories and orders should only be made once they had gone down to the field to understand the real issues faced by the people.

"This is not a political issue. This is not an issue which should be turned into a polemic. It is an issue of the ummah which requires conscience to understand and not to punish. We need to help these youth," she said.

Former Health deputy director-general Datuk Dr Christopher Lee said PrEP was proven to reduce HIV transmission.

"It's the responsibility of the Med fraternity to provide all current, evidence-based info to prevent this. The choice is the individual's," said the infectious disease expert who was also the founding president of the Kuala Lumpur AIDS Support Society (KLASS) and a founding member of the TREAT ASIA HIV Network.

Galen Centre for Health and Social Policy chief executive officer Azrul Mohd Khalib said the advisory was misinformed and likely to mislead the public.

He said denying or providing selective access is bad medicine, poor practice and has no basis in public health.

"It is essential to ensure that health interventions to address public health priorities such as HIV/AIDS and most recently, Covid-19, are evidence informed, rights based and grounded in the realities of the communities we work with," he said in a statement.

"We have learned from bitter and tragic experiences of the past, that imposing beliefs, judgments, attitudes and dogma into such programmes, often brings about more harm than good.

"It might make us feel better but has either no relevance or impact on those communities or worse, brings about harm and deprives them of much needed assistance and treatment.

"In this case, it would deprive them of a way to prevent HIV infection. Why should we deny people at risk access to life-saving treatment?" he added.

He said providing access to PrEP to those who need it, without discrimination, is key to ensuring that the treatment does what it is supposed to do, which is reduce the number of people newly infected with HIV.

He said for almost two decades, the Health Ministry has taken a pragmatic, compassionate and far-reaching approach to HIV prevention by adopting the harm reduction programme, which involved exchanging needles and syringes, and providing opioid substitution therapy.

As a result, Malaysia’s HIV epidemic changed dramatically with new infections dropping significantly, and the epidemic was no longer driven by injecting drug use.

Malaysia has also been highlighted as a best practice country.

"We know what works and has impact, and what does not. We need to be guided by the science, patient-centred care, and the experiences of the people and communities who need such services.

"I recommend that the Selangor Mufti Department review its published position on this issue and consult with Malaysia’s infectious diseases and public health experts to improve its understanding of this issue," he added.

The Selangor Mufti Department had said in the advisory that administering the drug to homosexuals is "prohibited" because it was akin to colluding in sinful activities.

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