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Sunday December 2, 2012

Even straight people get HIV

Yesterday was World AIDS Day. After more than 25 years and with 80,000 Malaysians living with HIV/AIDS, there are still those who continue to discriminate and remain seemingly unaware of the disease.

WRITING about HIV/AIDS for more than a decade has been among my most enriching experiences as a journalist.

It goes beyond looking at statistics and being cautiously optimistic when the figures show a decline in the infection rate in this country.

It is about meeting Miss X or Mr Y whose stories of living with HIV are typically written with their identities being kept a secret. It is about hearing their stories and not caring about their past but wanting instead to know how they are fighting to keep illness at bay.

It is about knowing people like Michael Chow and Kirenjit Kaur, who are HIV positive but put themselves out there to make a difference in how the disease is viewed in Malaysia.

And then there is the bunch of tough-as-nails physicians like Datuk Dr Christopher Lee and Prof Dr Adeeba Kamarulzaman. Both are relentless in their quest to reduce the numbers and treat patients.

Of course, we cannot forget Datin Paduka Marina Mahathir who gave a withering stare every time a ridiculous remark or question about HIV/AIDS was posed to her when she was Malaysian AIDS Council (MAC) president.

Writing about HIV/AIDS keeps one grounded and “human”. It can sometimes be frustrating because stigma and discrimination issues still persist despite all the efforts over the past 25 years to remove them.

And it is mind boggling how fellow Malaysians treat each other and make remarks suggesting that people living with HIV/AIDS should be put on an island or place blame on the lesbian, gay, bisexual and transgender (LGBT) community.

Since the harm reduction programme among injecting drug users (IDU) was implemented in Malaysia, the number of IDUs being diagnosed with HIV has dropped. Infection from sexual transmission has overtaken it with a ratio of six to four.

Overall, Health Ministry statistics have been showing a downward trend in the number of infections since 2003 due to various preventive actions undertaken over the years.

A total of 3,749 cases were detected last year and 2,544 cases have been recorded in the first nine months of this year.

Heterosexual transmission tops the list with 1,036 infections. This is followed by IDUs (916) while homosexual or bisexual transmission accounts for 424 cases.

In total, 81,879 people were living with HIV in Malaysia between 1986 and Sept 30 this year.

Those living with the virus are really not much different from you and I. With treatment, they go about their daily business and live ordinary lives.

Click to view graphic Click to view graphic

Unfortunately, there are remarks alleging that those who are infected may have made choices that society deems deplorable, wrong and just plain sinful and therefore they deserve it.

There are tonnes of information out there. All it takes is a little initiative to be aware and to stop the blame game.

MAC honorary secretary Hisham Hussein has observed that while Malaysians are aware about the disease, they still attach “tags” such as sex workers, promiscuity and drug users to it.

“They know about safe sex but not the details,” adds Hisham who has been active in HIV/AIDS work for close to two decades.

“We need to address the awareness. Ignorance is there. It doesn't matter what your sexuality is. You need to pump in money for education.”

Hisham reminds that the number of women infected has increased over the years, currently about one in five of total infections.

“The bulk of them have had only one partner and think they are safe. But are they?”

He stresses that the people should be educated about the principles of practising safe sex.

“We are not telling them to have sex because there are still the moral and religious values. But in reality, one can't stop what goes on behind closed doors.”

So the practical thing to do is to inform them to “be fully equipped”, Hisham suggests.

On the trend of transmission, he says: “It is shocking and there is a strong denial across the board.”

Nevertheless, the Health Ministry finds that HIV in the country is still concentrated among the most-at-risk populations especially IDUs, sex workers and transgenders.

Hisham says there have been strides in battling the disease, including ministry allocation for treatment.

Some RM101.7mil was spent by the ministry in 2011 for programmes that include prevention, promotional activities, harm reduction, screening and anti-retroviral medication.

Hisham adds that the ministry allocated RM100,000 for prevention work among sex workers but none was given to carry out such work with transgenders and men who have sex with men.

The increase in the number of infected women is certainly not caused by gay men, says Marina wryly.

“It is heterosexual transmission,” she stresses, adding that politics sometimes gets in the way of how Malaysia addresses the disease.

“There are people who want to make a political point and are therefore uninterested in the facts,” she says.

The disease, she adds, needs to be treated as a public health issue.

“It is more immoral that we are not doing work to prevent a disease that is preventable.”

Marina also connected the cases of babies being abandoned with risks that can contribute to the HIV problem.

“Obviously, there is no safe sex going on,” she points out bluntly.

Lack of scientific understanding of how the virus spreads also has a bearing on the infection rate or vulnerable groups, according to Monash University Sunway Campus School of Arts and Social Sciences senior lecturer Dr Yeoh Seng Guan.

An inaccurate or wrong understanding can involve people of different religions, educational backgrounds, social classes and ethnic groups, he says.

Dr Yeoh adds that Malaysia is no different from other Asean countries when it comes to HIV infection. There are those who are well-educated or informed through public service announcements or self-education about the causes and vectors of the disease, he notes. “And there are those who are still quite ignorant.”

For him, what makes Malaysia vulnerable to HIV are perceptions that “it only happens to others and not me”, “it is a disease of sinful people” and “it is a disease confined to certain kinds of people.”

“Blaming the LGBT or using them to explain the infection rate in the country is a dangerous myth that needs to be continually addressed through sound empirical and ethical health research,” he says.

“Already, there is data out there collected by various agencies in Malaysia and elsewhere that problematise this kind of stereotypical thinking. HIV is equally at home with heterosexuals and these straight' people have, in many countries, outstripped the LGBT community in terms of infection.

“Stereotyping and scare mongering are not going to help.”

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