AIDS in Malaysia

Abstract

Like many countries in the region, Malaysia’s HIV epidemic has been predominantly driven by injecting drug use although latterly heterosexual transmission and transmission amongst MSM have been on the rise. The estimated adult prevalence of HIV infection is 0.4% with the last few years seeing a significant trend in the percentage of women becoming infected with women and girls making up almost 25% of newly reported HIV infections nationwide by the end of 2006. The estimated HIV prevalence amongst injecting drug users who are predominantly male range from 16–40% with continuing high rates of needle sharing and low usage of condom during sexual interactions. Scaling up HIV prevention in Malaysia remains a significant challenge due to the existence of legislative and socio-cultural barriers. Nonetheless in recent years, harm reduction programs have become possible including the piloting of methadone maintenance and needle exchange programs. Efforts at scaling up both these programs nationwide are currently underway. On the treatment front, Malaysia took the bold step of issuing compulsory licensing in 2001 and together with direct negotiation with pharmaceutical companies saw a marked decrease in the cost of many antiretroviral agents. This enabled free access to first line HAART therapy to those infected since. Nevertheless a large proportion of those eligible to treatment remain untreated due to various factors including poorer access in rural areas and the pervasive stigma and discrimination that prevents many from coming forward for medical care. In conclusion, although significant progress has been made in the country’s response to HIV/AIDS, scaling up prevention, treatment and care to meet Universal Access goals remain a challenge in this country.