The first cases of HIV and AIDS in South East Asia were reported in the 1980s, and since then countries have been experiencing concentrated epidemics affecting key populations. There has been a dramatic reduction in new cases reported as major advances have been made in treatment therapies and the scale-up of prevention.
Malaysia fits this pattern, with 112,000 reported cases of HIV in 2016. Dr Susan Chong, a lecturer in the Department of Public Health at La Trobe University, believes that although Malaysia has made significant progress managing the epidemic, particularly among people who inject drugs, strategies are needed to tackle the rise in HIV cases through sexual transmission.
“Any money spent on HIV is needed, but the majority of the HIV budget is allocated to the broad area of treatment,” says Dr Chong. This leaves the small remainder for prevention, particularly to stem sexual transmission.”
Dr Chong has worked in the field of HIV and AIDS for more than 25 years, and had previously coordinated an Asia Pacific network of non-government organisations. Her current research is focused on hepatitis C treatment, HIV policy and advocacy for those living with the disease.
“Unfortunately, the Malaysian public associates HIV with illicit and illegal behaviors. This is fueled by sensationalised media coverage of law enforcement raids on brothels, gay venues or rounding up drug users,” says Dr Chong. “The threat of arrest causes considerable worry among marginalised populations and the community workers who work with these groups. It drives them underground, and makes it a challenge to reach out to them and discuss HIV prevention and treatment.”
Dr Chong is working with Professor Adeeba Kamarulzaman from the University of Malaya to research what causes the delay in treatment seeking among people living with HIV. A preliminary survey has been conducted, with the aim to further extend it throughout Malaysia.
“A very high percentage of people living with HIV are not presenting to hospitals in time to be effectively treated,” says Dr Chong. “By understanding their motivation we can start to encourage people who are at risk to test for HIV, and if infected, to start anti-retroviral treatment.”