Reuters examines how laws, conservative attitudes are hampering efforts to fight HIV/AIDS in Malaysia

Reuters on Thursday examined how some laws and widespread conservative attitudes are hindering efforts to fight the spread of HIV/AIDS in Malaysia, a predominantly Muslim country where high-risk groups are driven "deeper underground" because of the situation.

Soliciting sex work and sodomy are illegal in Malaysia, and the country has heavy punishments for illegal drug use, according to Reuters. In addition, although efforts from some advocates have garnered government support for HIV/AIDS programs and the distribution of condoms and clean needles, "implementation is far from easy," Reuters reports.

Celine Ng, who runs a needle-exchange program, said that her biggest challenge is the police. "Even my staff encounter problems with them. We have the endorsement of the narcotics (authorities) and we give needles, not drugs," she said, adding, "So if they catch our clients with drugs, we can't stop them, but you can't catch those with just needles." Laws make it difficult to distribute condoms to sex workers and men who have sex with men. In addition, oral and anal sex is illegal in all circumstances and is punishable by up to 20 years in prison. Although sex work is not illegal, solicitation is punishable by up to 10 years in prison. Drug trafficking carries a mandatory death sentence, according to Reuters.

People in high-risk groups are "driven underground, so you can't reach them," Adeeba Kamarulzaman, president of the government-supported Malaysian AIDS Council, said. He added, "We have (our) outreach workers getting arrested. They (authorities) raid and catch everyone, we are forever trying to bail out our outreach workers from the lockup, which is a major headache on a day-to-day basis." Injection drug users comprise the largest risk group for HIV in Malaysia and accounted for 65% of the 4,549 new cases recorded in 2007. Malaysia recorded a total of 80,938 people living with HIV at the end of 2007, but many sources say that the actual number of cases could be much higher. "Infections are going up, but surveillance is very poor in Malaysia," Raymond Tai of the Pink Triangle Foundation said, adding, "Many young [MSM] only know of their illness for the first time when they are warded with AIDS. How long have they been positive, how long have they been infectious? It is critical."

There also are concerns that HIV/AIDS is spreading from high-risk groups to women in the general population in the country. High-risk groups do not "exist in isolation," Kamarulzaman said, adding that IDUs "have wives, drug users patronize sex workers, they buy sex, they sell sex." Some groups are attempting to promote HIV/AIDS prevention messages, which can be difficult because advertisements are under government control, according to Reuters. Ads for condoms are not permitted on national television, except in certain circumstances such as promoting use for married couples. Advocates also are stressing that increased action should be taken and that the government should acknowledge the situation and cooperate with nongovernment organizations (Lyn, Reuters, 7/31).