Baradan Kuppusamy
KUALA LUMPUR, Jan 4 2009 (IPS) – A raging debate over mandatory HIV screening has exposed fear and ignorance within government, despite years of awareness campaigns to eradicate prejudice against people living with the virus and acquired immune deficiency syndrome (AIDS).
Some high officials have suggested that those with HIV be quarantined at specially constructed camps, or even isolated on islands, to safeguard the general population.
Others are calling for new mandatory rules forcing all Muslim couples, about to tie the knot, to be tested for HIV status before being allowed to marry. They also want rules to bar infected couples from having sex or having babies.
There have even been calls for mandatory screenings for all Malaysians, irrespective of race of religion.
Muslim clerics have already announced that limited mandatory testing for HIV would be extended nationally to cover all Muslim couples from Jan. 1, 2009.
Despite protests from HIV/AIDS experts and civil rights activists who say mandatory screening is a serious violation of individual rights and does not prevent spread of the disease, the government intends to widen the mandatory screening rule to all Malaysian couples.
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This is because numerous non-Muslim organisations, individuals and religious bodies argue that the spread of the HIV infection can be curbed only if mandatory testing is extended to all couples.
Deputy Prime Minister Najib Razak, who announced last month that all Muslim couples would have to undergo mandatory HIV screening before they are allowed to marry, is in favour of extending the measure to non-Muslims on a voluntary basis.
Najib received strong official and public support for ordering mandatory testing, including from a senior opposition leader who went further to say couples having HIV should not be allowed to marry or have children.
I think it is a gross error to allow somebody very sick like that, an HIV carrier, to marry, said Mohammad Nizar of the pro-Islamic PAS party who is chief minister of northern Perak state.
If there s any breeding sorry for having to use that word the embryo will also carry the same virus. It s very unjust to the child, Nizar told local newspapers, demanding immediate mandatory testing.
The issue has revealed a deep gulf in thinking in this multiracial nation of about 27 million people. AIDS activists have slammed official attitudes that they say are stigmatising and isolating people with the HIV/AIDS.
They are being treated like people with the plague it is tragic that despite so much public campaigning about HIV and against discrimination, officials and ordinary people remain ignorant, said civil rights activist Irene Fernandez who runs an HIV/AIDS helpline.
Fear and ignorance are driving the demands to isolate, to quarantine and to order mandatory testing, Fernandez told IPS. The government should not be making such choices for people.
After so many years of HIV/AIDS education people have such views and attitudes, she said, adding that such views were frightening.
Ironically, the debate comes as Malaysian officials report a halving of HIV infections in recent years after introducing harm reduction methadone treatment and launching a campaign to curb needle sharing by distributing free needles.
Due to strong protests from clerics both methods were introduced in a controlled manner and its application limited.
However, those gains were offset by a significant 35 percent rise in infections among married women between the ages 21 to 35 a new trend that has alarmed the government.
A newly released report brought out by the Ministry of Health (MoH) and the United Nations Children s Fund (UNICEF), Women and Girls Confronting HIV and AIDS in Malaysia , reveals that infections among married women through sex increased from five percent of total cases in 1997 to 16 percent in 2007.
Kedah, Terengganu and Kelantan, on the eastern coast of the peninsula and overwhelmingly Muslim-Malay, recorded the highest numbers of infected housewives.
While the government has ordered an in-depth study into the new trend, experts are attributing it to husbands catching the infection through unsafe sex with sex-workers and passing it on to their wives.
They blame an uncontrolled and unrestricted proliferation of massage parlours, which are undisguised fronts for prostitution, as a key reason.
According to United Nations figures, more than 82,500 Malaysians have been infected with the virus since records began in 1986 and, while precise data is hard to obtain, around 80,000 people are currently living with HIV/AIDS.
The number of new HIV infections is falling, however.
Last year, 5,400 new cases were reported compared to 6,900 the year before, the MoH says a figure expected to drop further in 2009 to nearly 3,500. Malaysian AIDS Council president Prof. Adeeba Kamarulzaman opposes any move to introduce mandatory testing, saying such methods reflect ignorance and lack of understanding of the disease and its effect on individuals.
She has written extensively in the local media opposing mandatory testing and condemning quarantine and isolation and giving facts and reasons why people with HIV can live a normal life despite carrying the virus.
People should not fear those living with HIV. They are normal and live normal lives, have careers and must be allowed to marry and have safe sex, the physician told IPS. The reactions and proposals show there is a lack of education about the latest developments in treating HIV/AIDS.
People with HIV and their families see infection as a death sentence, said a medical expert doing research on HIV infection among rural farmers who asked not to be named. There is a lot of ignorance. People see having HIV as an immediate death sentence. They don t know that with proper treatment and monitoring an infected person can live a normal life. In the West attitudes have changed with new knowledge even our neighbour, Thailand, has progressed but we have not, he said, blaming lack of open discussions, religious inhibition and official denial as reasons for the abysmal attitudes towards people with HIV/AIDS.
According to the MoH-UNICEF report, in 2006, when a survey on knowledge, attitudes and risk behaviour was conducted respondents seemed to understand the nature of HIV and AIDS and the common routes of HIV transmission.
But, the report said, there were difficulties in translating this knowledge into behavioural change with socio-cultural and religious factors coming into play.
