HIV/AIDS In Malaysia

Malaysia is home to one of the fastest growing AIDS epidemics in the East Asia and Pacific region with its current rate of HIV infections doubling every three years. People living with HIV represent all sectors of society, but the disease hits four groups hardest: injecting drug users, sex workers, their clients and partners, and men who engage in risky sex with men.

Between the first detected case in 1986 and June 2008, 82,704* people have been infected with HIV while 10,783* have died of AIDS. These statistics suggest that an average of 16 people test positive for the virus each day.

Malaysia’s epidemic is largely dominated by injecting drug users who make up about 72% of total cases. There is concern however that heterosexual transmission is on the rise. The proportion of women reported with HIV has increased dramatically in the last decade from 4% of new cases in 1995 to 15% of new cases in 2006. Surveys show that in 2006, more housewives tested HIV-positive than sex workers. At the same time, the percentage of babies born with HIV has also increased from 0.2% in 1991 to 1.4% in 2006.

As in most parts of the world, young people in Malaysia account for an increasing number of HIV infections every year. December 2006 statistics from the Ministry of Health reveal that 36% of infections are amongst people aged between 13 to 29 years old. It is likely that people infected with HIV before the age of 30 were infected in their twenties and sometimes even during their teens.

Gender inequity, stigma, discrimination, silence, denial and ignorance fuel the epidemic in Malaysia.

* Source: Ministry of Health, Malaysia

The History of HIV – HIV TimeLine

In July 1981, the New York Times reported an outbreak of a rare form of cancer among gay men in New York and California, first referred to as the “gay cancer”; but medically know as Kaposi Sarcoma. About the same time, Emergency Rooms in New York City began to see a rash of seemingly healthy young men presenting with fevers, flu like symptoms, and a pneumonia called Pneumocystis. About a year later, the CDC (Centers for Disease Control) link the illness to blood and coins the term AIDS (Acquired Immune Deficiency Syndrome). In that first year over 1600 cases are diagnosed with close to 700 deaths.

As the number of deaths soared, medical experts scrambled to find a cause and more importantly a cure. In 1984, Institut Pasteur of France discovered what they called the HIV virus, but it wasn’t until a year later a US scientist, Dr. Robert Gallo confirmed that HIV was the cause of AIDS.

Following this discovery, the first test for HIV was approved in 1985. Over the next several years medications to combat the virus were developed as well as medicines to prevent infections that flourish when the immune system is damaged by HIV and AIDS. By the end of 1987, there were 71,000 confirmed cases of AIDS, resulting in over 40,000 deaths.

So where are we today? Thanks to an ever-changing array of new anti-retroviral drugs and improved funding for early medical care, AIDS related deaths in the US are declining. People are healthier and living longer. But, in other parts of the world, the AIDS epidemic rages on. Some estimate that 40 percent of persons in the sub-Sahara region of Africa are HIV infected. Many of these people don’t realize they are infected, resulting in the infection of others, adding to the spread of the disease. Another grim reminder of the epidemic is the number of African children orphaned by AIDS. Streets are clogged with children who have lost their parents to AIDS, have no food, and no place to go. And with no money available for expensive HIV drugs, the epidemic is expected to get much worse, with estimates of 20,000,000 infected over the next 5 years.

HIV Around the World

Could anyone have foreseen that the mysterious illness affecting a few gay men in 1981, would become the epidemic of the 20th. century? We have made much progress, but still so much needs to be learned. Until then the epidemic continues.

HIV/AIDS Worldwide Statistics

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How HIV is Transmitted

HIV is only transmitted from HIV infected humans to other humans, but not as easily as the influenza virus or the tuberculosis bacillus, which can be passed to others through the air, by coughs or sneezes, for example (droplet infection). HIV infection can only occur if bodily fluid containing the virus comes into contact with mucous membranes or broken skin, or reaches the blood directly (Trojan horse). HIV cannot penetrate the stratum corneum, the skin’s horny outer layer.

HIV is present in various body fluids. Blood, semen and vaginal secretions contain very large amounts of the virus. Smaller amounts have been identified in saliva, breast milk, tears and urine. But HIV has not been found in sweat.

Routes of Transmission

Sexual intercourse The HIV infection is primarily a sexually transmitted disease. Transmission occurs via the sperm, as well as the vaginal secretions. A single sexual act with an HIV infected person can suffice to become infected. The danger of infection can also not be excluded in oral sex and so-called “French kissing” (deep kissing).

Drugs With the sharing of HIV-contaminated syringes and needles (syringe swapping) injecting drug addicts are particularly at risk.

Mother-child transmission An HIV positive mother can infect her baby during pregnancy, during the birth or during breastfeeding (via the milk). The incidence of infection is around some 20–30%; this can be markedly reduced by AZT therapy.

Blood transfusions and organ transplants In all industrialised countries blood and organ donors are tested for a possible HIV infection . The residual risk of failing to detect an infection in the donor is extremely low.

Rare routes of transmission In addition to the aforementioned, routes of transmission there are also very rare routes which, though just as tragic, are of little significance epidemiologically. These include tattoos, bite wounds, transmission of the virus from an infected surgeon to a patient, and so on.

No Risk of Infection

  • In everyday life: buses, LRT, school, toilets etc.
  • Skin contact: shaking hands or stroking, kissing on the cheek
  • Sports: swimming, ball games
  • Eating: in a restaurant
  • Sexuality: there is no risk of infection in an amorous relationship where both partners remain true (provided that neither of the partners is exposed to non sexual infection risks)

It is naturally a precondition that the customary rules of hygiene are observed, and that no contact with open wounds occurs.

Ways to Protect against an HIV Infection

Since no protective inoculation (serum) or curative drugs are available in the foreseeable future, prevention by means of the safest possible behaviour is of decisive importance.

  • Faithfulness In a faithful love relationship between two non-infected partners an infection with HIV is excluded.
  • Careful choice of partners Today, the risk of an HIV infection is present in any new sexual relationship. For this reason it is particularly important to choose one’s partner with great care. Only if the partner is not infected is transmission completely excluded. The fewer sexual partners one has, the lower the risk of becoming infected.
  • HIV test If one of the two partners could have become infected with HIV at an earlier date, an infection could, with virtual certainty, be excluded or confirmed by means of an HIV test.
  • Condom if a sexual partner is HlV-infected, the use of a condom can reduce, but not completely exclude, the risk of HIV transmission. In view of the fatal nature of the disease AIDS, even with state-controlled condoms there remains a non-negligible residual risk factor of several percent. Young people in particular often have little or no experience with condoms, so that the danger of incorrect application is considerable.
  • Abstinence from drugs Drugs and alcohol dull the consciousness of reality and responsibility, as well as weakening one’s powers of judgement and self-control, thus leading to overhasty and, frequently, unprotected sexual contacts. Abstinence from drugs is, therefore, an important factor in AIDS prevention.

On getting to know a new partner: careful choice of partner, the HIV test and condoms are the three measures with which one can exclude or reduce the risk of HIV infection. Combined they are all the more effective.

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