Reaching out to hidden population in Malaysia: MSMs ...

Reaching out to hidden population in Malaysia: MSMs ...

Malaysian AIDS Council Reaching out to hidden population in Malaysia MSMs, Transgenders and Sex Workers in Muslim Majority Setting Where Sex is a Crime Malaysian Population 2018 = 31.2 Million Religion Percentage Ethnic group Percentage Muslim 61.3% Malay

50.1% Buddhist 19.8% Chinese 22.6% Christian 9.2% indigenous 11.8% Hindu 6.3% Indian 6.7%

Overview of HIV Epidemic in Malaysia 2016 Source: HIV/STI Sector, Division of Disease Control, Ministry of Health Malaysia Estimated Population Size HIV Prevalence* (2012) HIV Prevalence* (2014) Injecting Drug Users (IDU) 170,0001 18.9% 16.3% Female Sex Workers 40,0002

4.2% 7.3 % Transgender 20,0002 4.8% 5.6 % Men who have Sex with Men (MSM) 173,0003 7.1% 8.9 % Reid G, Kamarulzaman A, Sran SK. (2007). Malaysia and harm reduction: the challenges and responses. International Journal of Drug Policy. 18,136-40. Population Size Estimates, 2007 2 Lim HE, Ang CL, Teh YK Size Estimation for Local Responses in Malaysia For HIV Prevention in Sex Work, 2010.

3 Based on 1.9% reported through the NHMM III survey * Results from the Integrated Bio-Behavioural Surveillance (IBBS) 2012 , 2014 in NSPEA 2016-2030 1 Sexual transmission is on the rise 4500 4000 3500 HIV CASES BY MODE OF TRANSMISSION, MALAYSIA 2005 - 2016 3000 2500 2000 1500 1000 500 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Injecting Drug Use Sexual Transmission

What is pushing people away? Shariah Law Section 60. Illicit intercourse Section 61. An act preparatory to illicit intercourse Section 62. Muabbad or ghairu muabbad relation Section 63. Liwat (sodomy) Section 64. Musahaqah (lesbianism) Section 65. Sexual intercourse against the order of nature Section 66. Male person posing as a woman Section 67. Indecent acts Section 68. Qazaf (prosecution without witness) Section 69. Prostitution Section 70. Muncikari (pimping) Section 71. Persons living on or trading in prostitution Section 377. Carnal intercourse against the order of nature A British Colonial Rules Stigma and discrimination Public shaming and dehumanizing Hatred and violence Fear mongering Social injustice What is pushing people away?

Maneuvering around Challenges GOVERNMENT NGO PARTNERSHIP Country Coordinating Mechanism Other Agencies and Stakeholders Religious Department, Public Security, Research Centers, other Ministries, SCO, Private Sectors, WHO, Academe MOH -HIV Sector MAC AIDS Department State and District 46 NGOs/CBOs all over Malaysia Government Clinics Community Members Creating an enabling environment An innovative and sustainable approach Case Management Program

PrEP Social Network Non reactive Result Online Outreach Venue Based Outreach HIV Screening/Community Based Testing Reactive Result NegSocial Networkativ e Result Client centered Care 85 Case Workers One of the GF Best Practices

52 Government Clinics Community Friendly Clinics Confirmatory Testing Positive Result Treatment & Care Empowerment/ Treatment Adherence Case Mangement July 2016 - May 2018 16000 57% from Sexual Transmission Group 14000 14214 12000 10000

12.24% 11.22% 58.16% 8000 7665 18.37% 6000 5978 4000 4584 2000 0 3652 3209

2466 1990 822 All KP 303 183 65 PWID Reached Testing SW105 53 Reactive HAART 534 MSM 185

Creating an enabling environment A step towards New Malaysia Eliminating Stigma and Discrimination Collaboration and Partnership Community empowerment Human Rights and Social Justice Acceptance Political will and commitment Terima Kasih Thank You Dank je [email protected] [email protected]

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