Navigating HIV avoidance policy and Islam in Malaysia: contention, reconciliation or compatibility? Findings from in-depth interviews among key stakeholders

Abstract

Background

Malaysia is a society that is multicultural predominantly consists of a Muslim bulk population , where Islam is influential. Malaysia has a concentrated HIV epidemic amongst risky teams, such as for example, Intravenous Drug Users (IVDU), intercourse workers, transgender people that have sex with Men (MSM). The aim of this study would be to know how Islam forms HIV prevention methods in Malaysia by interviewing the 3 key stakeholder groups recognized as being influential, specifically the Ministry of Health, Religious leaders and folks managing HIV.

Techniques

Thirty-Five in depth semi organized interviews had been undertaken with spiritual leaders, Ministry of health insurance and individuals managing HIV within the last 50 % of 2013 utilizing purposive sampling. Interviews honored a subject guide, had been audiotaped, and transcribed verbatim and analyzed utilizing a framework analysis.

Outcomes

Themes including the need for Islam to wellness, stakeholder relationships and views on HIV avoidance emerged. Islam ended up being seen to rela pivotal part in shaping techniques associated with HIV avoidance in Malaysia both straight and indirectly. Stakeholders usually held different ways to HIV avoidance, which needed to be sensitively considered, with some favouring promotion of Islamic maxims, whilst other people steering towards a far more general public health approach that is centred.

Conclusions

The analysis implies that Islam certainly plays an role that is important shaping wellness policies and methods associated with HIV prevention in Malaysia. Definitely, stakeholders do hold differing viewpoints, such as for example stances of exactly what comprises the approach that is right HIV avoidance. nonetheless there’s also regions of broad opinion, including the value in Islamic tradition to stop damage and condition, which is often crafted into existing and future HIV prevention techniques in Malaysia, plus the wider world that is muslim.

Background

Malaysia is a society that is multicultural made up of a Muslim bulk populace where Islam is influential in moulding policies, including those who relate with wellness, sexuality and HIV [1]. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as for example Intravenous Drug Users (IVDU), intercourse workers, transgender gents and ladies that have intercourse with guys (MSM), with a shift to sexual transmission[2] that is predominating. The demography of HIV in Malaysia is comparable to other nations documented when you look at the Southern East Asian area, in addition to those in the Muslim World, like the center East and North Africa, that have focused epidemics in high-risk teams such as for instance amongst MSM [3]. Amongst MSM, there’s been compelling proof of the necessity to concentrate on this key group [4], where usually social, social along with other structures render this team susceptible to acquiring HIV. A term used to describe sexual activity under the influence of drugs [5] in Asia the prevalence of HIV amongst MSM is rising often associated with practices such as‘chem’ sex.

In Malaysia, regardless of the price of HIV transmission from male to male sex being 19 percent, only 0.2 percent of this total HIV avoidance spending plan had been allotted to MSM development [6]. Particular biological factors such as for instance unprotected anal that is receptive with internal ejaculation within the MSM community [7], in addition to spiritual and social facets may imply that MSM are less inclined to be concerned in prevention programmes for concern about being learned to be gay.

Intercourse employees may also be susceptible to HIV in Malaysia with an increase of prevalence of HIV among this group [8] within a context where intercourse tasks are unlawful. Transgender females have actually a higher chance of acquiring HIV globally, be involved in high risk receptive rectal intercourse and they are put at a higher burden of danger including stigma and discrimination in healthcare settings just as one hindrance for accessing prevention and therapy [9]. In Malaysia, the prevalence of HIV among transgender females is 5.6 percent, even though this might be an underestimation [10], with present documentations of peoples legal rights punishment inside the grouped community[11]. Women can be more in danger of acquiring HIV as a result of social, social and economic facets, making little space to negotiate safe intimate techniques. In addition, as a result of forbiddance that is strong of relations in Islam, males who possess intercourse with guys in Malaysia face social pressures and might frequently have a wife or gf with who they’ve sexual relations.

Malaysia has made great progress in terms of damage reduction, a strategy utilized in the context of HIV prevention amongst IVDU, by applying needle trade and has now shown great leadership in this area [12]. Nonetheless, this too must be very carefully navigated to garner support through the imams, using maxims associated with the ‘lesser and greater harm’ within the face of rising HIV amounts, which now is becoming prevalent. Notwithstanding, although great strides have already been made in harm decrease amongst IVDU, utilising Islamic maxims of conservation of life, the cannot that is same stated of avoidance of HIV attributed through sexual transmission [13], that has been considerably underfunded in contrast [14]. There’s been considerable Islamic engagement in Malaysia with respect to tackling HIV, both in terms of sensitizing imams to HIV, using Islamic maxims also spiritual frontrunner participation in instigating premarital HIV tests for Muslim partners. Nonetheless advertising of other HIV prevention measures, such as for instance condom usage and cultivating an enabling environment is more difficult considering the fact that most of the tasks of high-risk teams in danger of HIV are forbidden in Islam and so tough to get together again because of the norm of present HIV prevention techniques into the world that is non-Muslim. The same cannot be said of religion [16] while there is ever increasing interest in how culture affects health [15]. Even though there is significant information and research concerning HIV in Malaysia, there clearly was hardly any associated with HIV in Malaysia and Islam, with a gap of knowledge associated with just how Islam affects HIV prevention policies in Malaysia. There clearly was a pressing need certainly to critically analyse exactly how perceptions of Islam actually affect HIV prevention policy in Malaysia, from a neutral, general public wellness perspective, cognisant of and responsive to the Islamic and governmental context. Therefore, the primary goal associated with research is always to know how Islam really and practically shapes HIV prevention strategies in Malaysia. This research plays a part in understanding HIV that is regarding amongst in Malaysia additionally the wider Muslim World, with a view to making tangible suggestions for policy and training.

Techniques

Navigating HIV avoidance policy and Islam in Malaysia: contention, reconciliation or compatibility? Findings from in-depth interviews among key stakeholders

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