exudates and Acquired-Immunodeficiency-Syndrome

Topics: Acquired Immunodeficiency Syndrome; Cambodia; China; HIV-1; Humans; India; Malaysia; Prevalence; Taiwan; Thailand; Vietnam

HIV/AIDS is one of the most serious problems in many parts of the world, and is a high priority for health managers and decision-makers. The aim of the qualitative part of this study will be to develop a mobile SMS (short messaging services) counselling intervention to prevent HIV/AIDS, while the quantitative part will be to test the effectiveness of a mobile SMS counselling intervention to improve the knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS.. A mixed methods approach will be used. Qualitative part: Design: focus group discussions (FGDs) will be conducted.. Hospital/NGOs in Terengganu, Malaysia.. Three FGDs will be conducted with male and female HIV/AIDS patients, and one group of local community leaders. One FGD will be conducted for each group. Three in-depth interviews (IDIs) will be conducted with patients who had HIV/AIDS, of which one will be female. Quantitative part: Design: a cluster randomized clinical trial with 384 HIV/AIDS patients in Terengganu, Malaysia.. Mobile SMS counselling intervention for patients concerning the prevention of HIV/AIDS.. The main outcomes of this study will be the differences in knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS between the baseline and immediate follow-up after the intervention, and after 3 months.. The mobile based SMS counselling intervention developed will be effective in improving the knowledge, attitude, and practices of patients concerning HIV/AIDS prevention in Terengganu, Malaysia.. Thai Clinical Trials Registry, TCTR20200212001; 7/02/2020.

Topics: Acquired Immunodeficiency Syndrome; Counseling; Female; Focus Groups; Health Knowledge, Attitudes, Practice; HIV Infections; Hospitals; Humans; Malaysia; Male; Organizations; Program Evaluation; Qualitative Research; Text Messaging

Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART).. Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.. A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.. The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.. Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Antiretroviral Therapy, Highly Active; Cell Phone; Distance Counseling; Female; Humans; Malaysia; Male; Middle Aged; Patient Compliance; Peer Group; Telemedicine; Treatment Outcome

To aid public health policymaking, we studied the cost-effectiveness of buprenorphine, naltrexone, and placebo interventions for heroin dependence in Malaysia.. We estimated the cost-effectiveness ratios of three treatments for heroin dependence. We used a microcosting methodology to determine fixed, variable, and societal costs of each intervention. Cost data were collected from investigators, staff, and project records on the number and type of resources used and unit costs; societal costs for participants' time were estimated using Malaysia's minimum wage. Costs were estimated from a provider and societal perspective and reported in 2004 US dollars.. Muar, Malaysia.. 126 patients enrolled in a randomized, double-blind, placebo-controlled clinical trial in Malaysia (2003-2005) receiving counseling and buprenorphine, naltrexone, or placebo for treatment of heroin dependence.. Primary outcome measures included days in treatment, maximum consecutive days of heroin abstinence, days to first heroin use, and days to heroin relapse. Secondary outcome measures included treatment retention, injection drug use, illicit opiate use, AIDS Risk Inventory total score, and drug risk and sex risk subscores.. Buprenorphine was more effective and more costly than naltrexone for all primary and most secondary outcomes. Incremental cost-effectiveness ratios were below $50 for primary outcomes, mostly below $350 for secondary outcomes. Naltrexone was dominated by placebo for all secondary outcomes at almost all endpoints. Incremental treatment costs were driven mainly by medication costs, especially the price of buprenorphine.. Buprenorphine appears to be a cost-effective alternative to naltrexone that might enhance economic productivity and reduce drug use over a longer term.

Topics: Acquired Immunodeficiency Syndrome; Buprenorphine; Cost-Benefit Analysis; Heroin Dependence; Humans; Malaysia; Naltrexone; Risk Factors; Risk-Taking; Treatment Outcome

The aim of this study was to investigate the knowledge, attitudes and behaviour of university students regarding acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV).. A randomised controlled trial of 530 university students was done using peer-adult facilitators. Participants completed a questionnaire before and after the intervention, which was a four-hour group session. A prevention programme was developed by local experts, health educators and peer facilitators. The peer-adult-led programme was designed to provide a conceptual model of HIV risk reduction through information, motivational and behavioural skills, a harm reduction module and health promotion theme.. The main outcome measured was the level of knowledge, attitudes and behaviour scores. The results suggest that relative to the control group, participants in the intervention group had higher levels of knowledge (30.37 vs. 25.40; p-value is 0.001) and a better attitude (12.27 vs. 10.84; p-value is 0.001). However, there was no difference in the behavioural score (9.47 vs. 9.41; p-value is 0.530). The correlation between the level of knowledge and age and the level of education was found in the intervention group, but not in the control group (p-value is 0.01). Attitude and gender were found to be correlated in the intervention group only (p-value is 0.01).. Our programme was successful in increasing knowledge and improving attitudes towards AIDS and HIV. However, it did not improve risk-taking behaviour. Peer-adult-led educational programmes for youth using various interactional activities, such as small group discussions, poster activity and empathy exercises, can be successful in changing the prevailing youth perceptions of AIDS and HIV.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adolescent Behavior; Adult; Health Education; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Outcome Assessment, Health Care; Peer Group; Risk Factors; Risk-Taking; Students; Substance Abuse, Intravenous

The growth in mobile technology access, utilization, and services holds great promise in facilitating HIV prevention efforts through mobile health (mHealth) interventions in Malaysia. Despite these promising trends, there is a dearth of evidence on the use of mHealth platforms that addresses HIV prevention among Malaysian men who have sex with men.. The goal of this study was to gain insight into (1) access and utilization of communication technology (eg, landline phone, internet, mobile phone), (2) acceptability of mHealth-based interventions for HIV prevention services, and (3) preferences regarding the format and frequency of mHealth interventions among Malaysian men who have sex with men.. We conducted a cross-sectional survey with Malaysian men who have sex with men between July 2018 and March 2020. Participants were recruited using respondent-driven sampling in the Greater Kuala Lumpur region of Malaysia. We collected information on demographic characteristics, HIV risk-related behaviors, access to and the frequency of use of communication technology, and acceptability of using mHealth for HIV prevention using a self-administered questionnaire with a 5-point scale (1, never; 2, rarely; 3, sometimes; 4, often; 5, all the time).. A total of 376 men participated in the survey. Almost all respondents owned or had access to a smartphone with internet access (368/376, 97.9%) and accessed the internet daily (373/376, 99.2%), mainly on a smartphone (334/376, 88.8%). Participants on average used smartphones primarily for social networking (mean 4.5, SD 0.8), followed by sending or receiving emails (mean 4.0, SD 1.0), and searching for health-related information (mean 3.5, SD 0.9). There was high acceptance of the use of mHealth for HIV prevention (mean 4.1, SD 1.5), including for receiving HIV prevention information (345/376, 91.8%), receiving medication reminders (336/376, 89.4%), screening and monitoring sexual activity (306/376, 81.4%) or illicit drug use (281/376, 74.7%), and monitoring drug cravings (280/376, 74.5%). Participants overwhelmingly preferred a smartphone app over other modalities (eg, text, phone call, email) for engaging in mHealth HIV prevention tools. Preference for app notifications ranged from 186/336 (53.9%), for receiving HIV prevention information, to 212/336 (69.3%), for screening and monitoring sexual activity. Acceptance of mHealth was higher for those who were university graduates (P=.003), living in a relationship with a partner (P=.04), engaged in sexualized drug use (P=.01), and engaged in receptive anal sex (P=.006).. Findings from this study provide support for developing and deploying mHealth strategies for HIV prevention using a smartphone app in men who have sex with men-a key population with suboptimal engagement in HIV prevention and treatment.

Topics: Acquired Immunodeficiency Syndrome; Biomedical Technology; Cross-Sectional Studies; HIV Infections; Homosexuality, Male; Humans; Malaysia; Male; Sexual and Gender Minorities; Sexual Behavior; Substance-Related Disorders; Surveys and Questionnaires; Technology; Telemedicine

The HIV epidemic is fueled by poverty; yet, methods to measure poverty remain scarce among populations at risk for HIV infection and disease progression to AIDS in Malaysia. Between August and November 2020, using data from a cross-sectional study of people who use drugs, (PWUD), transgender people, sex workers and men who have sex with men, this study examined the reliability and validity of a material security scale as a measurement of poverty. Additionally, we assessed factors associated with material security scores. We performed confirmatory factor analysis (CFA) for 268 study participants included in the analysis. A revised nine-item three-factor structure of the material security scale demonstrated an excellent fit in CFA. The revised material security score displayed good reliability, with Cronbach's alpha of 0.843, 0.826 and 0.818 for housing, economic resources and basic needs factors, respectively. In a subsequent analysis, PWUD and transgender people were less likely to present good material security scores during the pandemic, compared to their counterparts. The revised nine-item scale is a useful tool to assess poverty among key populations at-risk for HIV/AIDS with the potential to be extrapolated in similar income settings.

Topics: Acquired Immunodeficiency Syndrome; COVID-19; Cross-Sectional Studies; HIV Infections; Homosexuality, Male; Humans; Malaysia; Male; Pandemics; Poverty; Reproducibility of Results; Sexual and Gender Minorities; Transgender Persons

Health-related quality of life (HRQoL) is increasingly recognized as an important outcome and as a complement to traditional biological end points of diseases such as mortality. Unless there is a complete cure available for HIV/AIDS, development and implementation of a reliable and valid cross cultural quality of life measure is necessary to assess not only the physical and medical needs of HIV/AIDS people, but their psychological, social, environmental, and spiritual areas of life.. A qualitative exploration of HIV/AIDS patients' understanding, perceptions and expectations will be carried out with the help of semi structured interview guide by in depth interviews, while quantitative assessment of patient reported adverse drug reactions and their impact on health related quality of life will be carried out by using data collection tool comprising patient demographics, SF-12, Naranjo scale, and a clinical data sheet.. The findings may serve as baseline QOL data of people living with HIV/AIDS in Malaysia and also a source data to aid construction of management plan to improve HIV/AIDS patients' QOL. It will also provide basic information about HIV/AIDS patients' perceptions, expectations and believes towards HIV/AIDS and its treatment which may help in designing strategies to enhance patients' awareness which in turn can help in addressing issues related to compliance and adherence.

Topics: Acquired Immunodeficiency Syndrome; Antiretroviral Therapy, Highly Active; Cross-Sectional Studies; Female; HIV Infections; Humans; Malaysia; Male; Patient Safety; Qualitative Research; Quality of Life; Research Design; Surveys and Questionnaires

Abstract. This paper examines the effectiveness of media in public awareness of the HIV/AIDS issue among the public in an area in central Selangor, comprising Kuala Lumpur and its surroundings and suburbs in Malaysia. Cross-sectional survey questionnaires were distributed to 384 respondents about accessing the public awareness of modes of HIV transmission, perceptions and attitudes towards people living with HIV/AIDS, as well as people's understanding about government policies to curb HIV/AIDS. Health care practitioners and newspapers were the preferred sources of information seeking on HIV/AIDS among the public. Most of the respondents were aware of the modes of HIV transmission. However, they were some respondents who still have misconceptions about the modes of transmission. Most of the respondents were not aware about the government's significant policies to address HIV/AIDS in the region. Overall, the respondents had certain knowledge about HIV transmission modes and moderate positive perceptions and attitudes towards people living with HIV/AIDS. Future studies should be conducted to examine about who sets the agenda in the media, and apart from gatekeepers, who are the real decision makers in deciding what is important to inform the public.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Communicable Diseases; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Health Policy; HIV Infections; Humans; Malaysia; Male; Mass Media; Public Opinion; Surveys and Questionnaires; Young Adult

Topics: Acquired Immunodeficiency Syndrome; Australia; Drug Users; Female; Harm Reduction; HIV Infections; Homosexuality, Female; Homosexuality, Male; Humans; Injections; Malaysia; Male; Prisons

Medical students are future doctors who are trained to treat all kind of diseases including people living with HIV/AIDS (PLWHA) without prejudice. This study was to determine the factors associated with knowledge on HIV/AIDS and stigma towards PLWHA among medical students.. This was a cross sectional study with stratified random sampling conducted in a public university, Malaysia. The participants were preclinical-year (year 1 and year 2) and clinical-year (year 3 and year 4) medical students. Simple randomisation was carried out after stratification of medical students into preclinical and clinical-year. The selfadministered questionnaires were consisted of sociodemographic data, items assessing HIV/AIDS knowledge and items assessing stigmatisation attitudes towards PLWHA.. We had 100% response rate of 340 participants. Pre-clinical and clinical year medical students each contributed 170 (50%). Majority was female (64.1%). About two-thirds (60.6%) was Malay, followed by Chinese (31.2%) and Indian (7.1%). Pre-clinical students were significantly more stigmatizing in subscale of "attitudes towards imposed measures" (t=3.917, p<0.001), even with adjustment for previous encounter and ethnicity (B= 1.2, 95% CI 0.48 to 1.83, p=0.001). On the other hand, clinical students were found to be significantly less comfortable in handling HIV/AIDS cases (t=0.039, p=0.039), even after controlled for previous encounter and ethnicity (B=0.6, 95% CI 0.29 to 0.98, p< 0.001).. Clinical encounter with PLWHA was associated with higher knowledge in HIV/AIDS. Medical students in preclinical years were having stigmatizing attitude towards imposed measures compared to the clinical years who had more stigmatizing attitude in being less comfortable with PLWHA.

Topics: Acquired Immunodeficiency Syndrome; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Students, Medical

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) presents a serious healthcare threat to young individuals in Malaysia and worldwide. This study aimed to identify trends in HIV-related risk behaviors among recognized high-risk groups and to estimate HIV transmission up to the year 2015. Data and necessary information were obtained from the Ministry of Health Malaysia, published reports from the World Health Organization and United Nations Program on HIV/AIDS, and other articles. The Estimation and Projection Package was used to estimate HIV transmission. The results of the present study revealed that within the high-risk groups, intravenous drug users (IDUs) had the highest prevalence rate of HIV transmission, followed by patients with sexually transmitted infections (STIs), female sex workers (SWs), and men who have sex with men (MSM). Within these at-risk populations, patients with STIs have the highest prevalence of HIV, followed by IDUs, MSM, and SWs. If the transmission rate continues to increase, the situation will worsen; therefore, there is an urgent need for a comprehensive prevention program to control HIV transmission in Malaysia.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Disease Transmission, Infectious; Female; Humans; Incidence; Malaysia; Male; Middle Aged; Prevalence; Sexual Behavior; Substance Abuse, Intravenous; Young Adult

This retrospective study was conducted among 59 HIV/AIDS patients with opportunistic infections admitted to the University Malaya Medical Centre between 2000 and 2009. Fifty-five point nine percent of cases were Chinese, 25.4% were Malays, 11.9% were Indians and 6.8% were of unknown ethnic origin. The male:female ratio was 2.9:1 (44 males and 15 females). The highest prevalence (38.9%) occurred in the 30-39 year old age group. Men comprised 47.7% and women 53.3%; the majority of both were married. The majority of cases were Malaysians (89.8%) and the rest (10.2%) were immigrants. Most of the patients (18.6%) were non-laborers, followed by laborers (11.9%), the unemployed (5.1%) and housewives (3.4%). The most common risk factor was unprotected sexual activity (20.3%). The two most common HIV/AIDS related opportunistic infections were Pneumocystis carinii (jirovecii) pneumonia (PCP) (62.7%) and toxoplasmosis (28.8%). Seventy-two point nine percent of patients had a CD4 count <200 cells/microl and 5.1% had a CD4 count >500 cells/microl. Eleven point nine percent of cases died during study period. A low CD4 count had a greater association with opportunistic infections. Most of the patients presented with fever (44.1%), cough (42.4%) and shortness of breath (28.8%). Detection of the etiologic pathogens aids clinicians in choosing appropriate management strategies.

Topics: Academic Medical Centers; Acquired Immunodeficiency Syndrome; Adult; Age Distribution; Aged; AIDS-Related Opportunistic Infections; CD4 Lymphocyte Count; Comorbidity; Emigrants and Immigrants; Female; Health Behavior; HIV Infections; Humans; Malaysia; Male; Middle Aged; Pneumonia, Pneumocystis; Retrospective Studies; Risk Factors; Sex Distribution; Socioeconomic Factors

The transition of drug policy from prohibition to harm reduction has never been easy. The deeply entrenched belief in prohibition shared by policy makers and religious leaders provided little room for alternatives, and change came only slowly. The non-governmental organisations (NGOs) in Malaysia played a pivotal role in effecting such a change. Understanding how they did so may be instructive for other similarly placed countries.. Data collected via reviews of published secondary sources, media reports and in-depth interviews with pioneers of harm reduction drawn from NGOs, medical practitioners and the police were analysed to construct the paper.. The policy change was the outcome of competition between three groups in the drug policy subsystem--the state, the Muslim religious lobby and the NGOs. Developments such as the poor outcomes from the prohibition programmes and the outbreak of HIV/AIDS did not change policy but did lead to a rethink of core beliefs in the state alliance and spawned a state-NGO partnership. The subsequent failure to meet the Millennium Development Goal with respect to HIV/AIDS in 2005 was seen as a failure of the Health Ministry which then led the final charge for a policy change arguing that a health crisis was imminent. The NGOs played a pivotal role in this process by educating their partners in the state coalition, by drawing academics and medical practitioners into advocacy and by engaging the religious lobby (albeit with varying success). They were also frontline players in implementing harm reduction programmes and successfully deflected criticisms from unconvinced Islamic groups away from the state.. Given their central role in the needle-syringe exchange programme, the NGOs are well positioned to convince injecting drug users to opt for voluntary medical treatment. This can potentially reduce both the harm from drug use and the prevalence of it.

Topics: Acquired Immunodeficiency Syndrome; Harm Reduction; Health Plan Implementation; Health Policy; HIV Infections; Humans; Islam; Malaysia; Needle-Exchange Programs; Organizations; Public Opinion; Public-Private Sector Partnerships; Substance Abuse, Intravenous

The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use.. This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers.. Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded.. Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p = 0.021, r(s) = 0.148), monthly income (p = 0.001, r(s) = 0.260), and family history of CAM use (p = 0.001, r(s) = 0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use.. This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Aged; Attitude to Health; Complementary Therapies; Dietary Supplements; Family; Female; HIV Infections; Humans; Interviews as Topic; Malaysia; Male; Massage; Middle Aged; Motivation; Outcome Assessment, Health Care; Physician-Patient Relations; Plant Extracts; Self Disclosure; Socioeconomic Factors; Young Adult

This study aimed to assess knowledge of and attitudes toward HIV/AIDS among a community in a semi-urban setting in Malaysia, to determine factors affecting perceptions toward people living with HIV in the community, and to provide baseline information for planning preventive measures against HIV/AIDS. This cross-sectional study was conducted in August 2009. Two hundred sixty-two household members were interviewed with a semi-structured questionnaire. Most respondents (232; 88.5%) had heard of HIV/AIDS. Only a few respondents (6; 2.6%) could correctly answer all the questionnaire items. Misconceptions about disease transmission were seen among surveyed participants, such as the belief HIV/AIDS can be contracted from saliva (104; 44.8%), mosquito bites (95; 40.9%) or casual touch (86; 37.1%). A multivariate linear regression model showed better perceptions towards people living with HIV depend on an improved knowledge of HIV/AIDS transmission. Current data emphasize the need to scale up HIV/AIDS education incorporating the mode of disease transmission.

Topics: Acquired Immunodeficiency Syndrome; Adult; Cross-Sectional Studies; Data Collection; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Male; Middle Aged

To evaluate the level of knowledge, attitudes, and risk perceptions of University Sains Malaysia final-year pharmacy students regarding human immunodeficiency virus (HIV) and acquired immunity deficiency syndrome (AIDS).. A cross-sectional study among pharmacy students. Data were analyzed with Chi-square to find difference at p value < 0.05.. The majority of students (83.07%) responded showing a difference in gender and race. Students showed low willingness (9.2%) to assist patients and low confidence (36.1%) in their education about HIV/AIDS patients. Students recommended HIV testing for health care professionals (69.4%) and patients (75.9%) before surgical procedures. Students knew little about Post Exposure Prophylaxis (18.5%) or about the time for HIV to develop into AIDS (57.4%). About 40% of students were unaware of the inability of antivirals to treat HIV/AIDS. Students had low awareness for opportunistic infections (18.5%), and low agreement on competency to treat and counsel HIV patients (12.9%).. The study highlighted students' misconceptions, negative attitudes, and risk perceptions towards HIV/AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adult; Attitude of Health Personnel; Attitude to Health; Chi-Square Distribution; Cross-Sectional Studies; Data Collection; Education, Pharmacy; Female; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Male; Racial Groups; Risk Factors; Sex Factors; Students, Pharmacy; Young Adult

Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.

Topics: Acquired Immunodeficiency Syndrome; Adult; Algorithms; Behavior; Cross-Sectional Studies; Developing Countries; Educational Status; Female; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Linear Models; Malaysia; Male; Middle Aged; Multivariate Analysis; Prejudice; Public Sector; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Universities; Workplace

HIV/AIDS poses a serious threat to young people, both in Malaysia and throughout the world. A nationwide cross-sectional survey was conducted to assess the knowledge, attitudes, and beliefs about HIV/AIDS among the Malaysian public. This article reports the findings of knowledge about HIV/AIDS among young adults.. A total of 1075 young adult respondents aged 15-24 years participated in this survey. The response rate was 82.2%.. The data indicated that HIV/AIDS knowledge among the respondents was moderate, with a mean knowledge score of 20.1 out of 32 points. The great majority had adequate knowledge of the major routes of HIV transmission, but fewer were aware of other modes of transmission, such as tattooing and piercing, sharing personal items, and breast-feeding from an infected mother. The great majority knew that HIV is not transmitted by mosquito bites, sharing meals, casual contact, and using public swimming pools and toilets.. Misconceptions about HIV/AIDS exist although generally knowledge on HIV/AIDS transmission and prevention was accurate. Education and intervention programs are needed to increase the level of knowledge and awareness of HIV/AIDS. The findings have important implications for the development of primary HIV/AIDS prevention programs for young adults in Malaysia.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Age Factors; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Male; Young Adult

In Malaysia the response to illicit drug use has been largely punitive with the current goal of the Malaysian government being to achieve a drug-free society by 2015. This paper outlines the results of a desk-based situation assessment conducted over a 3-week period in 2004. Additional events, examined in 2005, were also included to describe more recent policy developments and examine how these came about. Despite punitive drug policy there has been a substantial rise in the number of drug users in the country. Over two-thirds of HIV/AIDS cases are among injecting drug users (IDUs) and there has been an exponential rise in the number of cases reported. Further, data suggest high risk drug use practices are widespread. Harm reduction initiatives have only recently been introduced in Malaysia. The successful piloting of substitution therapies, in particular methadone and buprenorphine, is cause for genuine hope for the rapid development of such interventions. In 2005 the government announced it will allow methadone maintenance programmes to operate beyond the pilot phase and needle and syringe exchange programmes will be established to serve the needs of IDUs.

Topics: Acquired Immunodeficiency Syndrome; Anti-HIV Agents; Data Collection; Drug and Narcotic Control; Government Programs; Harm Reduction; Health Policy; Heroin Dependence; HIV Infections; Humans; Illicit Drugs; Malaysia; Needle-Exchange Programs; Organizations, Nonprofit; Risk Factors; Substance Abuse, Intravenous

It has been almost two decades ago since the first AIDS case was reported in Malaysia. It has also been approximately eight years ago when the method of backcalculation was used to estimate the past HIV infection rate from the AIDS incidence data and an estimate of the incubation period distribution. This method is used because it makes use of the Malaysian AIDS incidence which is fairly reliable and reflects the trend of the epidemic as compared to the HIV infection rate recorded. The latest results generated show a slowdown in the increase of the number of estimated infected HIV+ cases in the late 1990s and this trend is supported by a slowdown in the increase of the number of AIDS cases recorded.

Topics: Acquired Immunodeficiency Syndrome; Data Interpretation, Statistical; HIV Infections; Humans; Incidence; Malaysia; Models, Theoretical; Risk Assessment; Risk Factors; Sentinel Surveillance; Time Factors

Since the first case of HIV/AIDS was identified in 1986 in Malaysia, the number of infected individuals has increased steadily each year, so that by the end of 2002 the cumulative number of people living with HIV/AIDS was 57,835 (51,256 with HIV and 6,579 with AIDS), with 5,676 AIDS deaths. The epidemic in Malaysia, currently in a concentrated epidemic stage, is primarily fueled by drug use, but there is ample evidence that heterosexual transmission has increased over the last few years. A strategic plan that includes prevention, care, support, and treatment run by both the government and nongovernmental organizations has been in place since the beginning of the epidemic. However, Malaysia will need to take a more pragmatic approach to reduce new infections (which numbered 19 each day in 2002) among the youth on whom the country relies for development. Leaders need to recognize that HIV/AIDS is not just a health issue, but also a socioeconomic concern that can eliminate all the developmental gains achieved over the years. Working together, Malaysians can overcome the epidemic, but there is a need to act quickly and to act in effective ways so that the devastating effects (already evident in the number of AIDS orphans and widows) can be reduced.

Topics: Acquired Immunodeficiency Syndrome; Female; Health Policy; HIV Infections; Humans; Incidence; Malaysia; Male; National Health Programs; Population Surveillance; Prevalence; Risk Factors

This was an international study of women's health issues, based on an Official Study Tour in Southeast Asia (the Philippines, Thailand, Malaysia, Hong Kong, and Singapore) and Canada. The objectives of the study were to identify and compare current gaps in surveillance, research, and programs and policies, and to predict trends of women's health issues in developing countries based on the experience of developed countries. Key informant interviews (senior government officials, university researchers, and local experts), self-administered questionnaires, courtesy calls, and literature searches were used to collect data. The participating countries identified women's health as an important issue, especially for reproductive health (developing countries) and senior's health (developed countries). Cancer, lack of physical activity, high blood pressure, diabetes, poverty, social support, caring role for family, and informing, educating, and empowering people about women's health issues were the main concerns. Based on this study, 17 recommendations were made on surveillance, research, and programs and policies. A number of forthcoming changes in women''s health patterns in developing countries were also predicted.

Topics: Acquired Immunodeficiency Syndrome; Canada; Developing Countries; Educational Status; Female; Hong Kong; Humans; International Cooperation; Malaysia; Male; Neoplasms; Philippines; Population Surveillance; Risk Factors; Singapore; Socioeconomic Factors; Surveys and Questionnaires; Thailand; Women's Health

Three hundred and one sera of HIV/AIDS patients were tested for anti-Toxoplasma IgG antibody by ELISA technique. The seroprevalence of toxoplasmosis was 41.2% (95% CI: 35.5-46.9) in HIV/AIDS patients. The seroprevalence was significantly higher in the Malay (57.9%) than the Chinese (38.7%), followed by the Indian patients (29.6%) (p<0.05). No possible risk factor, such as contact with cats, consumption of uncooked meat, and history of blood transfusions was found to have any significant association with the presence of anti-Toxoplasma antibody in the study sample (p>0.05). Multivariate analysis was employed to find any association between Toxoplasma seroprevalence and a single subject having single or multiple risk factors. It was found that the association was not statistically significant (p>0.05). Among the HIV/AIDS study samples, 124 (41.2%) samples were found to have positive anti-Toxoplasma antibody, the association between the presence of anti-Toxoplasma antibody and CD4 cell count was determined but no statistically significant association was found (p>0.05). During the study period, only one case of active CNS toxoplasmosis was registered and the diagnostic criteria included: clinical presentations, CT scan finding, serological evidence of anti-Toxoplasma IgG antibody, and respose to anti-Toxoplasma therapy.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Aged; Antibodies, Protozoan; Blotting, Western; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Female; Humans; Malaysia; Male; Middle Aged; Risk Factors; Seroepidemiologic Studies; Socioeconomic Factors; Toxoplasmosis; Young Adult

Recognition and articulation of patient rights are core issues in the medical jurisprudence of most nations. While the nature of rights in medical care may vary from country to country, reflecting the idiosyncrasies of domestic law and health delivery, there are commonalities in this area of law that cut across borders. This paper presents five case studies in the patient rights area from Malaysia, Ireland, South Africa, Indonesia and the United States, respectively. The case discussions range from ongoing and fundamental concerns over broad patient rights issues, such as access to health care and informed consent, to rights concerns of those suffering from HIV/AIDS, to a novel consideration over ethical and legal issues concerning ownership of infant organs. It is the hope of the authors that individually, and collectively, the cases will provide helpful insights into this core area of medical law.

Topics: Acquired Immunodeficiency Syndrome; Child; Female; Health Services Accessibility; HIV Infections; Humans; Indonesia; Informed Consent; Ireland; Malaysia; Male; Parental Consent; Patient Rights; South Africa; Tissue and Organ Procurement; United States

Urgent action is needed to fight the alarming spread of HIV/AIDS that infected 1.3 million people in Southeast Asia last year alone, Malaysia's foreign minister said July 24, 2000. Syed Hamid said the Association of Southeast Asian Nations (ASEAN) should tackle at regional and national level an epidemic that was taking its most drastic toll among the region's youth. "HIV/AIDS not only represents a major public health and social problem but is a serious challenge to development as well," Syed Hamid told the opening ceremony of ASEAN's 33rd annual foreign ministers' meeting. The crisis requires commitment at the "highest political level," he said, warning that HIV/AIDS could become a transnational problem within the 10-member group. Foreign ministers have recommended their leaders discuss the crisis later this year at an informal summit in Singapore and hold a summit on HIV/AIDS in conjunction with the 7th ASEAN Summit in Brunei next year. "I think people recognized the importance and the adverse impacts on our social development," Syed Hamid told reporters later. "I think it is a real issue that we cannot run away from." Among ASEAN members, Thailand, Cambodia, and Myanmar have some of the highest infection rates in Asia of HIV, the virus that causes AIDS.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Health; HIV Infections; Malaysia; Public Health; Social Problems; Virus Diseases

Islamic clerics, scholars, activists, and other authorities in Malaysia decided to lay in education for everyone as a solution to the AIDS epidemic in their country. In addition, they called on the community to be caring towards sufferers, which they believe is the way of Islam. This resolution was agreed upon during a meeting wherein religious officials recognized their role in AIDS prevention by equipping people with spiritual values and teaching everyone compassion. The resolution, however, has challenged the orthodoxy in some Islamic circles where AIDS is regarded as a "manifestation of God's punishment" which has consequently scared off many Muslim sufferers from approaching religious bodies. Religious advisers also admits that their call for full information about prevention, from urging abstinence and marital fidelity to promoting the use of condoms, still needs to be supported by individual state authorities. Among the AIDS council's future plans are to set up an information booth at a Kuala Lumpur mosque and to raise awareness in state religious departments through a booklet entitled AIDS Education Through Imams.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Communication; Developing Countries; Disease; Education; Health Knowledge, Attitudes, Practice; HIV Infections; Islam; Leadership; Malaysia; Religion; Virus Diseases

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Female; HIV Infections; Humans; Malaysia; Male; Risk Factors; Sex Work; Sexual Behavior; Substance-Related Disorders

In Asia, attempts to control HIV/AIDS through education have not achieved the necessary behavior changes. This is especially true for young women who are unable to apply their knowledge to their sex behavior because of inequalities in gender relations. Thus, the impact of AIDS on women is significantly greater in settings where the status of women is low. Women in developing countries are at greatest risk because the epidemic is fueled by poverty, lack of information, and lack of autonomy. Prosperity in a developing country, such as Malaysia, entails its own risks because it creates new social norms and values that exist in tandem with debilitating old norms, such as the patriarchy that disempowers women and a resurgence in polygamy and wife abandonment. Subservient gender roles not only increase women's chances of infection, they also target women as the primary caregivers for infected individuals. Young girls may have to abandon school to care for infected parents, and female health care providers are assigned to the lowest ranks of the profession. While most women have been infected by their husbands, they must also bear the stigma of being considered immoral infectors of their husbands. The futures of AIDS widows and orphans is jeopardized by the discrimination that attends the disease, and if the mother dies, her young children face a higher death rate. In settings new to the epidemic, it is difficult to convince men of the importance of addressing women's needs and of seeking the input of women in policy and program development. Only by empowering both sexes to work together to protect society will there be a reasonable chance of reducing the impact of HIV/AIDS.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Economics; Evaluation Studies as Topic; HIV Infections; Interpersonal Relations; Malaysia; Socioeconomic Factors; Virus Diseases; Women's Rights

At a 3-day meeting sponsored by the Association of Southeast Asia Nations (ASEAN), Thailand, Malaysia, Viet Nam, the Philippines, Indonesia, Singapore, and Brunei pledged to implement a series of high-profile projects to combat the acquired immunodeficiency syndrome (AIDS) epidemic. Although details of the projects were not revealed, they focus on education, information sharing, and improved surveillance. Voluntary groups, the private sector, community organizations, and government departments will be enlisted in the AIDS prevention effort. Participants noted that earlier concerns that condom promotion would encourage premarital and extramarital sex have proved unfounded. A survey conducted in Thailand indicated that AIDS education programs have increased condom use with prostitutes to 60%. Almost 3000 new cases of human immunodeficiency virus (HIV) occur each day in South and Southeast Asia.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Brunei; Condoms; Contraception; Developing Countries; Disease; Family Planning Services; Health Planning; HIV Infections; Indonesia; Malaysia; Organization and Administration; Philippines; Policy Making; Singapore; Thailand; Vietnam; Virus Diseases

Interruption of the spread of human immunodeficiency virus (HIV) across southeast Asian borders by legal and illegal migrant laborers is a major concern of the Association of Southeast Asian Nations (ASEAN). ASEAN intends to move immediately to implement regional projects focused on education, information sharing, and improved surveillance. HIV transmission from laborers from poorer countries in search of jobs in economically booming regions underscores the global nature of the AIDS problem. Malaysia, for example, has over 1 million illegal workers. Moreover, many legal guest workers who enter Malaysia with letters from a physician stating they are not HIV-infected have falsified documents.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Demography; Developing Countries; Disease; Economics; Emigration and Immigration; Employment; Health Workforce; HIV Infections; Malaysia; Population; Population Dynamics; Prevalence; Research; Research Design; Thailand; Transients and Migrants; Virus Diseases

Malaysia has an estimated population of 18.8 million people. The first AIDS case of Malaysian origin was detected in December 1986. As of April 30, 1995, there were cumulatively 12,122 reported HIV infections and 228 cases of AIDS. Of the 12,122 HIV cases, 78% are attributed to IV drug use, 17% to other unknown routes, and 2% to heterosexual sex. While the Malaysian government's initial anti-AIDS campaign used fear tactics, public campaigns have recently been revised to employ a softer approach, minimizing fear tactics and referring to transmission risks as high-risk behavior. The government's main anti-AIDS strategy has concentrated upon preventing transmission through mass awareness campaigns and motivating behavioral change. Harm reduction measures such as condom distribution remain limited to specific target groups such as people already infected with HIV/AIDS. Syringe and needle exchange activities are not allowed under Malaysia's anti-drug laws. Complementing and supporting the government's anti-AIDS campaign are nongovernmental organizations working upon HIV/AIDS which are affiliated with the Malaysian AIDS Council. The majority of programs concentrate upon basic education and awareness, although some programs provide direct service-oriented activities.

Topics: Acquired Immunodeficiency Syndrome; Asia; Asia, Southeastern; Developing Countries; Disease; Government Programs; HIV Infections; Malaysia; Organization and Administration; Virus Diseases

Topics: Acquired Immunodeficiency Syndrome; Asia, Southeastern; Emigration and Immigration; Ethnicity; Female; Health Education; HIV Infections; Humans; Malaysia; Male; Motivation; Sex Work; Transients and Migrants; Voluntary Health Agencies

We report a 39-year-old male who presented with tuberculous meningitis and was found also to be HIV-infected. In the course of his illness, he developed multiple opportunistic infections such as herpes genitalis, oesophageal candidiasis, CMV retinitis and finally succumbed to Penicillium marneffei septicaemia.

Topics: Acquired Immunodeficiency Syndrome; Adult; Humans; Incidence; Malaysia; Male; Mycoses; Penicillium

Topics: Acquired Immunodeficiency Syndrome; Humans; Malaysia; Sexually Transmitted Diseases; Venereology

Five positive and negative experiences of families dealing with AIDS are recounted. Imrat in Malaysia is an HIV-infected son who was not rejected by his family. Prudence of Botswana is an infected widow with five children who had a less positive experience with her in-laws, while Eric of Sweden considers his friends to constitute his family. His relationships with friends have only strengthened since his HIV-positive status became known. Mary of Zimbabwe, however, was infected with HIV by her husband. She was formerly angry at him for having brought home the virus, but they have since stop quarreling and are focusing upon building a stronger relationship. Finally, the brief story of Juan in Colombia is told. Thirty-two years old, married, and with a 17-month old daughter, Juan did not tell his wife that he was actively bisexual. Once infected with HIV, Juan's wife threw him out, more because he had sex with men than because of his HIV serostatus.

Topics: Acquired Immunodeficiency Syndrome; Africa; Africa South of the Sahara; Africa, Eastern; Africa, Southern; Americas; Asia; Asia, Southeastern; Botswana; Colombia; Developed Countries; Developing Countries; Disease; Europe; Family Characteristics; Family Relations; HIV Infections; Latin America; Malaysia; Scandinavian and Nordic Countries; South America; Sweden; Virus Diseases; Zimbabwe

The first people to be infected with HIV in Malaysia were mainly homosexual men with foreign connections. IV drug users, however, rapidly became the population group with the highest prevalence of HIV. Accurate, timely data are needed in order to responsibly describe the pattern of HIV infection and AIDS in any given setting. In Malaysia, however, there has been little systematic surveillance in population groups other than blood donors. This surveillance indicates the existence of a rapidly increasing rate of seropositivity among blood donors. Otherwise, many people are loathe to undergo voluntary HIV testing to determine their serostatus. Moreover, some people with STDs avoid contact with the health system and the potential for HIV testing. The extent to which AIDS cases are underreported or reported late is unknown. On the other hand, an estimated 10% of notified AIDS cases have been wrongly classified as such. The lack of hard data on HIV/AIDS in Malaysia makes it difficult to project the future course of the epidemic in the country. Since Malaysia shares a land border with Thailand and there is much sea-borne traffic between the two countries, it is highly possible that Malaysia will experience a significant epidemic of HIV infection similar to its neighbors. A National AIDS Committee was established April 1985 to develop responses to the HIV epidemic, while the National AIDS Program Manager of the Ministry of Health is responsible for controlling STDs. A national plan of action for the prevention and control of AIDS, drawn up in 1985 and revised in 1988, includes planning for the continued surveillance of HIV infection and AIDS through existing notification systems, and for screening and sentinel programs for IV drug users, prostitutes, and STD patients. Recent nongovernmental organization responses complement government efforts to prevent HIV and AIDS in Malaysia.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Child; Child, Preschool; Health Policy; HIV Infections; Humans; Infant; Infant, Newborn; Malaysia; Male; Middle Aged

Topics: Acquired Immunodeficiency Syndrome; Adult; Attitude to Health; Female; Humans; Malaysia; Male

The report from the Sao Paulo Epidemiological Vigilance Center in Brazil indicated that the number of women with AIDS had increased dramatically in 6 years. While in 1986 there was only 1 woman with AIDS for every 26 such men in the state of Sao Paulo, in 1992 there was 1 infected woman for every 4 such men. About 60% of all AIDS cases in Brazil are in the state of Sao Paulo. On the other hand, there were 4008 men with AIDS in Sao Paulo in 1992, a reduction from 1991 when 4504 were infected. Nevertheless, 16.5% more women were infected in 1991 than in 1990, and in 1992 there were 20% more female victims than in 1991. Among the 935 women who got infected with AIDS in 1992, 41.7% got the disease through injecting narcotics, 40.7% via intercourse with infected men, and 5.7% via infectious blood transfusions. Of the 22,027 AIDS cases reported in the state of Sao Paulo, 14,561 are already dead. In 1992 at least 300 men died of AIDS who were not registered as AIDS carriers. The authorities in Cuba introduced forced internment of the HIV infected in order to prevent the spread of AIDS. Since AIDS was detected in 1986, only 903 persons have been infected, of whom 102 have died. Only 0.0009% of Cuba's population is HIV positive, the lowest in the region. The reason is the comprehensive HIV testing: 13 million tests have been taken so far, and HIV positive persons are immediately sent to special sanatoria. In Malaysia discussions are continuing about the introduction of sex education in the schools, but religious leaders resist it strongly. The official line is that only prostitutes, hemophiliacs, and drug addicts can get AIDS. In the course of 3 years it is estimated that the number of HIV infected will double to 35,000 cases. Official figures indicate only 4437 carrier in Malaysia, but the real figure is much higher. By December 10, 1992, 313,000 AIDS cases were registered in the Americas and 191,913 AIDS-related deaths had been reported.

Topics: Acquired Immunodeficiency Syndrome; Adult; Brazil; Cuba; Female; Humans; Malaysia; Male

In order to control the spread of HIV infection, Malaysia will have to carry out systematic studies of at-risk populations, but doing so will also require legal and societal changes. Thailand's explosive HIV is already spreading from Thailand to neighboring countries, including Malaysia. By December 1990, 750 cases of HIV infection and 19 AIDS cases had been reported in Malaysia. Intravenous drug use accounted for 76% of transmissions. Despite the increasing problem of HIV, Malaysia has yet to conduct any systematic serological survey of at-risk populations. Furthermore, there is currently no easy way to obtain a fully confidential HIV test. Partly a result of Islam teachings, there is a reluctance to discuss sexual and drug-related matters, making it difficult for health personnel to be effective counsellors and educators. The government's policy of dealing with drug addicts -- strict nonvoluntary rehabilitation or detention -- also undermines efforts to control the spread of HIV, since it drives high risk group underground. Combating HIV infection will require research into high risk activities, especially drug and sexual habits. Such information can be used to devise education campaigns. Malaysia will ultimately have to develop a prevention and control strategy which is acceptable in an Islamic society, but the country must also consider the more pragmatic approaches that have been effective in the US and Europe.

Topics: Acquired Immunodeficiency Syndrome; Disease Outbreaks; Humans; Malaysia; Patient Education as Topic; Prevalence

In September 1991, the 7th IUVDT Regional Conference on Sexually Transmitted Diseases (STDs) convened in Kuala Lumpur, Malaysia, to exchange information on the importance of controlling STDs and HIV-AIDS in Asia. Speakers from Thailand, Malaysia, and Japan provided the latest HIV-AIDS epidemiological data. In Thailand, heterosexual transmission of HIV is catching up with iv drug use. Most infected women are 15-24 years old. In Malaysia, drug use iv drug use trails heterosexual transmission of HIV. In Japan, hemophiliacs comprise 85% of HIV-positive people. Current problems do not compare to the sizable task Asian countries face in affecting the progression of the HIV-AIDS epidemic. All countries need to implement control measures quickly and at the same time. They should not pretend traditional values and beliefs would shield their people from the epidemic. Asian countries should especially stop promoting themselves as places of sexual adventure. Control programs should also target STDs. Australian presenters discussed the results of the Sydney Sexual Lifestyle Study and a study on the effect of zidovudine therapy on the prognosis of AIDS. Another presentation focused on the possibility of a vaccine for chlamydia infection. Several papers centered on the treatment of chancroid and gonococcal and nongonococcal urethritis and evaluation of a detection test for chlamydia infection. 1 participant reviewed the role of human papilloma virus in cervical carcinogenesis. Another participant demonstrated a link between bacterial vaginosis and adnexal tenderness and pelvic infection. The conference concluded with a presenter challenging everyone to meet the HIV-AIDS challenge. Reasons why current control measures do not work include inadequate facilities to manage STDs, tendency not to consider HIV another STD, failure to promote and lack of condoms, and not educating school children about HIV-AIDS.

Topics: Acquired Immunodeficiency Syndrome; Humans; Malaysia; Sexually Transmitted Diseases

This paper examines the impact of cultural values and government policies on the content of AIDS educational literature prepared by public health agencies in Malaysia and the Philippines. The literature from these countries, which has been distributed to the public and is intended to inform them of the danger of AIDS, how the HIV is and is not transmitted, and how to avoid infection, is analyzed and evaluated for effectiveness and congruence with the dominant religious tenets and cultural practices in each country, and attitudes to sexual behavior. The paper also describes the response of these countries to the AIDS pandemic, and concludes with suggestions about how this form of AIDS education can be improved.. AIDS is a pandemic that threatens the public health of every country in the world. In Southeast Asia, the impact of AIDS has been less than in other areas like Africa, or the West. Like many other countries from the region, the Philippines and Malaysia are classified as type 3 countries in terms of AIDS transmission. Thus, the response to AIDS has been less vigorous than in other countries. Malaysia is a diverse country with 60% of its population Malay, 31% Chinese, and 8% Indian. The malays are Muslim and the laws of the country can be described as consistent with conservative islamic customs. This means that laws are directed towards traditional family values of marriage and monogamy for women and against alternative life-styles like homosexuality, drug use, prostitution, premarital, and extramarital sexual activity. This context makes AIDS education very difficult since the lifestyles that put people at risk are illegal. The AIDS education campaign designed by the malaysian government is very naive in its presentation and relies on fear as a primary motivation to control the spread of AIDS. This strategy will fail because telling people to stop using drugs or prostituting themselves will not work. Evidence has shown in other countries that education about risk factors, rather than fear, is much more effective in slowing the transmission of AIDS. In the Philippines, 90% of the country's 60 million inhabitants are Roman Catholic. Their response to AIDS has been a public education campaign that includes elementary, high school, and college level education programs. Communication programs give information on HIV infection and transmission and prevention programs promoting condom usage for risk groups. The Filipino literature differs from the Malaysian literature in that it is more explicate in discussing risk factors and prevention advise is also more realistic. Every country must do something to help fight the spread of AIDS, but education programs that serve to reinforce traditional values instead of sale life practices will be less effective.

Topics: Acquired Immunodeficiency Syndrome; Cultural Characteristics; Health Education; Humans; Malaysia; Mass Media; Pamphlets; Philippines; Religion and Medicine; Risk Factors; Sexual Behavior; Social Values; Substance Abuse, Intravenous

The 1st case of acquired immunodeficiency syndrome (AIDS) in Malaysia was detected in 1987, 1 year after the Ministry of Health established a national AIDS task force. The patient was a 45-year-old Chinese man of Malaysian origin who had been living overseas for the past 30 years. The patient denied any homosexual relationships, blood transfusions, of intravenous drug use; however, he reported multiple sexual partners 10 years prior to developing AIDS. At hospital admission, the patient was in acute respiratory distress and Pneumocystis carinii was isolated from his sputum. The enzyme-linked immunosorbent assay and Western blot tests revealed antibodies to human immunodeficiency virus (HIV). The T- helper/T-suppressor cell ratio was inverted, 16:51%. There were no antibodies to cytomegalovirus or toxoplasmosis. The patient showed rapid clinical improvement after treatment with co-trimoxazole and was released from the hospital 2 weeks after admission. Although this is the 1st case of full-blown AIDS in Malaysia, individuals with antibodies to HIV have been identified.

Topics: Acquired Immunodeficiency Syndrome; Humans; Malaysia; Male; Middle Aged; Opportunistic Infections; Pneumonia, Pneumocystis