WHAT YOUNG MALAYSIANS SAY ABOUT HIV/AIDS

Professor Dr. Sarinah WY Low, Ph.DProfessor of Psychology

Health Research Development Unit (HeRDU)University of Malaya Medical Center

Kuala Lumpur

National Advocacy Seminar for Media on HIV/AIDS PreventionLangkawi, 7-8th July 2006

Introduction

• HIV/AIDS most challenging disease threat in modern times (fatal, no cure + uncertain window period + potential for spreading infections by carrier)

• Majority of HIV infections globally are due to sexual transmission. Is this true for Malaysia ???

• Due to the crisis nature of HIV/AIDS pandemic, efforts in fighting this disease should be intensified – through Education / media campaigns, Changing the social / physical environment and Enforcement / Legislation (where necessary).

• Apart from Government, NGOs & the community, the media is very important in helping to curb the spread of HIV/AIDS because it can affect anybody.

Reported new HIV infections, AIDS cases, and AIDS death in Malaysia

• An average of 500 to 600 reported cases/month.

• More than 7,000 have died

Reported cumulative HIV cases by risk categories in Malaysia,

1986-2002

• Of total reported cases, 76% IDUs– Ie. sharing needles

• Heterosexual (12%)– unprotected sex

– multiple sexual partner

Ministry of Health, 2004

Together they account for 88% of HIV infections!

Persons living with HIV/AIDS in Malaysia 1990,1995 and 2005:

71,000+ infectors !

Persons living with HIV/AIDS

Source: Ministry of Health 2003

Reported HIV infections by ethnicity and risk factors in Malaysia, 2002

• Majority Malays and Indians – get it from IDU’s

• Most Chinese Malaysian- get it from heterosexual route

Age-group distribution of new HIV/AIDS and cases in Malaysia, 2003

Distribution of new HIV and AIDS cases in Malaysia, 2003

AgeGroups

New HIV casesNo. %

New AIDS casesNo. %

Cumulative HIVNo. %

Cumulative AIDSNo. %

<1313-1920-2930-3940-49≥ 50

unknown

6178

219228191246

30456

0.901.15

32.4541.7318.44

45.00.83

194

210485255

976

1.770.37

19.5245.07

23.79.010.56

464902

2129524791

82811596

683

0.81.55

36.7142.7314.27

2.751.18

134190

172737231882

60929

1.622.29

20.8244.8922.69

7.340.35

TOTAL

Total 6756 100 1076 100 58012 100 8294 100

Source: Ministry of Health Malaysia, 2004

The Study : Protecting Young Malaysians from

HIV/AIDS and STIs

• Assess the knowledge, Attitudes and Behavior of young people on HIV/AIDS and STIs prevention

• Assess the capacity of family life educators and peer group members

Commissioned Consultants Sponsored

FFPAM Tey Nai Peng UNFPA Low Wah Yun Mary Huang

Methods

• Questionnaire Survey self-administered

– Young people (6,564)

– Family life educators (86) & peer group members (251)

• Qualititative study (focus groups) family life educators (7 FGDs = 61) & peer group members (10 FGDs = 91)

Respondents characteristics

• Kelantan (1874), Melaka (1,668), Penang (2,982) & Langkawi (193)

• 6,564 young people primary (393), secondary school (5,426) students, higher learning institutions (681), factory workers (51), Pusat Serenti (13)

• 82% between 13- 18 years (median 15 yrs)• Females (4,198) > males (2,366)

Percent of youths who have heard of HIV and STIs

37.8 3547.9

33.5 39.7

0

20

40

60

80

100

All Kelantan Melaka Penang Langkawi

HIV

STIs

Mean score on the knowledge of HIV transmission

6.96.8

7.8 7.7

7.1 7.2

6.5 6.5

5.86

6.26.46.66.8

77.27.47.67.8

Kelantan Melaka Penang Langkawi

All Respondents

Secondary school

Percent who provided incorrect response to the modes of HIV transmission

10.8

42.5

29

14.8 13.9

43.6

24.8 23

33.4

42.3

0

5

10

15

20

25

30

35

40

45

Injec

tion

of d

rugs

(Yes

)

Sharin

g cu

ps (N

o)

Throu

gh A

ir (N

o)

Sex w

ith se

x wor

kers

(Yes

)

Blood

dona

tion

(Yes

)

Mos

quito

(No)

Mot

her t

o ba

by (Y

es)

Holding

han

ds (N

o)

Having

sex w

ithou

t con

dom

(Yes

)

Living

toge

ther

(No)

• 55% respondents HIV person can be identified

• 47% respondents HIV can be cured

• Unaware of the consequences of unprotected sex– 32.7% STIs

– 27.1% unwanted pregnancy

– 18.5% HIV

• Young people most likely to mention that parents (86.3%), followed by health workers (76.8%), friends (69%), schoolmates (64.3%) as persons whom they turn to for help from risky behavior

From where they obtained Information on HIV/AIDS

0 10 20 30 40 50 60 70 80 90

S

choo

l

Rad

io

Tele

visi

on

New

spap

ers

Mag

azin

es

Pam

phle

ts

Inte

rnet

Wor

ksho

p/ S

emin

ar

Frie

nds

Pee

r ed

ucat

ors

Rel

ativ

es

C

omm

unity

le

ader

s/vo

lunt

eers

Hea

lth

pers

onne

l

Sources of Information on HIV/AIDS and STIs

37.7

35

59.3

48.1

26.7

19.6

61.4

44.2

25.8

15.1

29.4

18.7

0

10

20

30

40

50

60

70

HIV

STIs

Preferred Sources of Information

0

10

20

30

40

50

60

70

HIV

STIs

Access to IEC and training materials on HIV/STIs

58.1

33.7 34.9

15.1

45.8

21.117.9

7.6

0

10

20

30

40

50

60

FLE Peer Group

HIV IEC

HIV Training

STIs IEC

STIs Training

Sources of IEC materials on HIV/AIDS

7268.7

86

41.7

48

27.824

18.324

18.3

149.6

0

10

20

30

40

50

60

70

80

90

FLE Educator

Peer group

Sources of training materials

on HIV/AIDS

62.1 60.4

89.7

49.1

37.9

32.1

13.8

24.5

20.7 22.617.2

5.7

0

10

20

30

40

50

60

70

80

90

FLE Educator

Peer group

Percent who felt that they have sufficient knowledge to protect young people

from HIV and STIs 61.6

52.250

30.7

0

10

20

30

40

50

60

70

HIV STIs

FLE Educator

Peer group

WHAT YOUNG PEOPLE WANT?

• Improving knowledge on HIV/AIDS among the youths and educators

– Knowledge tends to be superficial– Not aware of specific modes of transmissions myths

and misconceptions about disease perpetuate stigma & discrimination

– Need to educate young people & teach them life skills negotiation, conflict resolution, critical thinking, decision-making & communication, improve self-confidence & ability to make informed choices, postponing sex until they are mature

– Increasing knowledge thro schools, communities, media

Putting knowledge into practice : Life skills

“Self-discipline. Now, they know that is wrong and then sometimes the need is there. So, what am I going to do?

Well, think of the consequences, may be, they don’t or they know also, if I do this, but then…am… the self

discipline is not strong enough, you know…”

“Personal weaknesses could be like we ourselves are not open minded or we ourselves felt that we don’t

have enough skill, your own values, you know, unconsciously, you sort of pass over your

own values to the other person”

• Improving the IEC materials and sources of information

– Some aspects of HIV/AIDS are not known or understood by young people

– Many do no have access to IEC and training materials on the disease

– There is a need to improve materials and make them widely available

• Printed materials animated, contains lots of humor, entertaining, and should also contained articles and stories in Youth section of any newspapers or magazines for young people, eg. in the Didik section, Galaxie, Seventeen, Gila-Gila, Cleo, etc.

• Electronic materials simple and short, meaningful, and should be made available during commercial slots in the televisions. It should also be linked up with MTV station, cartoon network, Star World, AXN, Radio-Hitz.Fm or Mixed FM.

• Strengthening the capacity of FLE educators and peer group members– Interactions with young people play an important role in

creating greater awareness and sharing of knowledge on HIV/AIDS with friends

– Need to recruit and retain more FLE educators and peer group members

• Using various IEC/BCC channels to affect behavioral change– Inability of young people to see themselves as being

vulnerable – Need to create a greater sense of urgency to combat this

disease– Emphasize the importance of interesting and fun-filled

activities to affect behavioral change amongst young people youth friendly IEC/BCC package

“Rakan sebaya, bagi saya, mudah untuk membuat perbincangan. Dibandingkan dengan ibu bapa, pemikian

mereka lain. Dengan rakan sebaya, komunikasi lebih senang dan selesa”

 “Because peer members can communicate better and are more

understanding with each other, there are no problems with generation gap, and they are important in spreading

information and are usually accepted by peer members”

“Biasanya dan kebanyakan umur manjadi ‘gap’. It is hard to communicate. Oleh itu, perlu cari umur yang sesuai untuk memberi khidmat nasihat. Maksud saya, cari remaja yang

ada ‘knowledge’ untuk berbincang”

Importance of Peer Educators

• Reaching out and encouraging the involvement of young people– More innovative and interesting ways to create

awareness and empowering young people youth camps, drama, PROSTAR activities, outreach programs, co-curriculum activities, school clubs and societies, community programs, private sector (factories)

– Involve more young people in planning, organizing and implementing of various activities

– Need to identify target groups for intervention with appropriate programs and strategies

– Conduct training and counseling sessions on family life, reproductive health and HIV/AIDS to participants of National Service, Rakan Muda, Boy Scouts, St. Johns

• Promoting and encouraging the involvement of parents, health care providers, teachers & communities

– Most young people have cited parents, health care providers and teachers as persons whom they can turn to for help form risky behavior.

– They need the support of adults participation as educators in HIV/AIDS among the general population by discussion these issues via forums within the broader scope of reproductive health, health lifestyles, positive values, family well being and social development.

– There is a need to develop strategies, programs and activities targeted at parents (eg. parent-teachers association, social clubs), health care providers and teachers

Parents played an important role in educating and empowering young

people  

“Sometimes parents must be open. Family also need to have a knowledge because mereka lagi dekat dengan

anak-anak. Remaja dan keluarga penting dalam memberi ilmu kepada remaja dalam menyelesaikan

masalah dan memberi panduan kepada mereka untuk menyelesaikan masalah”

• Strengthen partnerships & multi-sectoral collaboration between government agencies, NGOs, civil societies including faith based organizations, private sectors and the community

• Media to play a greater role in getting the preventive messages across

“Remaja banyak tengok TV dan sebagainya. Contoh, Akademi Fantasia, masuklah mesej. Selitkan dalam

muzik juga. Biar dia orang yang sampaikan maklumat tentang hal ini.”

CONCLUSIONS

• Young people center of epidemic in terms of HIV transmission, vulnerability, impact and potential for change

• Young people has the right to youth-friendly information, skills and services for HIV prevention

• Young people are not only the beneficiaries of interventions, but also key resource in the planning, design and implementation of programs

• Need to scale up efforts in meet the urgent needs of young people

“Young people are and will remain at the front lines of combating the global AIDS pandemic,

however, we can and must do more. We must be bold and assume leadership in breaking the

conspiracy of silence and shame that drives AIDS underground and stigmatizes PLWHA”

Youth position paper on the 2001 United Nations General Assembly

Special Session on HIV/AIDS

THANK YOU