CHALLENGES OF SEXUALLY TRANSMITTED INFECTIONS AND HIV/AIDS PREVENTION AND CONTROL PROGRAMME IN MALAYSIA: A SCOPING REVIEW
DOI:
https://doi.org/10.37268/mjphm/vol.24/no.3/art.2615Abstract
Sexually Transmitted Infections (STIs) encompass a range of bacterial, viral, and parasite illnesses that can be transferred via sexual activity, including oral-genital contact and the sharing of certain objects or substances. HIV is a pathogenic infection that targets and compromises the functioning of the body's immune systems while AIDS represents the most advanced phase of the disease. The Western Pacific region exhibits the highest rates of incidence and prevalence of treatable STIs globally. While HIV prevalence in the region remains low at 0.1%, an estimated 100,000 new HIV infections continue to occur annually particularly among key populations. Malaysia reported a cumulative number of reported HIV and AIDS at 125,878 and 28,805 respectively in 2020. Unfortunately, Malaysia is off tracked of its 2020 objectives of reaching 95-95-95 targets in the testing-treatment-viral suppression cycle. While, sexual intercourse is the primary means through which both HIV and other STIs are transmitted. The preventive measures aimed at reducing the sexual transmission of HIV and STIs are similar, as are the target populations for intervention strategies. Hence, the identification of issues or constraints in STIs prevention and control programmes constitute a crucial component of HIV/AIDS prevention and control approach. This is a scoping review on sexually transmissible infections and HIV/AIDS prevention and control programs in Malaysia to determine the issues and constraints and also to analyse the challenges in implementing effective prevention programmes in Malaysia. Three online databases were used to identify articles published from 2014-2023, primary study from any type of study design conducted in Malaysia and studies with STI and HIV/AIDS as primary or secondary outcome. Non-English articles and those that were unable to have full access are excluded. A total of 16122 studies were screened against the eligibility criteria and 12 studies were included in the review. Majority of the included studies were conducted in East Malaysia and 77% of the articles reported quantitative study design. Generally, the studies examined STIs and HIV/AIDS challenges were among the key populations (41.7%). Highlighted challenges on prevention and control programmes were on knowledge, followed by issues of testing, stigma, issues on privacy and confidentiality, healthcare worker's challenges perspectives, and on barriers of implementation of pre-exposure prophylaxis. As conclusion, most studies focused on key populations, done in the states of West Malaysia and mainly are on HIV/AIDS rather than STIs. Barriers of poor knowledge and stigma remained the prevalent issues in Malaysia, and this review was unable to identified any study on pre-exposure prophylaxis as prevention and control strategy as it is still in the engagement session. The result of this review underscores the need for more rigorous study and improved quality of reporting of STIs and HIV/AIDS in order to support public health decision-making in Malaysia.
References
Aazmi S, Mohd Nor F, Shahrul Anuar T, Nur Syahirah Tengku Kamaruzaman T, Nazri Aziz M, Ibrahim N, et al. A Two Years Retrospective Study on Epidemiology Characteristics of Sexually Transmitted Infections From Malaysian Private Healthcare Perspective. Vol. 17, Malaysian Journal of Medicine and Health Sciences. 2021.
WHO. WHO. 2023 [cited 2023 Oct 1]. HIV and AIDS. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids
WHO. Meeting Report NATIONAL HIV, HEPATITIS AND STI PROGRAMME MANAGERS MEETING FOR SELECTED ASIAN AND PACIFIC ISLAND COUNTRIES [Internet]. 2017 [cited 2023 Oct 1]. Available from: https://iris.who.int/bitstream/handle/10665/260014/RS-2017-GE-47-PHL-eng.pdf
Ministry of Health Malaysia. The Global AIDS Monitoring Report 2021 [Internet]. 2021 [cited 2023 Oct 1]. Available from: https://www.moh.gov.my/moh/resources/Penerbitan/Laporan/Umum/20211130_MYS_country_report_2021.pdf
UNAIDS. UNAIDS/WHO Working Group on Globall l HIV/AIDS and STI Surveillance Estimated number of adults and children living with HIV/AIDS, end of 2003 [Internet]. 2004. Available from: http://www.who.int/hiv
Malley H. Theory & Practice This is an electronic version of an article published in Arksey [Internet]. Vol. 8, The International Journal of Social Research Methodology. 2005. Available from: http://journalsonline.tandf.co.uk/OpenURLlinktothearticle:http://www.journalsonline.tandf.co.uk/openurl.asp?genre=article&eissn=1464-5300&volume=8&issue=1&spage=19
Jaan Jaafar S, Awang Lukman K, Safian N, Myint T, Rohaizat Hassan M, Sutan R, et al. UNSAFE SEXUAL BEHAVIOUR AMONG HIV-POSITIVE MSM PARTICIPATING IN COMMUNITY-BASED TREATMENT ADHERENCE PEER SUPPORT PROGRAM. Vol. 21, Malaysian Journal of Public Health Medicine. 2021.
Ahmad MA, Shah H, Shah A, Nor AM. MALAYSIAN ONLINE JOURNAL OF PSYCHOLOGY & COUNSELING ONLINE COPING STRATEGY AMONG PLHIV WITHIN THE LGBTQ PEOPLE IN MALAYSIA: A QUALITATIVE STUDY [Internet]. 2022. Available from: http://mojc.um.edu.my/
Khati A, Wickersham JA, Rosen AO, Ralph Luces JB, Copenhaver N, Jeri-Wahrhaftig A, et al. Ethical Issues in the Use of Smartphone Apps for HIV Prevention in Malaysia: Focus Group Study With Men Who Have Sex With Men. 2022 [cited 2023 Oct 1]; Available from: https://formative.jmir.org/2022/12/e42939
Kim RS, Wickersham JA, Maviglia F, Galka JM, Azwa I, Gautam K, et al. Drivers of HIV self-testing among female sex workers: Findings from a multi-state study in Malaysia. Front Med (Lausanne). 2023;10.
Saad BM, Tan PL, Subramaniam G. Implication of HIV/AIDS Knowledge on Quality of Life of Young Women in Malaysia. Procedia Soc Behav Sci. 2015 Aug;202:218–26.
Hamid NC, Malek KA, Mat-Nasir N, Mohamad M, Nasir NM. Prevalence of Good Condom Usage and Its Association with Condom Use Self-Efficacy among Youth Attending HIV/STDs Clinics in Primary-Care Settings in Malaysia. Int J Environ Res Public Health. 2022 Oct 1;19(19).
Lemin AS, Drph ;, Rahman M, Pangarah A, Kiyu A. Factors Affecting Voluntary HIV Testing Among General Adult Population: A Cross-Sectional Study in Sarawak, Malaysia [Internet]. Vol. 14, ? Journal of Family and Reproductive Health. 2020. Available from: http://jfrh.tums.ac.ir
Folasayo AT, Oluwasegun AJ, Samsudin S, Saudi SNS, Osman M, Hamat RA. Assessing the knowledge level, attitudes, risky behaviors and preventive practices on sexually transmitted diseases among university students as future healthcare providers in the central zone of Malaysia: A cross-sectional study. Int J Environ Res Public Health. 2017 Feb 8;14(2).
Haladin NB, Ibrahim NA, Rajab A. HIV Communication Challenges Faced by HIV Specialist Nurses in Malaysia Government Hospitals. LSP International Journal. 2018 Jan 8;4(1).
Mekonnen AB, McLachlan AJ, Brien J anne E, Mekonnen D, Abay Z. Barriers and facilitators to hospital pharmacists’ engagement in medication safety activities: A qualitative study using the theoretical domains framework. J Pharm Policy Pract. 2018 Jan 23;11(1).
Rosen AO, Wickersham JA, Altice FL, Khati A, Azwa I, Tee V, et al. Barriers and Facilitators to Pre-Exposure Prophylaxis by Men Who Have Sex with Men and Community Stakeholders in Malaysia. Int J Environ Res Public Health. 2023 May 1;20(9).
Mansor N, Ahmad N, Rahman HA. Determinants of knowledge on sexually transmitted infections among students in public higher education institutions in Melaka state, Malaysia. PLoS One. 2020 Oct 1;15(10 October).
Rutledge R, Morozova O, Gibson BA, Altice FL, Kamarulzaman A, Wickersham JA. Correlates of Recent HIV Testing Among Transgender Women in Greater Kuala Lumpur, Malaysia. https://home.liebertpub.com/lgbt [Internet]. 2018 Dec 12 [cited 2023 Oct 1];5(8):484–93. Available from: https://www.liebertpub.com/doi/10.1089/lgbt.2018.0021
Rahman MM, Arif MT, Safii R, Tambi Z, Jantan Z, Ismail MF. Perceived knowledge, attitude towards HIV/ AIDS, and sexual behavior among migrant workers in Malaysia: A structural path analysis. HIV and AIDS Review. 2021;20(3):213–22.
Zin NM, Ishak I, Manoharan K. Knowledge, attitude and practice towards sexually transmitted diseases amongst the inmates of women shelters homes at Klang Valley. BMC Public Health. 2019 Jun 13;19.
Jefferson IS, Robinson SK, Tung-Hahn E, Schumann R, Marrero-Conti S, Walton JM, et al. Assessing and Improving the Knowledge of Sexually Transmitted Infections among High School Adolescents. Dermatol Res Pract. 2021;2021.
Qian HZ, Wang N, Dong S, Chen H, Zhang Y, Chamot E, et al. Association of misconceptions about HIV transmission and discriminatory attitudes in rural China. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2007 Nov;19(10):1283–7.
Etowa EB, Wong JPH, Omorodion F, Etowa J, Luginaah I. Addressing HIV Misconceptions among Heterosexual Black Men and Communities in Ontario. Healthcare (Switzerland). 2023 Apr 1;11(7).
Antabe R, Konkor I, McIntosh M, Lawson E, Husbands W, Wong J, et al. “I went in there, had a bit of an issue with those folks”: everyday challenges of heterosexual African, Caribbean and black (ACB) men in accessing HIV/AIDS services in London, Ontario. BMC Public Health. 2021 Dec 1;21(1).
Laprise C, Bolster-Foucault C. Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review. Canada Communicable Disease Report. 2021 Mar 4;47(2):105–25.
Palmiter D, Alvord M, Dorlen R, Comas-Diaz L, Luthar SS, Maddi SR, et al. American Psychological Association. 2020 [cited 2023 Oct 4]. Building your resilience. Available from: https://www.apa.org/topics/resilience/building-your-resilience
Li L, Wu Z, Wu S, Jia M, Lieber E, Lu Y. Impacts of HIV/AIDS Stigma on Family Identity and Interactions in China. 2008.
Xu JF, Ming ZQ, Zhang YQ, Wang PC, Jing J, Cheng F. Family support, discrimination, and quality of life among ART-treated HIV-infected patients: A two-year study in China. Infect Dis Poverty. 2017 Nov 21;6(1).
Pinyosinwat T. Field Actions Science Reports PHAMIT: A program on hiv/aids prevention among migrant workers Thongphit Pinyosinwat Electronic reference Thongphit Pinyosinwat, «?PHAMIT: A program on hiv/aids prevention among migrant workers Creative Commons Attribution 3.0 License. 2003;
Cao B, Bao H, Oppong E, Feng S, Smith KM, Tucker JD, et al. Digital health for sexually transmitted infection and HIV services: A global scoping review. Vol. 33, Current Opinion in Infectious Diseases. Lippincott Williams and Wilkins; 2020. p. 44–50.
UNAIDS. UNAIDS. 2023 [cited 2023 Oct 5]. Ten SDGs for ending AIDS. Available from: https://www.unaids.org/en/AIDS_SDGs#:~:text=Goal%203%3A%20ensure%20healthy%20lives&text=SDG%203%20includes%20the%20promise,by%202030%20(target%203.3).
Ministry of Health. Malaysia National Strategic Plan for Ending AIDS 2016-2030. 2016.
Wickersham JA, Gibson BA, Bazazi AR, Pillai V, Pedersen CJ, Meyer JP, et al. Prevalence of Human Immunodeficiency Virus and Sexually Transmitted Infections among Cisgender and Transgender Women Sex Workers in Greater Kuala Lumpur, Malaysia: Results from a Respondent-Driven Sampling Study. Sex Transm Dis. 2017 Nov 1;44(11):663–70.
Barmania S, Aljunid SM. Premarital HIV testing in Malaysia: a qualitative exploratory study on the views of major stakeholders involved in HIV prevention. BMC Int Health Hum Rights. 2017 May 10;17(1).
Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings [Internet]. 2006 [cited 2023 Oct 5]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
Tan HL, Koh KC, Koh D, Choy K. ©Academy of Family Physicians of Malaysia EBM COMMENTARY IS HIV SCREENING IN THE GENERAL POPULATION COST EFFECTIVE? Malaysian Family Physician [Internet]. 2008 [cited 2023 Oct 5];3(2):1985–2274. Available from: http://www.unicef.org/
Nyblade L, Stangl A, Weiss E, Ashburn K. Combating HIV stigma in health care settings: What works? Vol. 12, Journal of the International AIDS Society. John Wiley and Sons Inc.; 2009.
Malaysian Society for HIV Medicine. Malaysian Consensus Guidelines on Antiretroviral Therapy. PrEP is recommended in the Malaysian Consensus Guidelines on Antiretroviral Therapy 2022, and it lowers HIV transmission from sexual activity by 99% in MSM and 75% in heterosexuals if taken daily [Internet]. 2022 [cited 2023 Nov 15]; Available from: https://www.researchgate.net/publication/364689111_Malaysian_Consensus_Guideines_on_Antiretrviral_Therapy_2022/link/635752bf8d4484154a30c706/download
Disease Control Division Ministry of Health. The Global AIDS Monitoring Report 2022 [Internet]. 2022 [cited 2023 Nov 15]. Available from: https://www.moh.gov.my/moh/resources/Penerbitan/Laporan/Umum/MYS_country_report_2021.pdf
WHO. Update to WHO implementation guidance TECHNICAL BRIEF Differentiated and simplified pre-exposure prophylaxis for HIV prevention. 2022 [cited 2023 Nov 15]; Available from: http://apps.who.int/bookorders.
