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