HIV infections are on the rise among university students in Malaysia, with health analysts urging stronger HIV awareness campaigns aimed at young people and easier access to preventive measures.

Some 244 students between 18 and 25 years old were infected last year, a 31 per cent increase from 2021, said Higher Education Minister Zambry Abdul Kadir on Wednesday, with infections across the age group accounting for about 7 per cent of all new HIV cases last year.

Malaysia's 2023 report to the Joint United Nations Programme on HIV/Aids estimated that there were 86,000 people living with HIV in the Southeast Asian nation in 2022, with 80 per cent aware of their condition.

In January last year, Malaysia launched a pilot programme to provide public access to Pre-Exposure Prophylaxis (PrEP), which can lower the chances of getting HIV from sex by over 90 per cent and from injecting drugs by over 70 per cent if taken daily, according to the US Center for Disease Control and Prevention.

Before the initiative, PrEP was only available at private clinics. As of March this year, over 3,400 people have received the drug regimen under the programme.

Code Blue, a Malaysian medical news agency, reported in May that the transmission rate of HIV among those who have participated in the programme stood at just 0.2 per cent.

"This means that we successfully prevented HIV in 99.8 per cent of high-risk individuals. This shows that PrEP is very effective," said the health ministry's disease control division director Anita Suleiman, in Code Blue's report.

Ramesh Vadiveloo, who leads HIV/Aids advocacy group Advocate Asia, called the programme an "amazing initiative" but warned that students were often reluctant to go to a government facility because of stigma.

"They want it to be a community-based healthcare service provider, they want it to be accessible and they want it to be fast," he said to This Week in Asia.

Ramesh, who has experience managing a sexual health community clinic, said PrEP remains expensive even as it becomes increasingly available in private clinics.

"The price of PrEP at private clinics can be between 120 to 400 ringgit (US$25 to US$85), which is expensive for most tertiary students," he said.

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Tertiary students accounted for over three quarters of HIV infections in 2022, but the health ministry's report found that only 10 per cent of Malaysians between 15 and 24 years old accurately understood the risk of HIV transmission.

"This underscores the urgent need for targeted educational initiatives aimed at enhancing HIV literacy among young Malaysians," the report said.

HIV infections in Malaysia peaked at the turn of the millennium and plateaued in the last 10 years after a sharp drop in the previous decade, derailing Malaysia's goal of eradicating HIV and Aids by 2030.

Health experts say social stigma and a lack of sexual knowledge have contributed to the slower decline in cases over the last 10 years, with sexual transmission overtaking drug abuse as the main risk factor.

Malaysia, a largely Muslim and conservative country, has had reports of stigma in its medical sector, particularly towards unwed couples and those in same-sex relationships.

A 2023 research led by University of Malaya medical consultant Dr Tee Ying Chew found that over half of 568 Malaysian physicians in their research expressed discriminatory attitudes towards people with HIV.

Sex education remains taboo in Malaysian schools despite repeated calls to expand the topic beyond basic biology.

Women, Family, and Community Development Minister Nancy Shukri in June last year proposed comprehensive sex education in schools to educate students about sexual harassment and abuse, noting that many reported cases of abuse often involved family members.

"We must adopt a more open approach, as we always think differently when it comes to the word 'sex'," she said to local newspaper New Straits Times last month.
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