Abstinence advocacy not enough to prevent HIV - deputy minister

 

PARLIAMENT | The Health Ministry has been urged to engage in preventative methods such as abstinence programmes to prevent the spread of HIV infections, instead of dispensing free pre-exposure prophylaxis (PrEP) at public clinics.

However, Deputy Health Minister Lukanisman Awang Sauni said the ministry is already running abstinence programmes and has found them insufficient to bring down the number of HIV infections, especially among the youth.

“The Health Ministry always prioritises prevention based on noble values such as abstinence, but recently the issue of substance abuse has presented a major challenge to existing preventative efforts.

“Hence, PrEP is an additional prevention step which has been shown to be effective that needs to be provided as a supplement to existing preventative methods such as abstinence advocacy, condoms, risk reduction and others.

“Our worry is that (people) as young as 18 years old are already contracting HIV (which shows) it is not enough to have abstinence (programmes),” Lukanisman (above) said during the question-and-answer session in the Dewan Rakyat today.

All urged to support PrEP treatment

He stressed that data shows more than three-quarters of new HIV cases reported every year consists of youths aged between 20 to 39 years old, which shows that exposure to HIV infections starts from as early as one’s schooling days.

“We take the view that if we provide the PrEP treatment, we would like cooperation from the community and also all the professional groups and religious experts to help.

“While providing PrEP treatment, we will also carry out abstinence programmes to return them to the right path,” he said, adding that the main concern is the rise in HIV infection.

Lukanisman was responding to a question from Ahmad Yunus Hairi (Perikatan Nasional-Kuala Langat) who had asked for the rationale behind the PrEP pilot project.

Kuala Langat MP Ahmad Yunus Hairi

Sinful move?

Yunus also later said providing PrEP to prevent HIV infections could be seen as encouraging or allowing “deviant sexual activity”, and suggested the Health Ministry explore other preventative methods.

The ministry viewed dispensing PrEP as a way to reduce the rate of HIV infection and not to encourage deviant sexual behaviour, Lukanisman explained.

He added that they cannot be selective about which groups qualify to receive PrEP.

This view was then supported by Dr Kelvin Yii (Pakatan Harapan-Bandar Kuching) who said, as a doctor who took the Hippocratic oath, they are duty-bound to treat anyone regardless of their background.

The Selangor Mufti Department had previously said providing PrEP to prevent HIV infection to those engaging in “homosexual lifestyles” is colluding in sin but it is permissible to dispense the drug to married couples where one of them is infected with HIV.

Lukanisman pointed out that data from the Centre of Excellence for Research in AIDS (Ceria) shows that using PrEP to prevent HIV transmission has helped save RM47 million in treatment costs between 2006 and 2013.

This was in response to another question from Yunus on the financial effect of the PrEP project on the country.

In his follow-up question, Yunus claimed that the government did not consult fatwas or seek out views from several stakeholders for the PrEP programme before it was implemented in January.

Lukanisman denied this, saying that the Selangor Health Department held an engagement session with the Selangor Islamic Religious Department (Jais) in June 2022 followed by another discussion between the Health Ministry and the Islamic Development Department (Jakim) in December of the same year.

The Selangor Islamic Religious Council (Mais) had previously said it has yet to issue any fatwa regarding the prohibition of providing PrEP to those engaging in “homosexual lifestyles”.

Mixed response from doctors

It was previously reported that the Health Ministry’s decision to provide PrEP at public clinics to prevent HIV infections was criticised by conservatives – including doctors – fighting against giving the LGBT community free access to the drug.

This view has since received pushback from others in the medical community, such as infectious diseases expert Dr Christopher Lee, the Malaysian Medical Association (MMA) and the Malaysian Pharmacists Society (MPS).

Lee said medical professionals must refrain from imposing their moral values on patients while the MMA stressed that any government decision on providing access to the PrEP must be based on scientific evidence.

The MPS also supported the move to provide easier access to PrEP, saying “the reality is that HIV requires a non-religious intervention and prevention programme”.

All three pointed out that there is robust and overwhelming scientific evidence behind the efficacy of PrEP in preventing the spread of HIV infections. - Mkini