Although the vast majority of Muslims living with HIV in Malaysia are men who have injected drugs, over the last two years heterosexual sex has crept ahead of injection as the main way of transmitting HIV, with 45% of new cases the result of sex between men and women, compared to 38% for sharing needles.
“For years HIV has been seen as the problem of men who inject drugs,” says Zaki Arzmi of the Malaysian AIDS Council (MAC), “but these men don’t exist in a bubble – they have lives, they have sex – and as a result we are slowly seeing more women become infected. At the start of the Nineties, the ratio was one women infected for every 99 men. Now the ratio is 1 to 4.”
Shaleen, an outreach worker at a drop in centre for sex workers in Pahang, a state on Malaysia’s south east coast, knows the reality of the sexual transmission of HIV only too well. Her first husband was a drug user who she believes infected her with HIV.
“I had no idea that my first husband was using drugs,” she says, “I discovered I was HIV positive when I was pregnant with our first child. After my husband died I decided to start working here; I was inspired to start doing something for the community.”
In 2004 Shaleen met her second husband, a former drug user who is also living with HIV, and in 2007 they married. He also works at the drop in centre, which is supported by the Malaysian AIDS Council.
“I never thought I would get married again. I am inspired by what my husband has gone through,” says Shaleen. “He has taught me a lot about how to treat people. I am proud of what I am doing now; that people living with HIV are not being shunned and they have a place where they can find support.
“I also take pride in the fact that we can see behaviour change in the women coming here. Those that didn’t know how to put a condom on now do, those who weren’t able to negotiate safer sex can.
“Now that they know what a condom does they are more empowered to make choices, to make decisions, because they know what might happen to them without the condom. I see the change in their confidence that this brings.”
On Friday 20 July we'll be speaking at the AIDS 2012 pre-conference event ‘The twin epidemics of HIV and drug use’. You can read about the Alliance’s activities at AIDS 2012 here.