KUALA LUMPUR, December 23 – Proposals for compulsory screening and sex and marriage curbs for HIV sufferers have triggered an intense debate over how to handle a disease taking hold in mainly Muslim Malaysia.
The issue has revealed a sharp gulf in thinking in this multiracial nation of 27 million people, with AIDS activists critical of attitudes they say are stigmatising people with the deadly disease and its precursor HIV.
Last week, deputy premier Najib Razak said all Muslim couples would have to undergo mandatory HIV screening before they wed — a test so far only applied in certain states.
He also suggested the measure should be expanded on a voluntary basis for non-Muslim couples.
A senior opposition politician went further Monday, saying couples with HIV should not be allowed to marry at all or have children.
"I think it is a gross error to allow somebody very sick like that, an HIV carrier, to marry," Mohammad Nizar, of the conservative Pan-Malaysian Islamic Party (PAS), told the New Straits Times newspaper.
"If there’s any breeding — sorry for having to use that word — the embryo will also carry the same virus. It’s very unjust to the child," added Nizar, whose party controls the northern state of Perak.
According to United Nations figures, more than 82,500 Malaysians have been infected with the virus since records began in 1986 and, while precise data is hard to obtain, around 80,000 are currently living with HIV/AIDS.
The number of new HIV infections is falling, however.
Last year 5,400 new cases were reported compared to 6,900 the year before, the health ministry says, a figure expected to drop further in 2008 to nearly 3,500.
At the same time, infections among married women through sex have increased from five percent of total cases in 1997 to 16 percent last year.
Malaysian AIDS Council president Adeeba Kamarulzaman said screening plans reflected a lack of understanding of the disease.
"It is crazy. HIV-infected persons should be allowed to marry and have safe sex," she told AFP.
"These comments and proposals show there is a lack of education about the latest developments in treating HIV/AIDS."
Irene Fernandez, director of women’s group Tenaganita, said the government "should not be making such choices for people."
"It is a screwed-up perspective. After so many years of HIV/AIDS education they (the government) come up with such views. This is very worrying.
"We must let people decide on how to live their lives. We cannot deny the people their choice of whom they want to marry," she told AFP.
"If a couple gets married and one partner is found to be HIV positive, does it mean they will have to divorce? This clearly does not make sense."
Analysts say the comments by politicians showed they were behind the times on science and how to deal with the disease.
Tricia Yeoh, an analyst who focuses on social-political issues, said that government policies must reflect the changing face of HIV in Malaysia.
"Today, the infection is no longer treated as a social vice, but more as a disease which can be treated.
"Medical science has progressed … but the perception of politicians and many people in Malaysia of HIV remains fixed to the images of promiscuity and death from AIDS as it was in the 1980s."
Health minister Liow Tong Lai last week said six out of every 10,000 people who went for pre-nuptial HIV screening last year tested positive.
The Malaysian AIDS Council’s Adeeba warned that pre-marital testing would stigmatise the disease and make those at risk fearful of coming forward.
She said the Islamic religious department’s involvement in the process made the situation worse, as a person’s HIV status would no longer be private.
"I have had a case where I confirmed a patient’s HIV status but the couple still wanted to get married — so the religious department took it upon itself to inform the girl’s parents of her HIV status to stop her from marrying."