HIV in Malaysia

Abstract

This essay provides a short description of Malaysia, its demographics, geography, commerce, society, and living conditions. Much attention is paid to information concerning HIV and AIDS. Incidence by population, including age, gender, nationality, and way of transmission is thoroughly described. It is notable that the rate of infected males is much higher than the rate of infected females. Different HIV and AIDS treatment methodologies are analyzed and compared to treatment methodologies in the USA. The most popular methodology in both countries is the ARV treatment as it shows the best treatment results. Much attention is paid to the cost of treatment, as well as insurance and support of infected people. It is notable that the USA provides compulsory insurance of medical treatment and numerous programs, which help people to pay their treatment bills, while the Malaysian government pays more attention to granting free screening and first level treatment. Preventive measures like decrease of drug use and support to infected pregnant females are also thoroughly described and analyzed. Additionally, this essay contains some propositions for solving the existing issue of HIV and AIDS in Malaysia like providing governmental support to infected citizens.

HIV in Malaysia

Introduction

This essay provides a short description of Malaysia, its location, geography, economy, and demographics. Much attention is paid to peoples level of life and living conditions as they have a considerable influence on development of HIV and AIDS. Information concerning age, gender, and nationality of infected people is also presented below. Much attention is paid to preventive measures and insurance and their comparison to preventive measures and insurance in the USA. The concluding part contains some recommendations to the Malaysian government for solving existing HIV issues.

Countrys Overview

Malaysia is a federal constitution monarchy located in the South-Eastern part of Asia. Kuala Lampur is the capital of the country. Malaysia comprises 13 states and 3 federal territories. The South China Sea separates the country into East Malaysia and Peninsular Malaysia. The country has sea and land boarders with Singapore, Thailand, Philippines, Vietnam, Brunei, and Indonesia. The total area of the country is 329,847 square km (Central Intelligence Agency, 2015). Malaysia has a tropical climate. There are South-West monsoons from April till October and North-East monsoons from October to February.

In the current year, the population of Malaysia is about 30 million people. It consists of representatives of different ethnic groups: Malay (about 50 per cent), Chinese (about 22 per cent), Indigenous (about 11 per cent), Indian (about 6 per cent), and other. The official language is Bahasa Malaysian. However, people also speak Chinese, English, Thai, and other languages.

People practice numerous religions: Islam (about 60 per cent), Buddhism (about 19 per cent), Christianity (about 9 per cent), and others. The official religion of the country is Islam; however, a person has freedom to practice any other religion. This federal constitutional monarchy has a parliamentary system. The king is a head of Malaysia. People choose a king for five years on state elections. The prime minister is a head of the Malaysian parliament. The common law of the country creates the background for the whole legal system.

Nowadays, this country has a newly industrialized multi-sector market economy. The government adopts numerous initiatives for attracting investors into Malaysian high technologies, services, and biotechnologies. The country exports electronics, gas, oil, rubber, and palm oil to such countries as Singapore, Japan, the USA, China, and Thailand. Malaysia exports refined petroleum and petroleum gas, palm oils, integrated circuits, and computers from such countries as China, Singapore, Indonesia, Japan, and Thailand.

Main Malaysian agricultural products are palm oil, cocoa, rice, timber, and pepper. Main industries in the country are manufacturing of rubber and palm oil, natural gas and petroleum gas, medical technologies and pharmaceuticals, and electronics.

The Malaysian labor force comprised 14 million people in the previous year. Most people worked in the service sphere (about 50 per cent), industrial sphere (about 35 per cent), and agriculture (about 11 per cent). The unemployment rate was 2.9 per cent in 2014 (by 0.2 per cent lower than in 2013). GDP of the country was $746 million in previous year (by 5.81 per cent higher than in 2013). Malaysian population has upper middle income. The average household income was 5,900 Ringit (about $1,637) in the previous year (by 18 per cent higher than in 2012).

Living Conditions in Malaysia

Malaysia attracts people with the high level of living conditions and low cost of these conditions. In the capital, the cost of an apartment (or house) rent varies from 100 to 150 euros per month. Malaysia provides high quality health care treatment and numerous educational institutions. This is granted by a new industrialized developing economy, low taxation, absence of inheritance taxes, and absence of taxation on financial remittances from other countries.

HIV and AIDS Issues

Notwithstanding the high level of living conditions and developed health care in Malaysia, citizens of this country suffer greatly from HIV and AIDS. Below, there will be presented statistical information reflecting the amount of ill people, their age and gender, amount of death cases, etc. (HIV Statistics: AIDS in Malaysia, n.d.). It is notable that the prevalence of HIV (persons from 15 to 49 years old) has not changed for the last 15 years. It remains on the level of 0.4 0.5 per cent.

Table 1

Differentiation of HIV Infections and AIDS Cases depending on Gender (from 1986 till 2014)

Factor	Classification	HIV Infection	AIDS Cases
Sex / Gender	Male	82.603	14.482
	Female	8.759	1.870
	Total	91.362	16.352

It is notable that the amount of male which have HIV Infection is about 9.5 times higher than the amount of females with HIV Infection. However the amount of male AIDS Case is only 7.7 times higher.

Table 2

Differentiation of HIV Infections and AIDS Cases depending on Age (from 1986 till 2014)

Age groups	Classification	HIV Infection	AIDS Cases
	< 2 years	112	80
	2 12 years	797	154
	12 19 years	2.295	252
	20 29 years	30.443	3.018
	30 39 years	39.304	7.033
	40 49 years	14.698	4.029
	> 50 years	3.739	1.540
	No information	974	276
	Total	91.362	16.352

Table 2 shows that population from 30 to 39 years of age have the highest rates of HIV and AIDS.

Table 3

Differentiation of HIV Infections and AIDS Cases depending on Nationality (from 1986 till 2014)

Ethnic group	Classification	HIV Infection	AIDS Cases
	Malay	65,235	9,633
	Chinese	13,283	4,173
	Indian	7,190	1,271
	Bumiputra Sarawak	2.267	288
	Bumiputra Sabah	760	237
	Others	496	154
	Foreigner	1.596	575
	No data	535	21
	Total	91.362	16.352

It is notable that the Malay are mostly effected by HIV and AIDS in Malaysia. It can be explained by the fact that this ethnic group is the biggest in this country. Besides, attention should be paid to the fact that the amount of contaminated foreigners is rather high. It means that HIV and AIDS are brought to Malaysia from other countries.

Table 4

Differentiation of HIV Infections and AIDS Cases depending on Transmission (from 1986 till 2014)

Risk factor	Classification	HIV Infection	AIDS Cases
	IDU (injection drug users)	63,680	8,897
	Through blood	34	20
	Through organs transplantation	0	3
	Homosexual / bisexual	2,047	562
	Heterosexual	16,320	5,005
	From pregnant women to their children	832	215
	No data	8,449	1,650
	Total amount	91,362	16,352

The main causes of HIV and AIDS in Malaysia include high risk sexual behavior and use of drugs.

Treatment of HIV and AIDS in Malaysian and the USA

Malaysia uses different methodologies and practices in order to correspond to the issue of HIV and AIDS. The most popular initiatives include antiretroviral treatment (ARV)( Guidelines for the Management of Adult HIV Infection with Antitrovural Therapy, 2011.). The main directions of this therapy presuppose stipulation of changes of CD 4 levels. It is notable that treating patients earlier at higher CD4 cell counts, when immune systems are still largely intact, can greatly reduce mortality and prevent HIV transmission (Canavan, 2013). This treatment is recommended to pregnant females, children till the age of five years, and positive adults as early treatment of HIV. It is notable that the first line ARV medication is free.

The cost of ARV medication in Malaysia is about $330 per year (about $ 27.5 per month) for the second line treatment and about $1,500 per year (about $125 per month) for the third line treatment (Antiretroviral Drug Prices, 2014). The ART medication for treatment of HIV is also widely used in the USA. It is notable that the process of using ART medication depends greatly on such factors as components, region, and accessibility (Chaves, 2014). The cost of medication varies from $270 per month to $3,700 per month (Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, 2015).

The Malaysian government has adopted numerous initiatives in order to provide affordable antiretroviral treatment to all citizens of the country. The main goal of the government is that this treatment is free for people who need it. Besides, it should be mentioned that this treatment is provided to incarcerated individuals like prisoners. In Malaysia, any person can make a HIV screening test freely in any clinic and hospital. The government has adopted numerous initiatives for decreasing the harm to health from this treatment: the Opiate Substitution Therapy and the Needle Syringe Exchange Program.

Medication treatment (allopathic HIV treatment) is based on the use of different chemical substances for making harm or even killing the virus. The medication (inhibitors) is injected into human body for interruption of the life cycle of HIV infection. However, this treatment can also inflect harm on the human body (like multi organ failures). Malaysian health care providers use different medications like Agenerase (amprenavir), Kaletra (lopinavir), Norvir (ritonavir), Crixivan (indinavir), Sustiva (efavirenz), etc. Nowadays, the price of anti-Hiv medication is continuously decreasing due to numerous innovations in medicine and technologies. The cost of key medication (atazanavir/ritonavir and lopinavir/ritonavir) is about RM 75 per month ($25 per month) (High price of new HIV drugs, 2013). American health care providers also use this type of treatment for fighting against HIV and AIDS. Their medication is thoroughly checked and approved. It usually provides better results. The cost of treatment varies from $600 to $3,000 per month (Krucik, 2015)

The majority of HIV cases are treated in two ways: homeopathic treatment and medication treatment. Homeopathic treatment is based on the understanding that human body can heal itself. This kind of alternative medicine consists in application of different natural substances (vitamins, minerals, and herbal compositions), which can cure the organism without any considerable chemical intervention with organic processes of the human body. This methodology eliminates considerable harm that may be caused by anti-HIV medication. The cost of homeopathic treatment in Malaysia is about $100.00 per month. This type of treatment is not very popular in the USA as it does not provide strong results. Health care providers prescribe different daily doses of proved medication to different patients. These doses depend on health conditions of each patient

Besides, Malaysian health care providers use experimental opportunistic injection blockers for infecting human body with opportunistic illnesses that can block HIV and AIDS. The most common opportunistic infections in HIV patients are candidiasis, cryptococcal meningitis and histoplasmosis (Mei et al., 2011).

American citizens are required to purchase medical insurance for treatment of HIV. The government adopts and supports various initiatives to help people (especially citizens with low income) in this. The first initiative is programs funded by the government (like The Ryan White Program, Medicare and Medicaid, and AIDS Drug Assistance Programs (ADAP)). Medicaid provides medical treatment, HIV screening, and access to ARV medication to more than 200,000 low income citizens (about 50 per cent of people with HIV in the USA). Medicaid provides health insurance to people older than sixty five years and young adults with permanent disabilities. This program covers about 6 per cent of people with HIV in the USA. It also provides HIV screening and access to ARV medication and anti-HIV drugs (Bessessen, 2012). AIDS Drug Assistance Programs (ADAP) provide drug prescription to people who suffer from HIV and have no ability to pay for it. This program provides ARVs and drugs for opportunistic infections and HIV-related conditions and also purchases or maintains health insurance for clients because it is usually less expensive than financing ongoing medication (HIV Treatment in the USA, 2015). The Ryan White Program offers HIV diagnosis, provides care and support services to over half a million people living with HIV or AIDS each year, and goes further to provide support to families affected by the epidemic (HIV Treatment in the USA, 2015) to both underinsured and uninsured individuals who cannot cover bills on their medication. The second scheme is private work base scheme. According to it, treatment is covered by employer or labor union. The last scheme is coverage of treatment via private health insurance. It is usually used by self-employers.

One of the most popular preventive methodologies in Malaysia is PMTCT Program (Prevention of Mother to Child Transmission). It is directed on prevention and decrease of the percentage of transmission of HIV and AIDS from pregnant females to their children. It was firstly presented in 1997. Nowadays, this program is accessible to about 75 per cent of all pregnant females all over the country. The main direction of this program is HIV screening utilizing an opt-out approach (IAS, 2013). Besides, the government tries to spread information concerning the necessity of sex protection; and considerable harm of drugs. The Malaysian Ministry of Health introduces the distribution of clean needles and syringes to injecting drug users, and methadone maintenance therapy to encourage heroin users to switch to methadone (Thanasayan, 2014).

Moreover, numerous HIV prevention programs are established by the UNICEF (which is supported by the USA). These programs include providing technical assistance, research, and information concerning HIV to Malaysian citizens.

The Malaysian government can improve existing HIV issues by development and implementation of numerous HIV and AIDS insurance and support programs for citizens, especially the low-income ones. These initiatives will enable people to obtain necessary medication and drugs and will lead to a considerable reduction of the amount of HIV infected. Besides, attention should be paid to spread of information concerning the ways of protection from HIV (like the use of condoms).

Preventive Measures

To conclude, Malaysia has a developed economy, highly developed medication and education, and high living level. However, Malaysia has a high amount of HIV and AIDS infected citizens. Most of them are males. The main ways of transmission are the use of drugs and unprotected sex. The government develops and implements several initiatives to solve the existing health issue like providing free first level medication and free treatment of imprisoned persons. The most popular ways of HIV treatment are the following: the ARV treatment, drug treatment, and homeopathic treatment. Treatment by opportunistic injection blockers is just experimental. The government has developed and adopted several preventive initiatives (Prevention of Mother to Child Transmission, fight against drug use, etc.). It is notable that the cost of HIV treatment in Malaysia is lower than the cost of the same treatment in the USA. However, American health care providers use checked and approved medication and treatment methodologies. Moreover, the American government (unlike the Malaysian one) has developed numerous insurance initiatives for granting support to American citizens in paying their treatment bills. The Malaysian government can develop and implement similar supportive insurance programs for citizens of the country for a more effective and efficient struggle against HIV and AIDS.

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