July 2011—Sex between men is illegal in Malaysia and homosexuality is highly stigmatized. HIV organizations are consequently faced with the challenge of advocating for safe sex in an environment in which anal sex is prohibited and spaces where men meet are subject to police raids. In addition, clinical anecdotes suggest that HIV incidence may be increasing among men who have sex with men (MSM) in Malaysia.

To assess HIV prevalence and understand risk behaviors and knowledge about HIV transmission among MSM in Kuala Lumpur, a study—funded by a grant to the Malaysian AIDS Council from amfAR, with additional support from the World Bank—was conducted among men from Malaysia’s three main ethnic groups attending local entertainment venues. A total of 517 Malay, Chinese, and Indian men completed a survey on their risk behaviors and received an oral, rapid HIV test.¹

Surveys and HIV testing were conducted among MSM at a cruising park to determine levels of risk behavior. (Photo: CeRIA, University of Malaya Medical Center, Malaysia)

Among the participants, 3.9 percent tested HIV-positive, compared to 0.5 percent among the general Malaysian adult population. In addition, 59 percent of all participants reported that they had never previously been tested for HIV. Knowledge of HIV transmission was relatively high, with 80 percent understanding that HIV can be transmitted via anal sex. Almost half, however, reported having unprotected anal sex with a casual partner in the past six months. Within the three population groups in the study, the only significant difference observed was that Malay men were more likely to report unprotected anal sex with a casual partner than Chinese men.
The high-risk behavior and lack of easily accessible HIV testing for MSM observed in this study raise concerns about the potential for further growth in the HIV epidemic among MSM in Malaysia. The study authors acknowledge the current restrictive legal and social environment, which makes prevention work and behavioral interventions difficult, but stress the urgency of providing effective HIV education to Malaysian MSM.

^1. Kanter J, Koh C, Razali K, Tai R, Izenberg J, Rajan L, Van Griensven F, Kamarulzaman A. Risk behavior and HIV prevalence among men who have sex with men in a multiethnic society: A venue-based study in Kuala Lumpur, in Malaysia. International Journal of STD & AIDS. 2011;22: 30–37.