Malaysia Aims to End AIDS by 2030: Importance of Pre-exposure prophylaxis (PrEP)
In Malaysia, HIV cases among MSM (men who have sex with men) have risen sharply from 19% in 2012 to 62% in 2021, and it's expected that by 2030, three-quarters of all cases will involve MSM. The Ministry of Health in Malaysia is focusing on PrEP (Pre-Exposure Prophylaxis) as part of its National Strategic Plan to eradicate AIDS by 2030.
Government Subsidy May Not Be Enough For an Effective Scale-up
Presently, a pilot PrEP program has roughly 300 MSM participants, leaving a substantial gap to meet the needs of an estimated 220,000 MSM who could benefit.
While there's considerable interest and awareness about PrEP, relying solely on government subsidy may not be enough for an effective scale-up. Malaysia encounters hurdles due to stigma and discrimination against MSM, intensified by the criminalization of same-sex behavior in secular and Shariah law, further reinforced in healthcare settings. It's crucial to address these challenges, including costs and other concerns related to PrEP, to develop impactful PrEP delivery programs for MSM at risk of HIV.
Technology Boosts Uptake of PrEP among MSM
Successful PrEP adoption among Malaysian MSM is likely with targeted on-demand implementation, education, affordable perception, and injectable options for high-risk individuals.
Same-day initiation, reduced clinical visits, and innovative delivery methods like pharmacy-led PrEP, mobile clinics, telemedicine, and mHealth can boost uptake. Emphasizing privacy protection is crucial for an effective PrEP program. Preferences among Malaysian MSM vary, indicating a tailored approach is necessary, with a significant portion favoring injectable or intermittent PrEP. Involving patients in decisions, facilitated by decision aids, is essential for personalized PrEP regimens.