In December 2022, the Ministry of Health announced its Pre-Exposure Prophylaxis (PrEP) pilot programme slated to be launched in 2023 aimed at reducing HIV transmission. Funded by the Global Fund, the pilot project in Malaysia will be made available through 18 health clinics across Malaysia. 

PrEP is a HIV prevention medication that has proven to be 99% effective in preventing HIV transmission. The World Health Organization (WHO) has recommended PrEP as part of a combination approach to HIV prevention for all people who are at substantial risk of contracting HIV. Further, UNAIDS notes that ending the HIV epidemic requires synergy around the three zeros – zero new HIV infections, zero discrimination and zero AIDS-related deaths. 

In the last 10 years, the trend of HIV prevalence in Malaysia has shifted from sharing needles and syringes among people who use drugs to sexual transmission being the main mode of transmission. In 2020, 94% of the HIV cases in Malaysia were sexually transmitted. Additionally, 76% of new HIV cases are among people between 20 and 39 years old. 

Since its announcement, Justice for Sisters has observed concerted efforts by anti-rights actors, including PAS and other politicians, academics, health care practitioners, and media outlets to deny access of PrEP to gay, bisexual, queer (GBQ) and other men who have sex with men (MSM) and, by extension, LGBT people. 

The anti-rights actors argue, among others, that the availability of PrEP will ‘condone or normalize LGBT’ and overburden the healthcare system. Such prejudicial claims coupled with misinformation about PrEP’s side effects and call for continuation of ineffective, harmful and non-evidence based approaches, such as abstinence-only education and rehabilitation or conversion practices as the strategies to tackle HIV not only deprive LGBTQ people of right to life, health, non-discrimination and equality, but also undermine Malaysia and global efforts in ending HIV.  

Moreover, the call to restrict access to PrEP by anti-rights actors is inconsistent with the fundamental medical ethics of doing no harm. 

Consistent with UNAIDS’ call to effectively end the HIV epidemic through “zero new HIV infections, zero discrimination and zero AIDS-related deaths,” there is an urgent need for the Ministry of Health and Ministry of Digital Communication to address the HIV-related mis/disinformation by anti-rights actors. Left unchecked, the Special Rapporteur on Freedom of Expression notes even graver consequences of  disinformation, including the erosion of trust in democratic institutions. 

Studies already show that GBQ men and MSM as well as transgender, lesbian, bisexual, and gender diverse people show low health-seeking behaviour and knowledge and high trust-deficit in healthcare institutions due to criminalization, stigma and discrimination, pressure to ‘change’ their sexual orientation, gender identity and gender expression through various means, including marriage, among others. Ministry of Health’s annual HIV progress reports finds GBQ men and MSM as the hardest population to reach due to discrimination and at the same time projects GBQ men and MSM to be the main key affected population affected by HIV by 2030. 

In addition, Justice for Sisters recommends that the Ministry of Health:

• Assess the compliance of existing government HIV programmes and information disseminated by advocates with international human rights standards 

• Engage LGBTIQ and HIV human rights groups to reduce discrimination against marginalised populations 

• Hold consultations and workshops with media outlets and so-called HIV advocates to ensure access to accurate information and reduce stigma and discrimination. 

Please read our factsheet on PrEP, which addresses mis/disinformation related to PrEP by anti-rights groups