Introduction
The HIV epidemic continues to evolve globally, with men who have sex with men (MSM) emerging as a key population in the transmission of HIV. According to UNAIDS, MSM accounted for 44% of new HIV infections globally in 2023, making this group a significant driver of the epidemic. In the Asia-Pacific region, MSM represented approximately 50% of new infections, contributing to 230,000 cases in 2023 (UNAIDS, 2023).
In Malaysia, the trend is similarly concerning. While injection drug use was once the primary mode of HIV transmission, MSM have overtaken this group as the most affected population. Recent data indicate that MSM accounted for 64% of new infections in Malaysia in 2023 (Ministry of Health Malaysia, 2023). The prevalence of HIV among MSM has risen sharply, from 3.9% in 2009 to 21.6% in 2017, with the 2022 Integrated Bio-Behavioural Survey (IBBS) reporting a slight decline to 18.2% (IBBS, 2022). Despite ongoing efforts, this trend signals the need for more effective and culturally relevant approaches to tackle the epidemic.
What Has Been Done
Efforts to combat the HIV epidemic have included biomedical, behavioural, and structural interventions. Globally, measures such as pre-exposure prophylaxis (PrEP), antiretroviral therapy (ART), and harm reduction programmes have been implemented with varying degrees of success. Malaysia’s response includes community-based outreach initiatives that provide HIV testing, counselling, and prevention services to MSM. These efforts have resulted in higher rates of condom use and increased uptake of PrEP (Ministry of Health Malaysia, 2023).
Despite these advancements, significant barriers remain. Stigma and discrimination deter many individuals from seeking HIV-related services, while structural challenges, such as the high cost and limited availability of PrEP, restrict its accessibility. The National Strategic Plan to End AIDS (2016–2030) identifies MSM as a priority population, but the persistent rise in new infections highlights the limitations of conventional approaches.
The Tawhidic Approach
Islam provides a holistic framework for addressing the HIV epidemic, rooted in the principles of Tawhid (the oneness of Allah). Islamic teachings emphasise personal accountability, moral conduct, and the preservation of life. The Qur’an states, “And do not approach unlawful sexual intercourse. Indeed, it is ever an immorality and is evil as a way” (Qur’an 17:32). This directive underscores the importance of adhering to Islamic principles to prevent behaviours that lead to harm.
Central to the Tawhidic approach is a strong belief in Allah, which serves as a moral compass for Muslims. This belief fosters self-discipline, accountability, and a sense of responsibility to avoid harmful actions. Parents and community leaders play a vital role in nurturing youth with Islamic values, protecting them from negative influences such as exposure to media that normalise immoral behaviours.
Prevention is a cornerstone of Islamic teachings. By promoting chastity, self-restraint, and the value of family, individuals can develop a strong moral foundation. Religious leaders and mosques can reinforce these principles by providing education, raising awareness, and reducing stigma. Faith-based interventions can address the spiritual and social dimensions of HIV prevention, complementing biomedical efforts.
Way Forward
The solution to the HIV epidemic among MSM lies in the belief and practice of religion. A Tawhidic approach aligns with public health objectives while addressing the moral and spiritual needs of Muslim communities. Strengthening family values, providing comprehensive Islamic education, and promoting community engagement are essential steps.
Educational institutions should integrate Islamic teachings into their curricula, focusing on the consequences of immoral behaviour and the importance of accountability to Allah. Policymakers should work with religious leaders to design culturally sensitive interventions that resonate with Muslim communities.
Ultimately, the Tawhidic approach offers a sustainable and holistic solution, emphasising spiritual growth and moral integrity. By fostering a strong connection to Allah and adhering to Islamic principles, individuals and communities can effectively combat the HIV epidemic while ensuring the well-being of future generations.
References
Integrated Bio-Behavioural Survey (IBBS). (2022). Malaysia report. Ministry of Health Malaysia.
Ministry of Health Malaysia. (2023). Global AIDS monitoring 2023: Malaysia report. Retrieved from https://www.moh.gov.my/moh/resources/Penerbitan/Laporan/Umum/Laporan_Global_AIDS_Monitoring_2023.pdf
UNAIDS. (2023). Global AIDS update 2023. Retrieved from https://www.unaids.org/en/resources/documents/2023/global-aids-update
Qur’an. (n.d.). The Noble Qur’an: English translation of the meanings and commentary. Retrieved from https://quran.com/
Kamarulzaman, A., & Saifuddeen, S. M. (2017). Islamic biomedical ethics: The way forward for HIV prevention. Journal of the International AIDS Society, 20(1). https://doi.org/10.7448/IAS.20.1.21749