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GLOBAL AIDS MONITORING 2020 Malaysia HIV/AIDS Progress Report Ministry of Health Malaysia HIV/AIDS/Hepatitis C Sector Disease Control Division 1
2 MALAYSIA 2020 COUNTRY PROGRESS REPORT TO HIV/AIDS EPIDEMIC Reporting Period: January 2019 to December 2019 Report prepared by: HIV/STI/Hepatitis C Section Disease Control Division Ministry of Health Malaysia Tel: +60 3 8883 4387 Fax: +60 3 8883 4285 Correspondence: Dr Anita Suleiman dranita@moh.gov.my Malaysia Global AIDS Reporting 2020
3 THE GLOBAL AIDS MONITORING REPORT 2020 This report was coordinated and produced by HIV/STI/Hepatitis C Section of Ministry of Health Malaysia. Editorial Team Dr. Anita Suleiman (Chief Editor) Head HIV/STI/Hepatitis C Sector, Ministry of Health Malaysia Dr. Mazliza Ramly (Lead Author & Editor) Senior Principal Assistant Director (Behavioral Research) HIV/STI/Hepatitis C Sector, Ministry of Health Malaysia LIST OF MAIN CONTRIBUTORS 1. Dr Chai Phing Tze, HIV/STI/Hepatitis C Sector 2. Dr Fazidah Yuswan, HIV/STI/Hepatitis C Sector 3. En Azman Mohamed, HIV/STI/Hepatitis C Sector 4. Dr Mohamad Naim, TB/Leprosy Sector 5. En Parimelazaghan Ellan, Malaysian AIDS Council 6. Pn Tamayanty Kurusamy, Malaysian AIDS Council 7. Dr Rohemi Abu Bakar, State Health Department Perlis 8. Dr Azlina Azlan, State Health Department Kedah 9. Dr Janizah Abd Ghani, State Health Department Pulau Pinang 10. Dr Ariza Abd Rahman, State Health Department Perak 11. Dr Ismawati Ismail, State Health Department FT Kuala Lumpur & Putrajaya 12. Dr Gurpreet Kaur, State Health Department Selangor 13. Dr Sharifah Nor Ahmad, State Health Department Negeri Sembilan 14. Dr Mahanim Md Yusof, State Health Department Melaka 15. Dr Nurmawati Ahmad, State Health Department Johor 16. Dr Shahdattul Dewi Nur Khairitza Taib, State Health Department Pahang 17. Dr Mahani Nordin, State Health Department Terengganu 18. Dr Nik Normanieza Nik Man, State Health Department Kelantan 19. Dr Haseanti Hussien, State Health Department Sabah 20. Dr Ruziana Miss, State Health Department Sarawak 21. Dr Mohd Hafizuddin Ahmad, State Health Department FT Labuan Malaysia Global AIDS Reporting 2020
4 Table of Contents State of the Epidemic ................................................................................................ 6 Treatment Cascade .............................................................................................. 8 Prevention program ................................................................................................ 12 Key populations .................................................................................................. 12 Eliminating Mother-to-Child Transmission .......................................................... 14 Confronting Stigma and Discrimination .................................................................. 16 Stigma Reduction Initiatives ............................................................................... 16 HIV and Other Infection .......................................................................................... 17 HIV and Tuberculosis co-infection ...................................................................... 17 HIV and Hepatitis C co-infection ......................................................................... 18 Sexually Transmitted Infection ............................................................................ 19 Investing to End an Epidemic ................................................................................. 20 2019 galleries ......................................................................................................... 21 Malaysia Global AIDS Reporting 2020
5 List of Figures Figure 1: Annual Reported Cases, Malaysia, 1986-2019 ………………………………………………………………………………………. 7 Figure 2: HIV Incidence Rate per 1000 Uninfected Population, Malaysia, 2010-2019 ……………………………… 7 Figure 3: Top 5 States, Percentage of New HIV Infection, Malaysia, 2019 ……………………………………………………. 7 Figure 4: HIV Testing and Treatment Cascade, Malaysia, 2019 …………………………………………………………………………. 8 Figure 5: New HIV Infection, Malaysia, 1986-2019 ……………………………………………………………………………………………………. 9 Figure 6: Percent Change in New HIV Infection by State, Between 2010-2019 …………………………………………… 9 Figure 7: AIDS-related Deaths, Malaysia, 1986-2019 ………………………………………………………………………………………………. 9 Figure 8: Distribution of Reported Cases by Gender, 1987-2019 ………………………………………………………………………… 10 Figure 9: Trend of HIV Infection by Mode of Transmission, 2000-2019 ……………………………………………………………. 10 Figure 10: Distribution of HIV New Cases by State, 2019 ………………………………………………………………………………………. 11 Figure 11: Distribution of New Infection by Age Group, Malaysia, 2019 …………………………………………………………. 11 Figure 12: NSP and OST Coverage among PWID, 2016-2019 …………………………………………………………………………… 12 Figure 13: HIV Prevalence and Safe Injecting Practices among PWID, IBBS 2012-2017 ………………………. 13 Figure 14: Coverage of Prevention Programs among Key Populations, Malaysia IBBS 2012-2017 …… 13 Figure 15: Methadone Maintenance Therapy Clinic at Government Health Facility …………………………………… 13 Figure 16: HIV and Syphilis Test Coverage, 2010-2019 ………………………………………………………………………………………… 14 Figure 17: Cascade of Services for Preventing Vertical Transmission, Numbers of New HIV Infections and eMTCT rate, 2019 ……………………………………………………………………………………………………………………………………………………………. 14 Figure 18: HIV Vertical Transmission Rate, 2012-2019 …………………………………………………………………………………………. 15 Figure 19: MTCT of Syphilis, 2010-2019 ………………………………………………………………………………………………………………………… 15 Figure 20: Percentage of Person Aged 15 to 49 years with Discriminatory Attitudes Towards PLHIV, 2014-2019 …………………………………………………………………………………………………………………………………………………………………………………… 16 Figure 21: Proportion of Newly Enrolled PLHIV with Active TB, 2015-2019 ………………………………………………… 17 Figure 22: PLHIV Newly Enrolled in HIV Care Started on IPT, 2015-2019 …………………………………………………… 17 Figure 23: HCV Epidemic in Malaysia, 2003-2019 …………………………………………………………………………………………………… 18 Figure 24: Proportion of PLHIV Starting on ART Who Were Tested for Hepatitis C, 2013-2019 ………… 18 Figure 25: Number of Men Reporting Urethral Discharge in the past 12 months, 2013-2019 ………………. 19 Figure 26: Safe Sex Practices at Last Sex, IBBS 2012-2017 ………………………………………………………………………………. 19 Figure 27: HIV Resources Availability by Source, 2017-2019 ……………………………………………………………………………… 20 Figure 28: AIDS Spending by Category, 2016-2019 ………………………………………………………………………………………………… 20 Malaysia Global AIDS Reporting 2020
6 State of the Epidemic HIV/AIDS Epidemic Snapshot in Malaysia 2019 Number of People Total 77,903 AT A GLANCE Living with HIV Male (15+ years) 66,369 Women (15+ years) 11,233 Children (
7 Figure 1: Annual Reported Cases, Malaysia, 1986-2019 8000 40 7000 35 6000 2002: 6,978 2019 30 3,564 Number of cases Notification rate 5000 25 4000 20 1986 First reported 3000 cases of HIV 15 2000 10 1000 5 0 0 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL Notification rate Figure 2: HIV Incidence Rate Per 1000 Figure 3: Top 5 States, Percentage of New Uninfected Population, Malaysia, 2010- HIV Infection, Malaysia, 2019 2019 0.25 Selangor 30.4% 0.2 0.2 0.19 0.19 0.19 0.19 0.18 0.18 0.18 0.17 0.17 WPKL 12.6% 0.15 Johor 9.5% 0.1 Sarawak 8.1% 0.05 0 Penang 8.1% 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 0.0% 10.0% 20.0% 30.0% 40.0% Malaysia Global AIDS Reporting 2020
8 In 2019, the estimated people living in HIV (PLHIV) in Malaysia is around 87,000. However, through our national surveillance system, close to 78,000 PLHIV were notified out of which, 0.4% were children below 15 years of age. There were 3,564 people newly infected with HIV notified in 2019 (Figure 1), slightly more than half (56%) of estimated new HIV infection in 2019. Estimated HIV incidence rate per 1000 uninfected population is showing an increasing trend in the past two years (Figure 2). The overall epidemic is concentrated in urbanized states of Selangor, Kuala Lumpur, and Johor that contribute more than 50% of new HIV cases in Malaysia (Figure 3). Treatment Cascade Figure 4: HIV Testing and Treatment Cascade, Malaysia, 2019 Countries are left with just 1 year to reaching the fast track target of 90-90-90 by 2020. In that regard, Malaysia has achieved 89%-56%-85% which means in 2019, 89% of PLHIV in Malaysia know their status, 56% of them were receiving treatment, and 85% of them were virally suppressed (figure 4). Linkage to care still represents the single greatest challenge for Malaysia to reach 90-90-90 target as the highest gap to reaching 90-90-90 target stood at number of PLHIV needed to access treatment. Malaysia Global AIDS Reporting 2020
9 Figure 5: New HIV Infection, Malaysia, 1986-2019 Malaysia has done a tremendous work in reducing the annual number of new HIV infections since its peak in 2002 with our Harm Reduction Program. However, since 2010, the trend has reached a flat line. There has been only a modest 0.9% decline in the annual number of new HIV infections in Malaysia since 2010 (Figure 5). Several states showed strong decline in new infections between Figure 6: Percent Change in New HIV Infection by 2010 and 2019, such as Kelantan, 6 State, between 2010 & 2019 Terengganu, and Pahang (Figure 6). Percent change in new HIV 4 2 In contrary, most urbanized states 0 like Selangor, Kuala Lumpur and -2 -4 Penang showed increasing trend. -6 Kelantan Terengganu Pahang Johor Perak Melaka Perlis Labuan Kedah Sabah NS Sarawak WPKL Penang Selangor The reported AIDS-related deaths last year had increased slightly in 2019 compared to 2010 (Figure 7). Sabah was the only state with declined AIDS-related deaths greater than 50% during the 10-year Figure 7: AIDS-related Deaths, Malaysia, 1986-2019 period. While, Selangor had the highest increment of AIDS-related deaths of more than 100% during the same period. Since the beginning of the epidemic, the reported cases were predominantly male (Figure 8). Malaysia Global AIDS Reporting 2020
10 Figure 8: Distribution of Reported Cases by Gender, 1987-2019 8000 80 7000 70 6000 60 per 100,000 population number of cases 5000 50 4000 40 3000 30 2000 20 1000 10 0 0 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Female Male Male-specific rate Female-specific rate Figure 9: Trend of HIV infection by Mode of Transmission, 2000-2019 PWID Hetero Homo Vertical Blood/organ transfer Indeterminate PWID/Sex ratio 100.0% 6.0 90.0% 5.0 80.0% 70.0% 4.0 Proportion 60.0% Ratio 50.0% 3.0 40.0% 2.0 30.0% 20.0% 1.0 10.0% 0.0% 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 In the past one decade, the country observed gradual changes in the HIV epidemic landscape from predominantly PWID to more sexual transmission (Figure 9). The proportion of sexual transmission has increase to more than 90% in 2019. Malaysia Global AIDS Reporting 2020
11 Figure 10: Distribution of HIV New Cases by State, 2019 More than 70% of the new HIV cases reported in 2019 Kelantan, Perlis, 0.5% Terengganu, 3.0% Pahang, 3.1% were contributed by 6 1.8% WP Labuan, states - Selangor, Kuala Selangor, 0.4% Melaka, 3.2% 30.4% Lumpur, Johor, Sarawak, Negeri Sembilan, Penang, and Sabah (Figure 3.5% 10). Perak, 4.6% Kedah, 5.0% WP KL, 12.6% Sabah, 6.3% Pulau Pinang, 8.1% Johor, 9.5% Sarawak, 8.1% Figure 11: Distribution of New Infection by Age Group, Malaysia, 2019 More than 70% of new HIV infections were among people aged 20 to 39 years. While infection in children below 13 years old has remained lower than 1% consistently from the beginning of the epidemic (Figure 11). Malaysia Global AIDS Reporting 2020
12 Prevention program Key populations FSW MSM PWID TG Population size estimatea 22,000 220,000 75,000 37,000 HIV prevalenceb 6.3% 21.6% 13.5% 10.9% Know their HIV statusb 35.1% 43.3% 38.9% 43.0% ART coverageb 22.5% 62.6% 34.6% 34.0% Condom use last sexb 83.5% 65.4% 25.7% 83.3% aSize Estimation of Key Population Malaysia, 2018 bIBBS 2017 Figure 12: NSP and OST Coverage among PWID, 2016- 2019 Needle-syringes per PWID per year 30 90.0% 80.0% Access to Harm 25 70.0% Reduction Services OST coverage 20 60.0% 50.0% remains uneven 15 40.0% especially NSEP 10 30.0% 20.0% marked by highly 5 10.0% punitive approaches to 0 0.0% drug use. 2016 2017 2018 2019 NSP coverage (n) OST Coverage (%) Given that sharing injection paraphernalia is the main mode of transmission in Malaysia since the beginning of the epidemic, Harm Reduction Program that consist of Needle and Syringe Exchange Program (NSEP) and Opioid Substitution Therapy (OST) remained the mainstay of prevention programs to PWID in Malaysia. The OST Program coverage offered at selected government and private health facilities since 2006, has shown an increased to more than 70% since 2017 (Figure 12). While the NSEP program, implemented through smart partnership with NGO under MAC at their outreach points throughout the country has reported a significant reduction in program coverage of less than 50% since 2017. This is in line with the National Malaysia Global AIDS Reporting 2020
13 Figure 13: HIV Prevalence and Safe Injecting Strategic Plan for Ending AIDS that Practices among PWID, IBBS 2012-2017 encourage opioid injectors to shift to 20 120 OST to ensure better ART uptake. Safe injecting practices, % 100 HIV Prevalence, % 15 80 In the nutshell, these programs 10 60 (harm reduction) have positive 40 impact as reflected in the declining 5 20 of HIV prevalence and increasing 0 0 continuous safe injecting practices 2012 2014 2017 above 80% in this key population (Figure 13). Safe Injecting practices HIV Prevalence Figure 14 depicted results from Figure 14: Coverage of Prevention Programmes IBBS 2012 to 2017 on the Among Key Populations, Malaysia, IBBS 2012-2017 coverage of prevention packages 80 among key populations. Access to 60 HIV prevention services for FSW Percent 40 and MSM have been poor (less 20 than 50%) probably because they are the most hard-to-reach and 0 PWID TG FSW MSM difficult to identify due to stigma 2012 2014 2017 and discrimination. While for PWID and TG populations, the coverage of prevention packages have been Figure 15: Methadone Maintenance Therapy Clinic at moderate (50%-70%) Government Health Facility Malaysia Global AIDS Reporting 2020
14 Eliminating Mother-to-Child Transmission Figure 16: HIV and Syphilis Test Coverage, 2010-2019 100.5% 0.14% 100.0% 99.5% 0.12% Test coverage, % Seropositive (%) 99.0% 0.10% 98.5% 0.08% 98.0% 0.06% 97.5% 0.04% 97.0% 96.5% 0.02% 96.0% 0.00% 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Syphilis test coverage HIV test coverage HIV seropositive (%) Syphilis seropositive (%) HIV and syphilis test coverage for antenatal mothers to prevent vertical transmission in Malaysia has persistently reached beyond 95% for more than a decade, with seroconversion rate for both HIV and syphilis remained below 0.1% (Figure 16). This wide screening coverage has been persistent throughout the country since the Prevention of Mother-to-Child Transmission (PMTCT) program was implemented in 1998. The PMTCT Program in Malaysia is based strongly around early detection and prompt treatment of HIV and syphilis for mother and baby, safer modes of delivery and safer infant feeding practices. Figure 17: Cascade of Services for Preventing Vertical Transmission, Numbers of New HIV Infections and eMTCT Rate, 2019 Malaysia became the 250 99.3% 95% first country in WPRO 200 and first Muslim 150 Number country globally to transmission rate: 1.64 100 eliminate mother-to- Number of cases: 1 50 child transmission of HIV and Syphilis in 0 Estimated Women Infant of HIV New child 2018 pregnant receiving ARV mother tested women living to prevent VT within 2 infection through VT with HIV months of birth Malaysia Global AIDS Reporting 2020
15 An estimated 99.3% of HIV-positive pregnant women were receiving ARV in 2019 resulted in 1.64% transmission rate of mother-to-child transmission (Figure 17). This vertical transmission rate for HIV has reached the WHO elimination target (less than 2.00%) in both programmatic and estimated (Spectrum) data since 2016 (Figure 18). Similarly, reported congenital syphilis have been less than 10 cases per 100,000 LB persistently since 2010, which is far below the elimination indicator of less than 50 cases per 100,000 LB (Figure 19). Figure 18: HIV Vertical Transmission Rate, Figure 19: MTCT of Syphilis, 2010-2019 2012-2019 9.0 12.0 8.0 HIV vertical transmission (%) 10.0 7.0 New CS per 100,000 LB 8.0 6.0 6.0 5.0 4.0 4.0 3.0 2.0 2.0 0.0 1.0 2012 2013 2014 2015 2016 2017 2018 2019 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Programmatic Data (%) Spectrum (%) Adj. New paediatric CS infection WHO Elimination target (per 100,000 LB) Malaysia Global AIDS Reporting 2020
16 Confronting Stigma and Discrimination Figure 20: Percentage of Person Aged 15 to 49 The level of stigma towards PLHIV in Years with Discriminatory Attitudes Towards general population remained PLHIV, 2014-2019 between 20% to 50% in the last three 60.0% years (Figure 20). Almost a third 50.0% (30%) Malaysian said they would 40.0% avoid buying vegetables from a 30.0% PLHIV vendor, and 26% Malaysian 20.0% believed that children living with HIV 10.0% should not be allowed to attend 0.0% 2014 2017 2019 school with other children. Much still People who would not buy vegetables from a PLHIV need to be done to eliminate stigma shopkeeper People who think children living with HIV should not be against PLHIV. allowed to attend school other children Stigma Reduction Initiatives Starting mid-2020, a HIV- • HCW • Identify gaps • PLHIV • Design related stigma and intervention framework discrimination reduction through a quality improvement Baseline Review of approach in government results healthcare facilities program were initiated and this program will be piloted at 6 states Follow-up Intervention (Penang, Sarawak, Kuala Lumpur, Selangor, and Johor). • Repeat • Continuous questionnaire intervention • Review • For 4 months performance Malaysia Global AIDS Reporting 2020
17 HIV and Other Infection HIV and Tuberculosis co-infection Tuberculosis is the leading killer of Figure 21: Proportion of Newly Enrolled PLHIV with Active TB, 2015-2019 PLHIV. The risk of developing 25.0% tuberculosis (TB) is estimated to be between 16-27 times greater in 20.0% people living with HIV than among those without HIV infection. In 15.0% Malaysia, proportion of newly 10.0% enrolled PLHIV with active TB was 7.3% in 2019 compared to 19.3% in 5.0% 2018 (Figure 21). However, in 2019, only 15.8% of PLHIV newly enrolled 0.0% 2015 2016 2017 2018 2019 in HIV care was started on TB Isoniazid preventive therapy (IPT) (Figure 22). This data is far from Figure 22: PLHIV Newly Enrolled in HIV Care WHO recommendation in which all Started on IPT, 2015-2019 PLHIV who are unlikely to have 90.0% active TB (without any active 80.0% tuberculosis symptoms) should be 70.0% offered IPT. 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 2015 2016 2017 2018 2019 Malaysia Global AIDS Reporting 2020
18 HIV and Hepatitis C co-infection Hepatitis C virus (HCV) is a Figure 23: HCV Epidemic in Malaysia, 2003-2019 bloodborne virus transmitted 3500 12 through direct contact with the Reported HCV cases 3000 10 blood of an infected person. It is Notification rate 2500 8 2000 estimated that HCV affects 2–15% 6 1500 of people living with HIV worldwide 4 1000 (and up to 90% of those are people 500 2 who inject drugs (PWID)). In 0 0 Malaysia, the national surveillance 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 data showed that HCV is on the rise HCV HCV Notification rate with notification rate of 10.55 in 2019 (Figure 23). While reported HIV/HCV co-infection was 518 Figure 24: Proportion of PLHIV Starting on ART cases or 15.1% of total HCV cases Who Were Tested for Hepatitis C, 2013-2019 in 2019. Out of which, only 19.2% 120.0% of PLHIV co-infected with HCV 100.0% were on treatment for HCV (Figure 80.0% 24). 60.0% 40.0% 20.0% 0.0% 2015 2016 2017 2018 2019 National Strategic Plan for Hepatitis B and Hepatitis C, 2019-2023 was developed with an objective to decrease the transmission of viral hepatitis, limit the complications and to reduce the socioeconomic impact of viral hepatitis Malaysia Global AIDS Reporting 2020
19 Sexually Transmitted Infection Similar to HIV, STIs are spread Figure 25: Number of Men Reporting Urethral Discharge in the Past 12 Months, 2013-2019 predominantly by sexual contact, 3500 including vaginal, anal and oral sex as well as through non-sexual 3000 means such as via blood or blood 2500 products. Some STIs can spread Number of cases 2000 vertically from mother to child during 1500 pregnancy and childbirth. Majority of 1000 STIs are asymptomatic hence, the surveillance for urethral discharge is 500 used to provide early warning of the 0 2013 2014 2015 2016 2017 2018 2019 epidemic potential of HIV from sexual transmission and ongoing high-risk sexual activity. Figure 26: Safe Sex Practices at Last Sex, Figure 25 shows an alarming IBBS 2012-2017 increase of reported urethral 90 discharge in men with 2296 cases in 80 70 2019. This trend is consistent with 60 the data in Figure 26 where safe sex practices at last sex among MSM Percent 50 40 are less than 80% for all 3 cycles of 30 IBBS surveys. When used correctly 20 and consistently, condom is one of 10 the most effective methods of 0 protection against STIs and HIV. FSW TG MSM PWID 2012 2014 2017 Malaysia Global AIDS Reporting 2020
20 Investing to End an Epidemic Since the beginning of the epidemic, Figure 27: HIV Resources Availability, by Source, more than 90% of the investment for 2017-2019 HIV responses is from domestic 250 purse (Figure 27). The Global Fund 200 to Fight against AIDS, Tuberculosis and Malaria (the Global Fund) RM (Millions) 150 added some 2%-4% of total national 100 responses for HIV since 2011. 50 Compared to the year 2012 to 2016, 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 the total amount of expenditure for Domestic (public) Domestic (private) HIV responses decreased by more Global fund International (other) than 30% in 2017. This is due to the reduction in the price of ARV medication by more than half in Figure 28: AIDS Spending by Category, 2016-2019 2017. Since the beginning of the 100% implementation of National Strategic 80% Plan For Ending AIDS (NSPEA 60% 40% 2016-2030) in 2016, more than 70% 20% of the total funding were spent on 0% ‘test and treat’ strategy as knowing 2016 2017 2018 2019 one’s status is the first step in Others preventing infection (through Elimination of MTCT Mitigating sexual transmission behavior modification) and Prevention of HIV transmission through injecting drug use treatment reduce onward Test and treat transmission through sexual to uninfected partner by 96%. We aimed to first reduced the gap on the first and second 90 of HIV treatment cascade (Figure 28). Malaysia Global AIDS Reporting 2020
21 2019 galleries Multi-stakeholder Forum on National HCV Response 2019 – “Closing the gaps in HCV Response: Strategy on the Hard-to-Reach Populations” Training of Trainers (ToT): Stop the Stigma and Discrimination Towards PLHIV, PLHCV & Key Populations (HOPE) Module for Healthcare Worker, Cameron Highlands, Pahang Malaysia Global AIDS Reporting 2020
22 Stigma & Discrimination Among HCW Towards PLHIV Reduction Through Quality Improvement Initiatives Meeting with Stakeholders Site visit at Persatuan Cahaya Harapan Kedah/Perlis at Langkawi Island Community-based testing (CBT) by accredited personnel/NGO Malaysia Global AIDS Reporting 2020
23 Joint-visit MOH-MAC to Methadone Maintenance Therapy Clinic at Terengganu Joint visit MOH-MAC to NGO Baitul Cakna, Terengganu AEM & Spectrum Workshop: Update on 2019 data for National and Subnational Analysis at Langkawi Island with MOH, MAC, Dr Wiwat Peerapatanapokin, Consultant from East-Centre Hawaii and Dr Khin Cho Win Thin, Data Specialist from UNAIDS Malaysia Global AIDS Reporting 2020
24 Updates Medical Seminar for Plantation Paramedics, Port Dickson, Negeri Sembilan Development of Stop the Stigma and Discrimination Towards PLHIV, PLHCV & Key Populations (HOPE) Module for Healthcare Worker at Kuala Lumpur Strengthening of PROSTAR Program Workshop, Fraser Hill, Pahang Malaysia Global AIDS Reporting 2020
25 WORLD AIDS DAY 2019 ACTIVITIES World AIDS Day in Perak – World AIDS Day in Perak World AIDS Day in Perak Malaysia Global AIDS Reporting 2020
26 World AIDS Day in Pahang World AIDS Day in Johor World AIDS Day in Melaka Malaysia Global AIDS Reporting 2020
27 HIV/STI/Hepatitis C Section Disease Control Division Ministry of Health Malaysia Tel: +60 3 8883 4387 Fax: +60 3 8883 4285 www.moh.gov.my Printed, reproduced, and/or distributed by Disease Control Division, Ministry of Health Malaysia. Malaysia Global AIDS Reporting 2020
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