Barmania Sima, Aljunid Syed Mohamed
International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia, PPUKM Complex, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, 56000, Malaysia.
United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia.
BMC Int Health Hum Rights. 2017 May 10;17(1):12. doi: 10.1186/s12914-017-0120-8.
HIV screening has existed in numerous methods as an important part of HIV prevention efforts over the years. Premarital HIV testing for couples who wish to marry has been implemented in a number of regions, which often operate in a mandatory rather than voluntary basis and is considered a contentious issue, with viewpoints held in favour and against. One such region is Malaysia which has a policy of mandatory premarital HIV testing of prospective Muslim married couples. The purpose of this study is to understand stakeholders' views on premarital HIV testing given the Malaysian Islamic context.
35 in-depth face to face semi-structured interviews were undertaken with key stakeholder groups involved in HIV prevention policy in Malaysia, namely, officials from the Ministry of Health, religious leaders and people living with HIV. Participants were recruited from the Klang Valley area, from July to December 2013, using purposive sampling techniques. Inclusion criteria necessitated that participants were over the age of 18 and provided full consent. Interviews were audiotaped, followed a standardised topic guide, transcribed verbatim and analysed using a framework analysis.
Participants identified pre-marital HIV testing as an effective HIV prevention policy implemented in Malaysia and was viewed, for the most part, as a positive initiative across all stakeholders. Religious leaders were supportive of testing as it provides a protective mechanism, in line with the teachings of the Shariah, while Ministry of Health officials considered it a normal part of their HIV prevention screening initiatives. However, there were concerns surrounding issues such as confidentiality, counselling and discrimination surrounding the test described by the PLHIV group.
The findings of this study show that among the participants interviewed was strong support for mandatory premarital HIV testing, which could possibly expose the vulnerability to HIV, reluctance to test and other areas in the HIV response in Malaysia that need to be addressed. Furthermore, although international health organisations are vehemently against mandatory premarital HIV testing, the strong local support for such measures and the mismatch between these views is worth exploring in more detail, given the cultural, social and religious context.
多年来，艾滋病毒检测一直以多种方式存在，是艾滋病毒预防工作的重要组成部分。一些地区已对希望结婚的夫妇实施婚前艾滋病毒检测，这些检测通常是强制性而非自愿性的，这被认为是一个有争议的问题，存在支持和反对两种观点。马来西亚就是这样一个地区，该国实行对未来穆斯林已婚夫妇进行强制性婚前艾滋病毒检测的政策。本研究的目的是在马来西亚的伊斯兰背景下，了解利益相关者对婚前艾滋病毒检测的看法。
对参与马来西亚艾滋病毒预防政策的关键利益相关者群体进行了35次深入的面对面半结构化访谈，这些群体包括卫生部官员、宗教领袖和艾滋病毒感染者。2013年7月至12月，采用目的抽样技术从巴生谷地区招募参与者。纳入标准要求参与者年龄在18岁以上并提供完全同意。访谈进行录音，遵循标准化的主题指南，逐字转录，并使用框架分析进行分析。
参与者认为婚前艾滋病毒检测是马来西亚实施的一项有效的艾滋病毒预防政策，在大多数情况下，所有利益相关者都将其视为一项积极的举措。宗教领袖支持检测，因为它提供了一种保护机制，符合伊斯兰教法的教义，而卫生部官员则认为这是他们艾滋病毒预防筛查举措的正常组成部分。然而，艾滋病毒感染者群体描述了围绕检测的保密性、咨询和歧视等问题。
本研究结果表明，在接受访谈的参与者中，对强制性婚前艾滋病毒检测有强烈支持，这可能会暴露马来西亚艾滋病毒应对中易感染艾滋病毒的脆弱性、不愿检测的情况以及其他需要解决的领域。此外，尽管国际卫生组织强烈反对强制性婚前艾滋病毒检测，但鉴于文化、社会和宗教背景，当地对这些措施的强烈支持以及这些观点之间的差异值得更详细地探讨。
