“You Have to Keep Yourself Hidden”: Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy, Network, Community, and Individual Influences on HIV Risk

ABSTRACT

Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.

KEYWORDS:

• Malay-Muslim
• homosexuality
• stigma
• discrimination
• HIV/AIDS

Acknowledgments

We acknowledge the assistance of Bertlin Ng, Mohd Akbar for data collection, Dr. Ilias Yee, A/Prof. Raja Iskandar Shah Raja Azwa, Raymond Tai, and Hisham Hussein for their inputs in development of field guide. We also thank Prof. Boonmongkon Pimpawan for her advice in conceptualization of the article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Notes

1. A Hadith is a saying or act ascribed to the Islamic prophet Muhammad.

Additional information

Funding

This project was supported by the NIH Fogarty International Grant #5R25TW009340, IAS-NIDA  HIV and Drug Use Research Fellowship, National Institutes of Drug Abuse (K24 DA017072), and University of Malaya High Impact Research Grant (E-000001-20001).