Mak Nyahs in Malaysia: Does HIV/AIDS Knowledge Really Reduce HIV-Related Risk Behaviours?

Abstract

Introduction. Male-to-female transgender individuals are known as mak nyahs in Malaysia. Akin to many other countries, mak nyahs face discriminations in securing proper employment, thus many end up in sex trade, exposing them to HIV-related high risk behaviours. This paper aims to investigate the knowledge, attitude, and risk behaviours in HIV/AIDS among mak nyahs in Malaysia. Method. Validated questionnaires in local language were used. Knowledge, attitude, and HIV-related risk behaviours were measured. With respondent-driven sampling method, 54 subjects participated in the survey. IBM SPSS was used for data analysis. Results. Majority of the subjects reported to have HIV-related sexual risk, although only a quarter were sex workers. Misconceptions still remained among the subjects. Inconsistent condom use was common. Adequate knowledge did result in better attitude towards HIV/AIDS. However, multiple regression analysis showed that subjects with higher knowledge in HIV/AIDS tend to have higher sexual risks (β = 0.320, p = 0.030). Conclusion. Educating the transgender community about HIV/AIDS does not seem to adequately reduce the HIV-related sexual risks. Other approaches, i.e. socio-cultural values and religious practices may be effective to instil higher levels of awareness and self-responsibility in this community to eliminate HIVrelated high risk behaviours.

Trans Women Sex Workers in Northern Malaysia: A Qualitative Study

“…Lack of qualification has limited their abilities to find high-paying jobs. Unable to locate or maintain employment due to gender discrimination is another common problem (Maliya et al, 2018) 2017), sex work is an empowering activity which allows trans women not only to earn money but also to develop self-confidence and at the same time experience pleasure from it (Vartabedian, 2017). Nadal, Vargas and colleagues (2012) study reported that transgenders were involved in the sex work industry because they felt appreciated as real women by their male clients, an appreciation that they did not receive in other aspects of their lives (K. L. Nadal, Vargas, Meterko, Hamit, & McLean, 2012).…”

Exploring the barriers and enablers of oral health care utilization and safe oral sex behaviour among Transgender women of Malaysia: a qualitative study

“…(14) Even though HIV/AIDS knowledge was noted to be adequate among transgender women, it did not necessarily translate into safe sexual practices or better attitude towards HIV. (15) Condom usage was found to be inconsistent even when the knowledge was adequate, and the attitude of transgender women was not found to significantly predict HIV related high risk behaviour. (15) Significant gaps have been highlighted in empirical data required for the scale-up of HIV prevention programs such as treatment uptake, adherence and HIV continuum of care, especially for a developing country like Malaysia (16) (17, 18).…”

“…(15) Condom usage was found to be inconsistent even when the knowledge was adequate, and the attitude of transgender women was not found to significantly predict HIV related high risk behaviour. (15) Significant gaps have been highlighted in empirical data required for the scale-up of HIV prevention programs such as treatment uptake, adherence and HIV continuum of care, especially for a developing country like Malaysia (16) (17, 18). (19) Globally, public health intervention strategies to create awareness and curb the spread of sexually transmitted infections such as community education through key stake holders, distribution of free test kits and door to door visits and newer technology based intervention have been recommended as promising methods of reaching the target population.…”