2 August 2012
Last updated at 04:40
Ten years ago when HIV was at its peak in Malaysia, 18 people a day tested positive for HIV. The majority of people living with HIV were men who use heroin and had become infected by sharing needles. Now the number of new infections has halved thanks to grassroot schemes such as this one in Pahang on the south-east coast which sees former drug users giving out clean needles, counselling and condoms to the vulnerable.
In Pahang, fishermen are among those most at risk of HIV as they tend to stay at sea for six days straight before coming back to land to be paid for their catch. To cope with the harsh, isolated working conditions many of them use heroin.
The local drop-in centre, which is supported by the International HIV/AIDS Alliance and its partner the Malaysian AIDS Council, holds twice-weekly needle exchanges at the fishing harbour and village in Kuantan. Many of the outreach workers are themselves former drug users from the area and therein lies the success of the programme.
Mamat, 36, has been injecting drugs for seven years but now receives clean needles every week. “It gives me peace of mind,” he says. Harm reduction is an approach to drug use and HIV that aims to reduce the damage that using dirty needles can inflict.
At the drop-in, the health team get the chance to sit down and talk to the fisherman coming for clean needles, allowing them to gain a deeper understanding of their lives and the risks they are taking as well as teaching them how to inject more safely.
Former user Suharizal, 49, is now educating others about the risks.
Yuseuf, 42, began fishing when he was 14 and started using heroin the same year. He has been living with HIV for 12 years.
Of the 170,000 Malaysians who inject drugs, one fifth are living with HIV. In total, there are nearly 90,000 HIV+ people in the country, the vast majority are men who became infected by using dirty needles.
The outreach service attracts local people outside the fishing community too. Aqmel, 31, is living with HIV, his wife and child are negative. “I used to share needles, now that I know I can always replenish my stock there’s no need to.”
Ani, who works in a local cafe, knows about the needle exchange programme: “My uncle was a drug-user but he died. He did not have services available to him. I wish he had, that might have helped.”
According to project coordinator Zulkefli, people in Pahang used to be very afraid of anyone using drugs. “If they saw someone who looked like a drug users they would close their doors but because of the programme they seem more relaxed now. We are seeing a difference.” (Images: The International HIV/AIDS Alliance)