HIV/AIDS-Related Knowledge Among Malaysian Young Adults: Findings From a Nationwide Survey

Li-Ping Wong; Caroline-Kwong Leng Chin; Wah-Yun Low; Nasruddin Jaafar


Medscape J Med. 2008;10(6):148 

In This Article


Our results provided baseline data on the knowledge, attitudes, and beliefs about HIV/AIDS among the young adults in Malaysia. The level of general HIV/AIDS knowledge among young Malaysian adults was moderate, as indicated by a total mean score of general HIV/AIDS knowledge of 4.6 out of 7 points. The findings indicated that a majority of the respondents were aware of HIV/AIDS. However, there is a need for improvement as a considerable percentage incorrectly believed that persons living with HIV can be recognized by appearance and that there is a cure for AIDS. Those who are unaware that an HIV-infected person may by asymptomatic are more at risk because they are unaware that they could be infected by an apparently healthy partner.[18] Likewise, misinformation concerning a cure for HIV/AIDS should be corrected as this misconception is also another risk factor for contracting the disease. We also found that nearly half of the respondents did not believe that early detection could prolong life, and the majority had never heard of anonymous HIV testing. These findings are comparable to studies done elsewhere in Asia.[6,19,20]

The data in this study revealed a significant gender difference in general HIV/AIDS knowledge, with females being more knowledgeable than males. Gender differences in AIDS knowledge have been found in other studies[21,22];however, a study among college students in China, found males to be more knowledgeable than females.[23] General HIV/AIDS knowledge also appeared to vary with other demographic characteristics, with the highest knowledge among the Malays, those from urban areas, and the older age group. This finding is consistent with studies in other countries[23,24] and may reflect differences in the level of HIV/AIDS education. Educational efforts need to be targeted at those who are most misinformed to meet the needs of different populations: (1) particular age groups, (2) those in different geographical locations, and (3) different ethnic groups.

Despite the fact that anonymous HIV testing has been made available to the public, many have not heard of it. People are more likely to be voluntarily tested for HIV if the testing is anonymous; for example, a study reported an increase in the demand for HIV testing once the option of anonymous testing was provided,[25] and this may even contribute to early HIV medical care.[26] Hence, the availability of anonymous HIV testing needs to be emphasized in the information and education programs directed at people who are seeking testing.

Consistent with findings in the other Asian countries[23,27]and the United States,[28,29] the majority of young people appeared to rely on the public media (television, newspapers, and radio) as their primary source of HIV/AIDS information. Our findings suggest that future education campaigns on HIV/AIDS would best be conducted via mass media (specifically television, newspapers, and radio). There is overwhelming evidence for the effectiveness of mass media in raising awareness and increasing knowledge in developing countries.[30] The findings of this study are also consistent with other studies[31]that found that relatively high percentages of young people did not receive information from family members and medical professionals. Since the majority of respondents identified mass media as their main source of information, it may be one of the most effective channels for the delivery of HIV/AIDS-related information and education efforts.

Although it has been reported that the Ministry of Health's PROSTAR program (Healthy Living without AIDS for Youth) significantly increased the level of awareness among the club members,[32]our survey indicated the majority of young people were not members of PROSTAR and many had never heard of it. PROSTAR should attempt to reach more young people, especially from rural or hard-to-reach groups to create a future generation of well-informed youth in relation to HIV/AIDS.

It was observed in this study that although the large majority of the study population had correct knowledge of the most common modes of transmission, such as sharing injecting needles and sexual transmission, misconceptions were still held regarding nonsexual routes of transmission. Belief that HIV could be transmitted by mosquito bites, sharing meals, casual contact, and using public swimming pools and toilets still appeared prevalent. Mirroring a local study[33] conducted in 1991, this study showed that the majority of the adolescents interviewed were aware that HIV transmission resulted primarily from high-risk behaviors, such as having unprotected sex and sharing needles. For these reasons, efforts should be made to provide accurate information and address misconceptions about HIV transmission. The erroneous belief that mosquitoes are vectors for HIV is a quite common misconception, as has been shown in many other studies.[34,35,36,37,38]The proportion of respondents that were aware that HIV/AIDS is not transmitted by mosquito bites in our study (47.0%) was similar to the results from studies conducted among Asian-Indian adolescents (48.0%)[35] and Turkish adolescents (40.3%).[36] Casual contact and sharing meals were also more likely to be cited as a way to transmit HIV by those who had less awareness of the disease, and by those who held more stigmatizing views toward those living with HIV/AIDS. Many were also unaware that HIV transmission could occur from getting a tattoo or through body piercing.

In general, knowledge about HIV prevention was high among the respondents. Nevertheless, a significant number of respondents had misconceptions about HIV prevention methods, in particular the beliefs that washing the genital area with soap after sexual intercourse and avoiding touching people living with HIV could prevent infection. The knowledge of HIV/AIDS prevention in this study appeared slightly higher among the rural respondents than among urban respondents. Our findings differ from those of other studies that found the highest knowledge levels among students from urban areas and the lowest levels among those from rural areas.[23,24]Nevertheless, this may reflect differences in the level of HIV/AIDS education or information access in different regions; HIV/AIDS education should therefore target the underserved regions.

Although the knowledge of HIV prevention methods is good, it is important to know whether the young people are equipped with the necessary life skills to reduce their vulnerability to HIV infection, such as the ability to negotiate condom use. Elsewhere, many young people do not have the basic knowledge and skills to prevent themselves from becoming infected with HIV.[39] Having access to HIV/AIDS information is not sufficient; young people, especially adolescents, need to be guided and taught to incorporate this knowledge into daily life.[40]

The results of our study showed that an overwhelming majority of the respondents knew where to seek healthcare services related to HIV/AIDS. However, further study needs to be carried out to ascertain whether young people have access to the healthcare services provided in all government hospitals and clinics. Reports have shown that in many developing countries, young peoples' access to STI and HIV/AIDS healthcare services was insufficient and remained low compared with that of the adult population.[41,42] Nevertheless, knowing where to obtain STI and HIV/AIDS healthcare services is clearly an essential first step towards prevention and protection against HIV infection.


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