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A Review of Literature and Projects 2005 Figure 13: Number of HIV-positives detected among 20-29 year-olds, by year Source: Ministry of <strong>Health</strong>, Malaysia (2) Knowledge, attitudes and practices From the many studies reviewed, findings on knowledge, attitudes and practices regarding STI and HIV/AIDS include the following: • Knowledge of HIV/AIDS is generally high and has improved over the years. HIV is better known than AIDS. A large proportion of young people know that there is no cure for AIDS. Those who are older and have had more years of formal education are more knowledgeable. Those who are older and/or better educated are more likely to acknowledge the fact that they need to take special precautions against HIV infection. • The main modes of transmission (sex, needle sharing and blood transfusion) are known to almost all young people, but some mistakenly believe that mosquito bites and blood donations can also transmit the virus. Most young people know that befriending people living with HIV/AIDS, kissing on the cheek, sharing utensils and dishes, sharing toilets and holding or shaking hands are not modes of transmission. • Some adolescents do not realize that people living with HIV/AIDS may not show symptoms until the later stages of their lives and that it is impossible to identify those with HIV/AIDS except through testing. Still, many are not willing 41
Sexual and Reproductive <strong>Health</strong> of Adolescents and Youths in Malaysia to mix with them. Knowledge of HIV/AIDS is positively correlated to acceptance of people living with HIV/AIDS. In general, adolescents are sympathetic towards those living with HIV/AIDS and believe in protecting their rights, but they are not able to translate that attitude into behaviour change within themselves. • Young people do not see themselves as vulnerable, even although they know how the virus is spread. Perceived susceptibility, severity of HIV/AIDS and ability to protect from HIV infection are positively related to attitudes towards HIV/AIDS. Only perceived severity of HIV/ AIDS and subjective norms (peer pressure) tend to have influence over behaviour. • Knowledge and use of condoms is low, even among vulnerable groups like drug addicts, which is a worrying trend considering three-quarters of HIV/AIDS cases in Malaysia are among injecting drug users. Many adolescents would not insist on using a condom to protect themselves from HIV/AIDS. 3.2.6. Sexual violence Large numbers of young men and women face risks to their sexual and reproductive health, such as HIV, STI, sexual violence, and drug and alcohol abuse. Young women face particular risks because of their biology, discrimination regarding access to information and services, and constraints imposed by society (see Figures 14 and 15). While violence against women has been hotly debated in the last few years, violence against adolescents, specifically adolescent girls, has been neglected. In a study of 616 paramedic students, it was found that 8% of the women and 2% of the men had reported sexual abuse. This was defined as “vaginal or anal penetration, or unsolicited sexual contact and witnessing exhibitionism before the age of 18”. In another study of 214 female dental nursing students, 1.4% of the respondents reported that they had been raped when they were five or six years old. The data suggest that sexual abuse is more common than is being reported to the police. The 2002 Rape Report quoted a local study by a doctor at the General Hospital in Kuala Lumpur, who estimated that only one in ten rape survivors report their rape. 42
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