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In fact, special surveys conducted by the Ministry of Health among selected risk groupsshows highest prevalence rates among drug users, followed by sex workers, and othergroups with high exposure (Table B). In contrast, the MOH’s Voluntary ScreeningProgramme, piloted in Johor in 2001 and expanded nation-wide since 2003, found HIVpositiverates ranging from none in Sabah and Kuala Lumpur to a high of 4.31% inKelantan, followed by 2.26% in Johor (MOH 2004b). Although the figures based on thisprogramme may be biased since testing is voluntary and only 5,314 people havevolunteered to be tested over a two-year period, it nevertheless indicates much lowerinfection rates in the general population.Although injecting drug use is the main concern at present, it is recognised that sexualactivity may also be a source of risk among this group. Moreover, drug use and the saleof sexual services are often associated. Hence, the life circumstances and marginalisationof sex workers necessitates specific prevention strategies, particularly, if they are alsodrug users.Table B: HIV Prevalence Rates Among High-Risk GroupsSurvey group Source Year N % HIV-positiveDrug users and National Screening Programme in 1996 - 14.3prison inmates 27 drug rehabilitation centres and 1997 - 16.433 prisons1998 - 13.21999 - 17.92000 9,500 19.62001 35,763 13.22002 50,351 10.3Drug users National Screening Programme inrehabilitation centres in 11 states2002 12,532 16.8SWsHIV Sentinel SurveillanceAd-hoc survey in Kuala Lumpur(65% transsexuals, 35% female)199620006.32000 208 11.5Fishermen Survey in Pahang, Perlis, Kedah(northern region)Long distance Survey in Pahang, Kelantan,drivers Terengganu (east coast)Factory Survey in Selangor, Negeriworkers Sembilan, Melaka (west-centralregion)Sources: MOH (2004b), Ahamad (2004)1998 542 1.72000 906 3.72001 3,000 0.0By the same token, refugees and migrant workers are also considered population groupswith special vulnerabilities and needs for treatment, care and prevention. Very littleinformation is available on refugees and migrant workers in the context of HIV at present18