in asking them to use condoms, even mentioning HIV, as she was conscious of infectingothers. Yet, most clients still refused to use condoms. That clients of sex workers still donot, or prefer not to, use condoms is highly regrettable despite the resources spent onInformation, Education and Communication campaigns in the country. Clearly, themessage on protected sex is not reaching the appropriate target group or is not succeedingin promoting a change in attitudes and behaviour towards condom use.Counselling, care and supportThere is no doubt from discussions with PLHIV communities that they receive supportfrom a limited number of sources. The first source, which some are lucky to receive, isthe love, care and support from their own families. The acceptance by family members isevident for those who were infected by their husbands. In Sarawak, <strong>this</strong> family support isextended to infected sex workers as well.In <strong>this</strong> regard, participants spoke of how much better their families understood andaccepted their situation after they received counselling with their families from theirdoctors or counsellors at the hospital:“At that time, they have a person in charge to talk to my father and let himknow about my situation….and so on….so that now, my father is not afraidof it now.”(Male, 42yrs, Primary education, Heterosexual)“First is through hospital. They are very professional counsellors. Theywill meet your family and close relatives first before you get to them. Ithelps a lot. Like us - we just directly tell our relatives and friends, sure,they will be afraid of us…..because they haven’t been educated yet, so theydon’t know how to prevent and avoid be [becoming] infected. No matter,their wife, girlfriend or their mother, family….once they meet thecounsellor - the second time when they bring them along to the counsellor -95% of them will be able to accept it.”(Male, 36yrs, Primary education, Heterosexual)“I have to accept the fact because the result is there. And then, I wentthrough one counselling programme in Singapore. They gave me –explanation. Then, I understand what is the danger of HIV, how to preventor going to <strong>AIDS</strong>.”(Male, 49yrs, University education, DU)“Sebab saya koma. Saya koma, dia orang trace saya punya address last.Dia orang [keluarga] dapat tahu sebab saya kira 80% dah tak bolehhidup, tinggal 20%. Jadi, sebelum apa terjadi, dia mencari saya punyaaddress - dapat. Jadi, famili saya pun datang. Dia pun tidak sangka yangsaya ini…..aaah….jadi macam ini. Doktor telah memberitahu yang sayaini positive HIV. Dan permulaan sekali apa yang kaunselor sayamemberitahu saya, aaah…semasa you koma, keluarga you tak nak sentuhyou, tak nak lap you punya badan, tak nak tukar you punya pampers. Jadi,di situ gunanya kita ada kaunselor tolong. Dia akan memberitahu kepada44
keluarga you as….orang HIV positif dan penagih; ini life dia begini,begini, begini….”(“Because I was comatose. I was comatose, [so] they traced my lastaddress. They [family] got to know because I was about 80% near death,left 20% [chance to survive]. So, before anything happened, they lookedfor my address – found it. So, my family came. They didn’t suspect that Icould become like <strong>this</strong>. The doctor told them I am HIV positive. And thefirst thing the counsellor told me….when you were in a coma, your familydidn’t want to touch you, didn’t want to wipe your body, didn’t want tochange your pampers. So, there’s where a counsellor is useful. He/she willtell your family you are….a HIV positive person and an addict; his life islike <strong>this</strong>, <strong>this</strong>, <strong>this</strong>…..”)(Male, 32yrs, Lower secondary education, DU)“Bagi saya….bagi saya….keluarga saya …..keluarga saya mengetahuisaya ada HIV. Tapi peringkat permulaan tu, keluarga saya tak boleh nakterima lah. So, setelah saya ….daripada pergi ke hospital, dia dapatpenerangan daripada pakar pakar. So, keluarga saya bolehterima….boleh terima dengan apa yang saya alami lah – HIV ni.”(“For me….for me….my family….my family knows I have HIV. But atfirst, my family could not accept [me]. So, after…from going to thehospital, they got information from specialists. So, my family can accept[me]….. can accept what I am experiencing – <strong>this</strong> HIV.”)(Male, 34yrs, Upper secondary education, DU)The above testifies to the importance of counselling services delivered in the appropriateway. However, participants who were tested in prison reported that they did not receiveany counselling before of after testing when they are informed of its outcome. Bloodtesting is carried out routinely for all inmates and the result of the test given to them as amatter of course. After testing, inmates who are confirmed HIV-positive are thensegregated. With regards to Pusat Serenti, the Government drug rehabilitation centres,one participant said that whether or not counselling is given depends on the counsellorassigned to that person. However, according to procedure, every Pusat Serenti residentshould receive it:“Dalam pusat, kalau nak kaunseling tu, bergantung kepada kaunselor.Kaunselor dia yang jaga dia lah. Itu terpulang pada dia – dia nakkaunseling, kaunseling lah. Kalau dia tak nak….. Kalau ikut prosedur diapunya perkhidmatan, memang sepatutnya lah.”(“In the centre [drug rehabilitation], if you want counselling, it depends onthe counsellor. The counsellor assigned to take care of him. It depends onhim – if he wants to counsel, he counsels. If he doesn’t….. If serviceprocedures were followed, it should be [provided].”)(Male, 34yrs, Upper secondary education, DU)45
- Page 2 and 3: Table of ContentsPROJECT TEAM 5ACKN
- Page 4 and 5: Information received at the time of
- Page 6 and 7: AcknowledgementsThis research is fu
- Page 9: The main findings from the qualitat
- Page 14 and 15: school or work, transport costs for
- Page 16 and 17: is that the large majority of women
- Page 18 and 19: In fact, special surveys conducted
- Page 20 and 21: ObjectivesThe specific objectives o
- Page 22 and 23: have been rejected by their immedia
- Page 24 and 25: eport) that his/her healthcare (or
- Page 26 and 27: CommunityKnowledge/awareness of HIV
- Page 28 and 29: Framework of analysisA descriptive
- Page 30 and 31: urban and a rural community. In all
- Page 32 and 33: medication, the physical health com
- Page 34 and 35: husbands working in other places wh
- Page 36 and 37: (“And then, this doctor, he/she v
- Page 38 and 39: their food. Nurses and their attend
- Page 40 and 41: “Because we take drugs….no time
- Page 42 and 43: The same claim to 100% condom use w
- Page 46 and 47: “Normally…..normally, memang ma
- Page 48 and 49: (“But I continued using at that t
- Page 50 and 51: “Buat pada permulaannya, saya mem
- Page 52 and 53: However, not all experiences with d
- Page 54 and 55: yang amat sangat. Tak pernah I rasa
- Page 56 and 57: long term fears and anxieties. The
- Page 58 and 59: “The first time I heard from the
- Page 60 and 61: handset, I too, have handset. Some
- Page 62 and 63: have been turning to God since and
- Page 64 and 65: felt I’m indecent. But, at one ti
- Page 66 and 67: would certainly want to continue wo
- Page 68 and 69: (Transgender, 53 yrs, Upper seconda
- Page 70 and 71: “Sometimes I didn’t get enough
- Page 72 and 73: positively portray people living wi
- Page 74 and 75: “After my diagnosis...I’ll pay
- Page 76 and 77: not know or might not want to be bo
- Page 78 and 79: (UNAIDS 2005).(UNAIDS 2000):The fac
- Page 80 and 81: “…bawak saya pergi hospital. An
- Page 82 and 83: erpindah ke tempat lain makin lama.
- Page 84 and 85: pada HIV itu, dia nampak penagih. S
- Page 86 and 87: (Male, 49yrs, University education,
- Page 88 and 89: However this association with the n
- Page 90 and 91: “…..depends on who is the perso
- Page 92 and 93: (“I …my experience society will
- Page 94 and 95:
(“Can…can marry, no problem. Bu
- Page 96 and 97:
Harm Reduction programmeSome urban
- Page 98 and 99:
(“In my opinion such campaign sta
- Page 100 and 101:
Table 2aDistribution of Respondents
- Page 102 and 103:
female sex workers (seven out of 13
- Page 104 and 105:
NO. OF LIVING PARENTSNobody 7 1 1 2
- Page 106 and 107:
tested in drug rehabilitation cente
- Page 108 and 109:
GroupsDUHetero-SexuallyInfectedMenT
- Page 110 and 111:
y the Ministry of Health (74.2%) or
- Page 113 and 114:
Child CareYes, often 0 0 0 1 0 1 0
- Page 115 and 116:
GroupsDUHetero-SexuallyInfectedMenT
- Page 117 and 118:
Figure 5: Percentage of Respondents
- Page 119 and 120:
GroupsTable 12aEmotional Problems E
- Page 121 and 122:
Stigmatization and how it has affec
- Page 123 and 124:
GroupsTable 15How They Cope With Th
- Page 125 and 126:
Table 18Percentage Of Respondents W
- Page 127 and 128:
esponsible for their families. As m
- Page 129 and 130:
In this study, it took more effort
- Page 131 and 132:
eing transgender and sex worker whe
- Page 133 and 134:
denies them social and economic opp
- Page 135 and 136:
working towards their future, who c
- Page 137 and 138:
ReferencesAidsmeds.com (2006). Curr
- Page 139 and 140:
Sen G, George A, Ostlin P (2002). E
- Page 141 and 142:
Annex II: FGD Guide for PLHIV Group
- Page 143 and 144:
♦ Spouse: marital/sexual relation
- Page 145 and 146:
I. Attitudes and Perceptions relate
- Page 147 and 148:
I. HIV/AIDS Knowledge‣ What did y
- Page 149 and 150:
Annex V: Rapid Needs Assessment Que
- Page 151 and 152:
Types of support or responsibilityM
- Page 153 and 154:
Please tick (√)one onlyIf yes,ple
- Page 155 and 156:
more help would be useful for you i
- Page 157 and 158:
Annex VI: Ethics Approval Letter157