HIV Epidemic Among Men Who Have Sex with Men (MSM) and Transgender Women (TGW) in Sarawak, Malaysia: An analysis from the Integrated Biological and Behavioural Surveillance (IBBS) Lite 2024 Introduction Men who have sex with men (MSM) and transgender women (TGW) are among the key populations affected by the HIV epidemic in Sarawak, Malaysia. The objective of this study was to determine HIV prevalence and associated behaviour among MSM and TGW in Sarawak. Methods Respondent-driven sampling (RDS) was used to recruit MSM and TGW between June and August 2024. The study consisted of two components. The first component was a behavioural survey, conducted through a selfadministered online questionnaire via a web-based platform. The second component involved biological testing, where respondents were instructed to visit a community-based testing site of their choice for blood testing after completing the online survey. Statistical analysis was performed in RStudio using the Gile's Successive Sampling Estimator. Results This study recruited 217 MSM and 151 TGW. Consistent condom use among both groups remains low. While most MSM and TGW reported recent HIV testing, Hepatitis C testing and treatment rates are still low. HIV prevalence in Sarawak was 9.5% (95% CI: 2.9, 16.0) among MSM and 10.1% (95% CI: 1.8, 18.5) among TGW, with syphilis prevalence among MSM reaching a concerning 12% (95% CI: 1.8, 22.3). Conclusions In conclusion, improving HIV prevention and care for MSM and TGW in Sarawak requires promoting condom use, increasing awareness of Hepatitis C, and including substance use interventions in HIV programs. Community outreach using culturally sensitive approaches is crucial to improving access to services and building trust. Furthermore, integrating syphilis management into HIV prevention efforts is critical, given its strong association with increased HIV risk. Findings highlight the need for targeted interventions and continued surveillance among key populations in Sarawak to ensure a sustained and effective public health response.

Introduction: The rising prevalence of human immunodeficiency virus (HIV) among people who inject drugs is a major public health issue. This study intends to explore education and demographic correlates of use of condoms among male drug users in Malaysia. Methods: Data were extracted from the Integrated Biological and Behavioral Surveillance Survey 2017. Pearson’s chi-square tests and a logistic regression were used to examine the associations between condom use and education, and demographic factors. Results: Only a small proportion of drug users used condoms (25.7%). Educational backgrounds, age, ethnicity and marital status were associated with condom use. The likelihood of using condoms was lower among less educated drug users (aOR: 0.308–0.339). There was an interaction effect of education and age on condom use (aOR: 0.116–0.308). Chinese (aOR: 3.117) and those of other ethnicities (aOR: 2.934) were more likely to use condoms when compared with Malays. Being married (aOR: 0.291) or divorced/widowed (aOR: 0.346) was associated with reduced odds of using condoms. Conclusion: Education and demographic factors play an important role in influencing the decisions of Malaysian drug users to use condoms. Therefore, HIV-preventive measures targeting drug users could benefit by paying special attention to these factors.

KNOWLEDGE OF HIV TRANSMISSION AND ITS ASSOCIATION WITH SOCIODEMOGRAPHIC FACTORS AMONG MALE DRUG USERS IN MALAYSIA: FINDINGS FROM THE INTEGRATED BIOLOGICAL AND BEHAVIORAL SURVEILLANCE SURVEY (IBBS) 2017 Controlling the spread of HIV requires essential knowledge. This study explores how sociodemographic factors relate to HIV transmission knowledge among male drug users in Malaysia. This study utilised cross-sectional data from the Integrated Biological and Behavioral Surveillance Survey (IBBS) 2017 (n = 1,413). An ordered probit regression was used to evaluate parameters influencing the probabilities of having low-, middle- and high-level knowledge of HIV transmission. Almost half of drug users had low- and middle-level knowledge of HIV transmission. The likelihood of possessing low- and middle-level knowledge about HIV transmission were 2.1%–8.3% lower among drug users aged 30–49 than those aged ≥50. Drug users with secondary- and tertiary-level education were 5.8%–14.9% more likely to possess high-level knowledge about HIV transmission compared to individuals with primary-level education. The odds of possessing high-level knowledge of HIV transmission was 6.3% higher among divorced/widowed drug users, while it was 23%–32.9% lower among non-Malays when compared with others. In conclusion, drug users are more likely to have poor knowledge about HIV transmission if they are older, less educated, non-Malays and single. Future HIV-control initiatives should give particular consideration to the populations with these sociodemographic traits.

Objective: Various public health and social measures have been used during the COVID-19 outbreak, including lockdowns, contact-tracing, isolation and quarantine. The objective of this manuscript is to describe outbreaks of COVID-19 in Selangor, Malaysia, the public health strategies used and the observed impact of the measures on the epidemic curve. Methods: Information on all confirmed COVID-19 cases in Selangor between 25 January and 28 April 2020 was obtained. Clusters were identified, and cases were disaggregated into linked, unlinked and imported cases. Epidemic curves were constructed, and the timing of movement control orders was compared with the numbers of cases reported. Results: During the study period, 1395 confirmed COVID-19 cases were reported to the Selangor Health Department, of which 15.8% were imported, 79.5% were linked and 4.7% were unlinked cases. For two main clusters, the number of cases decreased after control measures were instituted, by contact-tracing followed by isolation and home quarantine for the first cluster (n = 126), and with the addition of the movement control order for the second, much larger cluster (n = 559). Discussion: The findings suggest that appropriate, timely public health interventions and movement control measures have a synergistic effect on controlling COVID-19 outbreaks.