HIV/Aids NGOs are exploring the idea of using television serials to spread awareness of the disease and remove the stigma surrounding the issue.

This is in an effort to reach out to housewives in Malaysia, whom according to a report by Unicef in 2008, is a growing demographic as far as HIV infections are concerned.

According to Women and Health Association Kuala Lumpur (Wake) president, Abu Bakar Jamaluddin, of the growing number of housewives referred to their outreach centres, many had their infections detected late.

"This is a cause for concern because the virus is more easily contained with early detection. It also means we can reduce the risk of mother-child transmission," he said.

By working closely with television broadcast networks like RTM and TV3, Abu Bakar feels that issues surrounding HIV/AIDS can be discussed in a language which the housewives understand.

This view is echoed by Malaysian Aids Council (MAC) women & youth cluster manager Mano Subramaniam, who feels that the approach, which has had considerable success in countries like India and South Africa, helps portray those infected with HIV/AIDS in a more positive manner.

"Local television serials often portray those infected with HIV as being very sickly and on their last legs, or engaging in high risk behaviour.

"This just adds to impression that the only people who get HIV are those with low morals," she said, adding that the stigma keeps many women from getting screened for fear of society's reactions if they are infected.

Combining against common foe

Mano added that another way to reach out to housewives is to work closely with religious bodies like World Vision, church groups as well as Islamic religious authorities, all of whom have been very supportive and open to working alongside NGOs on the matter.

"Masjid Wilayah had recently played host World Aids Memorial Day by holding events like tahlils and exhibitions, which were open to the public regardless of religion," she said.

Pre-natal tests, she added, are also used to reach out to housewives. MAC is working closely with the Ministry of Health, with government hospitals and reproductive health clinics - an effort which they believe is showing much promise.

PT Foundation Programme director, Raymond Tai, however, cautions that diverting attention to housewives may take away focus from the most-at-risk populations , including those who practice unsafe sex and are intravenous drug users.

"It is important to recognise that the situation in Malaysia is not like that in Africa where infection of housewives has become an epidemic in itself," he said.

Epidemic or not, Ministry of Health statistics show that in the months of January and June 2009, 135 housewives around Malaysia were infected with the disease.

Kelantan recorded the highest number of new infections at 36, which is a double whammy for the state government as it is also saddled with a large increase in new infections among those aged between 20-40 years old.

More housewives infected than sex workers

Housewives make up the third highest, after "unemployed" and "other occupation". It also far surpasses the eight sex-workers recorded to be newly-infected nationwide in the same period, thus challenging the stereotype of those infected with HIV.

Still, Tai noted, statistics can only show one side of the story. This is because housewives are usually infected by their spouses, who may be drug users or have multiple sex partners, including sex workers.

Intravenous drug use also remains the most common form of infection, indicating that focus should not be drawn away from drug users.

Further, it may be the case that new infections among sex workers do not get detected as they do not undergo screening.

In recognition of this, Wake's housewife-outreach programme includes visiting brothels to speak to sex workers and their patrons about the dangers of unsafe sex, not only to themselves, but also to their families - an effort which is also undertaken by PT, using the volunteer services of former sex workers themselves.

While this peer-to-peer outreach, which is partially funded by the government, has shown considerable success, Liu believes more can be achieved with further cooperation with the police.

"We find that sex workers are apprehensive to carry condoms in their purses, because they claim that this is used by the police as proof that they are soliciting sex," said Liu.

Despite recognising the increasing feminisation of HIV/Aids infections in Malaysia, there is little extra that is being done by the Ministry of Women and Community Development.

A ministry official who declined to be named noted that the focus of the ministry, through the department of women development, is largely on economic development.

While some awareness programmes are held by the department, health matters, including that of HIV/Aids, is largely left to the Ministry of Health.

But even the Ministry of Health has their hands full. For the moment, their policies indicate that priority remains with those who practice high risk behaviour. This, some may argue, is a right approach, considering the declining number of new infections since 2002.

However, with the proportion of women infected with HIV, most of which are housewives, increasing by three fold in the past 10 years, it is only hoped that this approach will also have significant spillover effects to nip this emerging trend in the bud.