HIV/AIDS/STD PREVENTIVE EDUCATION THROUGH TVET SYSTEM

IN MALAYSIA
1. INTRODUCTION
HIV and AIDS have a tremendous impact on the education and training systems and the labour
force. Therefore, the TVET systems of those countries most affected by the pandemic need to be
adapted in order to address these problems.
With regard to TVET, HIV/ AIDS/STD affect:
The demand for TVET: reduced enrolments through death and illness of students,
absenteeism related to care for infected relatives, the need to substitute for a deceased
income generating family member, that is having to work instead of going to school, etc.
The supply of TVET: impact on teaching and other education personnel and resources
The quality of TVET: by diverting resources and through absenteeism of staff and
learners
HIV/ AIDS/STD are also major threats to the world of work as they affect the most productive
segment of the labour force. They lead to
Reduced earnings
Increase of labour costs
Decline of productivity
Loss of skills and experience
Erosion of rights at work (discrimination and stigmatization of infected co-workers etc.)
Education can address the social, cultural and economic conditions that contribute to
increased vulnerability; it can also modify the behaviours that create, increase or perpetuate
the risk of HIV infection. Well-planned and implemented HIV/AIDS/STD Preventive Education
is associated with delayed sexual debut, fewer sexual partners and more widespread and
consistent use of condoms. It also contributes to an improvement in attitudes toward people
living with HIV and can reduce stigma and discrimination.
2. BACKGROUND OF HIV/AIDS/STD EPIDERMIC PROBLEMS IN MALAYSIA
The Ministry of Health (2010) recorded that the first three cases of HIV in Malaysia were
detected in 1986. As of December 2009, after more than 20 years into the HIV epidemic in
Malaysia, the country has recorded a total of 87710 persons with HIV. An estimated 105 439
people are currently living with HIV. In addition to that,a total of 13394 AIDS related deaths
have been reported as of 2009.
Men represent the majority (90.8 percent) of cumulative HIV cases while women and girls
account for less than 9.2 percent of this total. 35.9 percent of reported infections are amongst
young people between the ages 13-29 years old. Most reported infections occur among young
heterosexual males of Malay ethnicity, between the ages of 20 39 who inject drugs. Children
aged 13 years below consistently comprised 1.0 percent of cumulative total of HIV infections
from 1986 to December 2009.
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Currently, cumulative reported cases of HIV transmission has been predominantly through
injecting drug use (70.6 percent), followed by heterosexual intercourse (16.9 percent) and
homosexual or bisexual contact (2.0 percent). However, 2009 data indicates that 55.2 percent of
new HIV cases for that year were attributed to injecting drugs and 32.0 percent through sexual
transmission (heterosexual and homosexual/ bisexual) (Ministry of Health, 2010).
The HIV epidemic in Malaysia is mainly driven by injecting drug use and heterosexual
transmission. Amongst men, the main mode of HIV transmission continues to be via injecting
drug use where HIV prevalence is estimated to be 22.1 percent.5 On the other hand, the Ministry
of Health (2010) also reported that most HIV infections amongst women have occurred through
heterosexual transmission (70 percent). Women and girls are increasingly getting infected with
HIV, constituting around 18 percent of newly infected persons nationwide in 2009 compared to
being barely 5 percent ten years ago.
Economic Planning Unit and UNDP (2005) reported that the HIV epidemic in Malaysia is
mainly driven by injecting drug use and heterosexual transmission. Amongst men, the main
mode of HIV transmission continues to be via injecting drug use where HIV prevalence is
estimated to be 22.1 percent. On the other hand, the Ministry of Health reported that most HIV
infections amongst women have occurred through heterosexual transmission (70 percent).
Women and girls are increasingly getting infected with HIV, constituting around 18 percent of
newly infected persons nationwide in 2009 compared to being barely 5 percent ten years ago.
Examination of data from each state also revealed that there continues to be two main trends of
HIV infection which are geographically distinct. The majority of states in Peninsular Malaysia
have Injecting Drug Users (IDUs) driven epidemics but a number are increasingly having
heterosexual transmissions either equally contributing or leading HIV infection. States such as
Sabah and Sarawak, located in East Malaysia, have reported 97.7 percent and 83.6 percent of
their HIV cases respectively being transmitted through this route in 2009. Both scenarios require
specific responses and interventions which address the spread of HIV both through injecting drug
use and sexual transmission.
The magnitude of sexually transmitted infections (STIs) in Malaysia is very much under
represented. This is due to under-reporting and under diagnosis, asymptomatic manifestation of
the disease as well as patients preferring to access the private healthcare facilities to treat STIs
as opposed to seeking treatment at public hospitals and clinics. Some also prefer to self-treat
through alternative medicine. Despite the existence of the Prevention and Control of Infectious
Diseases Act of 1988 which requires reporting of incidences of syphilis, gonorrhoea, chancroid
and HIV, most cases of STIs are not reported by private practitioners.
As HIV prevalence continues to be less than 1 percent but ranging from 3 percent to 20 percent
among most at risk populations such as sex workers and drug users, the World Health
Organisation (WHO) currently classifies Malaysia as having a concentrated HIV epidemic.
In the next few years, based on recent estimations and projections work, HIV in Malaysia is
predicted to be increasingly spread through sexual modes of transmission while infections
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acquired through injecting drug use are expected to plateau. The number of reported cases
attributed to MSM (Men who have sex with men) and heterosexual route of transmission is
slowly increasing which is consistent with the HIV estimation and projections model developed
for Malaysia. It is expected that this evolving picture of the HIV epidemic will present new and
difficult challenges for HIV programming taking into consideration Malaysias cultural and
religious context and sensitivities.
3. POLICY AND PROGRAMMATIC RESPONSE
The Malaysian response continues to be guided by the National Strategic Plan on HIV/AIDS
2006 2010. A new sense of urgency and national commitment in responding to the challenge
of the sole unfulfilled sixth MDG (Millennium Development Goals) resulted in the development
and production of the 5 year National Strategic Plan (NSP) on HIV/AIDS 2006-2010. This NSP,
which was developed and drafted with the involvement of key civil society representatives in
2005 and 2006, incorporates a multi-sectoral strategy covering issues from young peoples
vulnerability to the delivery of healthcare services and antiretroviral treatment.
This framework provides a common basis for coordination and guidance of the work of all
Government and non-governmental partners involved in the national HIV response as well as
emphasises an integrated and comprehensive approach addressing the needs of prevention,
treatment, care and support.
The objectives of the NSP are as follows:
To reduce the number of young people aged 15-24 with HIV
To reduce the number of adults aged 25-49 with HIV
To reduce the number of HIV infections in IDUs
To reduce each year the number of HIV infected infants born to HIV infected mothers
To reduce the number of people from the marginalised population (i.e. sex
workers,transsexuals and MSM) with HIV
To increase the survival and quality of life among people living with HIV
4. RATIONALE FOR TVET

Young people (10 24 years) are estimated to account for up to 60 % of all new HIV
infections worldwide. Many young people can be reached relatively easily through TVET
schools and training institutions.
Prevention and social hygiene promotion programmes should extend to the whole school
setting, including students, teachers and other school personnel, parents, the community
around the school, as well as the school systems. Such activities are a key component of
national programmes to improve the health and social hygiene of children and
adolescents.
Education is empowering. It facilitates the acquisition and use of knowledge,
competencies, attitudes and behaviours that are essential for healthy lifestyles. In addition
to supporting learning throughout life, it enhances public accountability, promotes inter-

generational dialogue and leads to better use of available services, especially health and
social protection.
Social Sustainability is the third pillar of Sustainable Development in TVET. On both the
global and local scale, social sustainability involves ensuring that the basic needs of all
people are satisfied and all, regardless of gender, ethnicity or geography, have an
opportunity to develop and utilize their talents in ways that enable them to live happy,
healthy and fulfilling lives which is inclusive of HIV/AIDS/STD Prevention Education.
TVET provisions are not locked into the role of being a mere supplier of skilled labor to
industry and should be able to respond effectively to the needs of the sustainable
development strategies such as HIV/AIDS/STD Prevention Education. The TVET
professionals are called upon to reorient the TVET curriculum towards sustainability
while maintaining the principles of 6R that is Reduce, Reuse, Renew, Recycle, Repair
and Rethink perspectives. Therefore TVET system also needed to be aware of the concept
and challenges of HIV/AIDS/STD Prevention Education relevant for the work place
occupational hygiene.
The curriculum in TVET has to reflect these changes and needs to provide knowledge,
skills and values that will help technician students cope with and adapt to these changes.
The focus of this course revolves around how TVET will respond to the demands for
change so as to incorporate societal issues and introduce and integrate related In
HIV/AIDS/STD Prevention Education concepts into the curriculum of TVET
programmes. It is therefore the task of the TVET professionals to invent new ways in
which the concepts of In HIV/AIDS/STD Prevention Education can be infused into the
curriculum.

5. BASIC PRINCIPLES OF HIV/AIDS/STD PREVENTIVE EDUCATION

The following are some basic principles of HIV/AIDS/STD Preventive Education Through
TVET Andragogy-Pedagogy Approaches:
1. Methods for HIV/AIDS/STD Preventive Education in TVET should promote problem
solving skills, creativity and innovative skills.
2. All techniques should be designed to suit learner characteristics, meet their needs and
develop their interest and enthusiasm.
3. Methods should focus on real-life problem-solving, i.e., application of principles of
science, social science and technology to solve environmental problems.
4. Problem or project-centered approach is usually more appropriate than subject or
discipline approach for HIV/AIDS/STD Preventive Education.
5. Scientific and technological aspects of environmental issues should be supplemented with
values and ethical aspects.
6. Teaching approaches should shift away from lecturing towards group-work, self-study
and methods which use active involvement in projects and community life.
7. Team-teaching can effectively pool talents of specialist teachers to work in an interdisciplinary way.
8. Learners should have access to elective subjects suited to their own personal and
professional needs, interests and job opportunities.

6. THE CHALLENGES
HIV/AIDS/STD Preventive Education encourages dynamic ways of learning. To facilitate this,
assistance is needed and should be comprehensive. For example:
Include providing initial and in-service training for teachers.
Teachers should be given the time and resources to design, manage, and evaluate activities,
making teaching material available and grasping their duties.
Equity and ethics must be emphasised.
Best practices should be benchmarked and disseminated.
The commitment of academic leaders and governance is crucial, as well as parental
involvement.
The private sector should become more involved by sponsoring certain projects and by
involving directly as mentors. The private sector should see their involvement in
HIV/AIDS/STD Preventive Education as a long-term investment, and as an essential aspect
of their corporate social responsibility.
REFERENCES:
Economic Planning Unit and UNDP (2005). Achieving the Millennium Development Goals.
Success and Challenges. The UN Country Team Malaysia and the Economic Planning Unit,
Government of Malaysia
Ministry of Health and World Health Organisation (2010). National Consensus Workshop on
Estimation and Projection of the Malaysian HIV Epidemic.
Ministry of Health (2010). Statistics of HIV AIDS in Malaysia (1986 2009)
Malaysian AIDS Council (2010) Integrated Bio-Behavioural Surveillance (IBBS) survey with
IDUs, SW, TG. Powerpoint presentation. Presented on 11 March 2010

Requirements By The MQF

The Malaysian Qualifications Framework also outlines the Values, Attitude and Professionalism
as one of the four major learning outcome domains that must be in every programme
accreditation (see Table 4). As student achievements are measured by learning outcomes,
students should be able to demonstrate social skills and responsibilities. HIV/AIDS/STD
Preventive mindsets and skills can also be best promoted through learning by forms of practical
projects and activities.

How To Incorporate HIV/AIDS/STD Prevention Education In Curriculum?

I would like to suggest two types of approaches to integrating entrepreneurial
skills and behaviours into an educational programme:
a. Merged - Integrate HIV/AIDS/STD Prevention Education content into existing courses, or
b. Simulated - Students take on roles and make decisions related to a real or simulated
HIV/AIDS/STD Prevention Education.

In HIV/AIDS/STD Prevention Education, assessments are not limited to knowledge or

cognitive domain but also concerned for the formation of attitudes, values and life skills
among the students. Therefore, the choice and use of the most appropriate tool for a
particular grade level or group of learners is important. Assessment tools refer to the
different ways students can demonstrate that they have mastered the objectives. These
include tests and other subjective instruments. Tests often refer to objective and essay
tests. Other tools are rating scales, checklists, and questionnaires. Assessment tools are
designed based on clearly stated objectives. To construct valid assessment tools certain
principles and rules must be observed.
HIV/AIDS/STD preventive education and related programs provide an opportunity to
strengthen and accelerate existing existing school health and social hygiene education in
TVET settings. Education to prevent HIV/AIDS/STD are already integrated into the
school curricular such as Human Health & Reproductive Education, Life Skills, Physical
Education, Biology and Sciences, Career Guidances and Counselling Activities,
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Disciplinary and Students Surveillances System, and routine regular medical examination
and screening as prerequisite to the TVET programmes.
The existence of religious goals and the extent to which they are embedded in the TVET
curriculum added strength HIV/AIDS/STD preventive education. Religious Embedded in
religious education subjects such as Islamic Religion Study and Moral, Citizenship and
Civics Education helps to foster self esteem, caring, respects, decision making, selfefficacy and conditioning personal attitude values, knowledge and social hygiene skills
that allow healthy development of students and staff. This is dome through deliberate
conscious planning and efforts to incorporate into teaching materials, teaching and
learning activities, teachers training, schools supervision and surveillances, and the
participation of parents and communities.
Initiating curriculum development agencies such the Curriculum Development Centre
(Ministry of Education) extensively consulted academicians, teachers unions, parents,
professional bodies, and non-governmental agencies. These stakeholders participated in
curriculum design, adopting resolutions and suggestions from seminars, conferences,and
workshops; issuing memorandums.