Manual On HIV/AIDS mMISLAM k Department of Islamic Development Malaysia In Collaboration With Ministry of Health Malaysia Malaysian AIDS Council HE APrsimicargid e& ranma espe PMDEPARTMENT OF ISLAMIC DEVELOPMENT MALAYSIA www.islam.gov.my First print... 2014 © Department of Isiamic Development Malaysia Allrights reserved. No part of these pages, either text or image may be used for any purpose other than personal use. Therefore, reproduction, modification, storage in a retrieval system or retransmission, in any form or by any means, electronic, mechanical or otherwise, for reasons other than personal use, is stictly prohibited without prior written permission from the Director General of Department of Islamic Development Malaysia Malaysian National Library Catalogue Data-in-publication Manual on HIV/AIDS In Islam ISBN 978-983-042-431-6 1, AIDS (Disease)—Malaysia. 2. HIV infections—Malaysia. 3. AIDS (Disease}—Patients—Malaysia. 4. AIDS ( Disease)—Malaysia—Prevention 616979200297 Typesetting & Designing MIHAS Grafik Sdn Bhd No. 9, Jalan SR 4/19 ‘Taman Serdang Raya 43300 Seri Kembangan Selangor Darul Ehsan Tel: 03-8942 9052 Fax: 03-8042 9054 tHPAP etic 2 & eaxem iscoCONTENT Preface from the Director General Guideline for the use of Manual On HIV/AIDS In Islam Module 01: HIV/AIDS: Basic Introduction 8 Topic 01: HIV/AIDS: Ways of Transmission 8 Topic 02: HIV Antibody : Tests a Topic 03: HIV/AIDS: Frequently Asked Questions 26 Module 02: Facts and Figures on HIV/AIDS 32 Topic 01: HIV/AIDS — Facts and Statistics 33 Module 03: Prevention 44 Topic 01: Prevention — How & Why 4 Topic 02: Behavioral Changes 47 Module 04: Support & Treatment 52 Topic 01: The Needs for Support 52 Topic 02: ‘The Needs for Treatment 87 Topic 03: Support Responsibilities in the Islamic Approach 58 Module 05: Stigma & Discrimination 67 Topic 01: The HIV/AIDS Language 68 Topic 02: Presumptions of HIV Transmission Risks 69 Topic 03 : Determining Personal Presumptions Towards HIV/AIDS 70 Topic 04: —_ Islamic Perspective on Stigma & Discrimination ” Topic 05: Case Study- Stigma & Discrimination 7 Topic 06: Problem Solving 81 Module 06: Duty & Responsibilities of Ummah in the Combating & Fighting Against HIV/AIDS 83 Topic 01: —_ Islamic World's Reactions Towards HIV/AIDS 83 Topic 02: The Role of Mosques and Islamic Leaders 92 Topic 03: © Workshop Activities 98 Topic 04: Frequently Asked Questions On HIVIAIDS & Islam 100 Topic 05: Do’a From The Holy Quran & As-Sunnah 105 Module 07: Handling Of HIV Infected Dead Bodies 412 Topic 01: "Procedures in Handling Of HIV Infected Dead Bodies 112, Topic 02: Handling Of HIV Infected Dead Bodies in Islamic Perspective 113 Topic 03: Case Study 115 Module 08: Plan of Action 117 Appendix 1 (List of NGOs Providing HIV/AIDS related services) 124 Appendix 2 (Manual On HIV/AIDS In Isiam Exercise Assessment Form) 127 Appendix 3 (HIV/AIDS Glossary) 128 Acknowledgement 131 References 132PREFACE FROM THE DIRECTOR GENERAL DEPARTMENT OF ISLAMIC DEVELOPMENT, MALA’ Assalammuralaikum Warahmatullahi Wabarakatuh Alhamdulillah, our highest gratitude be to Allah the Almighty, for with His blessings, the Department of Islamic Development, Malaysia (JAKIM), with the cooperation of the Ministry of Health (MOH) has successfully published the English version of Manual on HIV/AIDS In Ista. With the publication of this manual, it would be able to further expand the usage of its contents to the global community. As.we are all aware, the issues and problems of HIV/AIDS in the life of Muslims is already critical. Statistics show the number of Muslims living with HIV/AIDS is continuing to increase from year to year. This phenomenon needs cooperation from all sides to arrest and solve the problems. Counseling and treatment to those with high risks of being infected and those living with HIV/AIDS should be intensified. This effort necessitates commitment from all sides as it is a social responsibility required in Islam. Therefore, itis my hope that this manual could be fully utilised to achieve the targeted objectives. | also hope that this manual is not just for keep in the libraries. This jewel should be promoted and used on all target groups. In conclusion, | express my congratulations and appreciation to those involved in the publication of this manual. Their cooperation in their joint ideas, efforts and commitments to produce it, is something to be proud of. For this effort, May Allah the Almighty shower His blessings on them for their noble and godly deeds. Thank You Kaw DATO’ HAJI OTHMAN BIN MUSTAPHA Director General Department of Islamic Development, Malaysia SiATnding et @ © sais aroraPREFACE FROM THE DIRECTOR GENERAL APA Su Aer sa] Assalammulalaikum Warahmatullahi Wabarakatuh: | would like to congratulate and convey my deepest appreciation to the Department of Islamic Development Malaysia (JAKIM) for succesfully producing this manual. Without doubt, JAKIM is one of Ministry of Health's strongest advocates in addressing the issue on HIV/AIDS and Isiam in this country. As we all know, HIV/AIDS is a threat to the well-being of mankind. Hence it is necessary for every one of us to take effective measures to deal with it. The role of every citizen of Malaysia is very important, be it the individual, governmental organizations, scholars or preachers, the community and families. ALLAH has entrusted each one of us with our bodies and we should avoid any act which will harm our physical or spiritual health. This manual addresses the issues of HIV/AIDS Through this manual, Muslim leaders will have some assistance in carrying out the very important task of imparting awareness and values to the Muslim community about issues on HIVIAIDS. | trust that this accurate and comprehensive information on HIV/AIDS from the Islamic teachings perspective. Therefore this manual will help Muslim leaders to deal compassionately and sensitively with those who are living with HIV/AIDS. | am confident that this manual will help enhance the understanding of Islamic leaders on HIV/AIDS and increase the effectiveness of missionary efforts helping the nations in preventing and controlling the HIV/AIDS as well as strengthening the support for those infected and affected. Wassalam, may Allah bless us all DATO’ DR. HASAN BIN ABDUL RAHMAN Director General Ministry of Health Malaysia O1F.A Peviminaryindd $ e& tanaa0u «190%GUIDELINE ON THE USE OF THIS MANUAL ON HIV/AIDS IN ISLAM PURPOSE OF THE MANUAL ON HIV/AIDS IN ISLAM This Manual on HIV/AIDS In Islam has been developed specially for Islamic Affairs Officers’ use at the state and district Islamic Religious Departments, Imam, Takmir teachers, Holders of Islamic teaching credentials (mosque, surau and madrasah) and leaders of the Muslim communities fo enable them to play a more effective role in the management of HIV/AIDS. in Malaysia This manual includes information for the leaders in Isiam conceming aspects of HIV/AIDS ‘which are significant to the general Malaysian community especially the Muslim communities Part of the information includes the basic facts on HIV/AIDS, prevention, treatment, support, counseling, stigma, discrimination and handling of HIV infected deads bodies. Allinformation provided is general in nature as its aim is to provide a basic guidance to assist the Muslim leaders’ involvement to increase the awareness and to get the participation of the Muslim community in managing HIV/AIDS. It is hoped that this Manual can be used as a guide in planning and conducting activities handling the challenges from HIV. HOW TO USE THE MAN It is recommended that all activities provided in the manual to be adjusted to difterent situations and targetted groups as well as types of targetted groups, time frame, issues and Tesources. HIVIAIDS is a complicated subject. Discussion on HIV/AIDS is private in nature and therefore, it is advised to use a practical approach, particularly in regards to lifestyle, morality and religious principle. Thus, it is encouraged to create a suitable setting to voice opinions and have open discussions in a safe environment. Allah SWT commanded in Surah al-Nahl, Verse 125: wecrle wd AG ascle SM Alas Kae Ra des ©. oe ey ais Meaning: 125. Call men to the path of your Lord (0 Muhammad) with wisdom and good exhortation. Reason with them in ways that are best and most gracious. For your Lord best knows those who stray from His path and those who are rightly guided. ® anacontWHO COULD USE THE MANU. 1. JAKIM Officers and other equivalent highest Islamic authorities world wide. 2, Islamic Affairs Officers at the state/distictiprovince Islamic Religious Departments. 3. Imam 4, Takmir Teachers. 5. Holders of Teaching Credentials, Certificated Ugama Teachers (mosque, mussola and madrasah). 6. __ Islamic Education Teachers at Primary, Secondary, national/conventional and Islamic schools. 7. Leaders of Islamic Organizations and Musiim Communities NOTE: i Itis hoped that the people listed above who have gone through the Manual on HIV/ AIDS in Islam could use this module to train other Muslim leaders, ii, This manual can be used by anyone interested to apply the Islamic approach in managing HIV/AIDS. BRN ela oreo sega nor Mac Peming. epphing._manierng are Sine felgats oes Cenc acattets ely AK (Cher casita Sava schoo) | Tring tea get ach ee Canyng cut xh tearm a Tecnu econ | Actos in Community Target Groups: General Public, Women, : — SEU Toneystiaet rie) Carrying out activities at individual level. Addicts, Gays and Bride ‘and Grooms te-be tie Acaaindd 2 ® anaoont 70180Prag ete Ceol LUNA ets Uesteeh (es un a hZAD TS Before engaging in any target groups, understand their backgrounds and problems before hand by considering the issues related to the groups in order to communicate effectively. This approach is modelled on an example of the Prophet Muhammad SAW during his sermon. He used relevant philosophy, language and example appropriate with the level of comprehension and character of individuals so that his reasons and sensibility could be easily comprehended and grasped. solo Fa IS py og OAH al Oy gO ply ile ts he Ct i ts J 1 hy Ob AS el OE pd UE hy Uh ye as Ud wo ta yf Oye h Ap ality 9 Od cast oa woe ods Sgt ot Od seca thy ples Soy th i V6 5 Od gi id vod) {iy Ob sca las 1 month) Pheurnocystis carinii pneumonia infection (PCP) (Cytomegalovirus infection (ngs, brain, retina) ‘Tuberculosis (brein/exra pulmonary) Fungus infection eg: Candida, cryptococcosis, histoplasma, Toxoplasmosis Herpes simplex (GIT, herpes zoster Infections ike Crypteoccosis, ricrospradum, isospora. ‘Cancer like lymehoma, Keposi sarcoma, 20 Manual On HIV/AIDS In IslamHow to Avoid HIV Transmission Refrain Yourself from Risky Activities Find cut your own HIV status. + Find cut your partner's HIV status. + Take HIV screen tests for bride and groom to be. + Take HIV screen test for pregnant mothers. + Infected mothers will be given treatment to avoid infection to baby. Avoid getting involved in risky activities like visiting prostitutes, drug abuse, and ‘sexual relationship with HIV postive people. HIVIAIDS prevention is our responsibilty rela HIV ANTIBODY TEST Objective By the end of the session, participants will be able to: 1. 2 3. Explain the motive and effects of HIV antibody test. Explain the term “Voluntary Counseling and Testing” (VCT). Give explanation to why a person may choose to or not take the HIV antibody test. 1. What is HIV antibody test? i 2. Why do you have to take the HIV antibody test? Main Areas 3. Why do some people choose not to take the HIV antibody test? 4, What is the meaning behind the test result? 5. What is the importance of combining counseling and education with HIV antibody test? 6. The difference between counseling before and after the test. 7. Confidentiality of test result. 8, Who needs to know if the test comes out positive? aWhat is HIV Antibody Test? itis a test to detect HIV antibody produced by the body as a reaction to the virus. The test does not detect the vinus itself, level or severity of the disease or when a person may develop diseases, Why Do You Have To Take The HIV Antibody Test? Ifyou have been involved in risky activities or have been through blood transfusion in the hospital, you have to take the test. Sexually transmitted disease like HIV may cause serious health complicationsifleft untreated. Early detection and treatment may help you to continue to be healthy. What Are “Risky Activities"? ‘Among other things, having sexual relations with more than one partner without using condoms and sharing needles or syringe What Are The Excuses Given To Not Take The HIV Antibody Test? Lack of knowledge on HIV. Unaware of the risk of HIV transmission Fear and anxiety over the possible result of the test. The fear of no confidentiality of test result Fear of stigma and discrimination of taking the test or finding out the result. Unaware that with early detection, a person with HIV may get treatment to help increase quality of life What is Window Period? What Does A Negative Result Mean? itis a time frame between the time infection took place and the time when screen test detects HIV antibody. Usually, itis between 6-18 weeks for a person with HIV to develop enough HIV antibody to be accurately detected. This means that you have to take the test again ifthe test was done within the window period 22| Manual On HIV/AIDS In Islam + There is no HIV infection. + There is HIV infection but the body has not developed enough antibody to be detected and the test has to be repeated 3 months later for conformation {also known as “false negative") What Does A Positive Result Mean? HIV transmission occurred That person may infect other people. That person may or may not have AIDS. That person may or may never have AIDS.What Does “Inconclusive Result” Mean? : There is no HIV infection but the result shows other infection : There is HIV infection but the body has net been producing enough antibody for accurate ‘window period reading and a folloveup test is recommended. What Should You Do If The Result Comes Back Positive? : Tell your spouse, people who may have shared needle with you or people to whom you have donated blood or organ. : Follow cautionary steps and live a healthy way of life to avoid further transmission or infection . Discontinue any risky activities because studies have shown that the time span to develop AIDS became shorter when a person continues this kind of behavier. : Do not donate blood, sperm, organ or body tissues. : ‘Seek a counselor to discuss your feelings and emotions (fear, feeling of loss, sadness, depression, denial, anger) : Get support and back-up from family, friend and your community What Should You Do If The Result Comes Back Negative? : Itis not @ guarantee that you will never be infected with HIV in the future, : ‘Your future depends on your behavior. : You should know the HIV status of your partner all the time if you are involved in risky activities, What is VCT? + VCT is Voluntary Counseling and Testing, which is a deliberate process that combines HIV antibody test with counseling before and atter the test. Principally, VCT helps a person in decision making about taking the HIV test. VCT is also a part of important preventive measure because it educates and makes people aware of HIV infection, + itis important to take into account that the test itself is not @ preventive measure. The test has to be combined with counseling because the most important part of the process is not just the test result but acourate information on HIV/AIDS, which can only be acquired through counseling. ‘Through counseling, a person will find out the next steps to take to move on, regardless of the test result. Only through education and awareness from counseling that the preventive measure will succeed, For example, @ person with negative result has to be told that the test is not an assurance against future transmission and should be counseled to take a new way of life. + VCT has been proven as an effective preventive measure and has been recommended by the Joint United Nations Program on HIVIAIDS (UNAIDS) and the World Health Organization (WHO) as 2 fundamental strategy for all nations of the world. VCT services have been considered as the door for people to access information and counseling needed on HIV/AIDS. Therefore, itis important to make sure that this test is backed-up by effective counseling by trained counselors to give out accurate information Manual On HIV/AIDS fn Islam | 23 1p ACeetindd & easeo 7ssonm+ Counseling Before The Test What Is The Explaining the implication of HIV test, getting the i result and getting the consent of the person to be Difference Between tested before the test is done. The process helps . prepare the person to face the possibility of getting Counseling Before a positive result to control shock, anger or mental pressure which may cause the tendency to commit And After The Test? suicide. It also enlightens the person about further information, counseling and support after the test + Counseling After The Test Explanation about test result and its implication. If the result is negative, the counsel given will have an emphasis on steps to Keep away from further exposure to infection risks. If the result if positive, counseling is focused on fears and issues faced by people with HIV, as well as personal support to help a person face the difficulty and trials of life from HIV infection. The counseling will also encourage the person to attend a follow-up session on treatment as well as further counseling Why Is There A Need For Counseling Assistance Before And After The Test? + For emotional support and help for the person taking the HIV antibody test. + To prevent depression and nervous breakdown + To provide accurate information on HIV and medical care needed if person is HIV positive + Todiscuss financial implication and future planning for the affected family and heir. + Toprepare the possibility of death or time of death Will The Test Result Be Confidential? + Yes. Consent from the patient is needed to disclose the test result. However, the spouse has the right to know the result within 24 hours. + Ifthe spouse refuses to reveal the result, itis the responsibility of the doctor conducting the antibody test to inform the spouse of the patient. 24| Manual On HIV/AIDS In Islam (GP ACutetindd 24 & easeo 7ssormRecommended Workshop Activities 1, Break the participants into four small groups (each group should not be more than 8) 2, Hand out discussion questions listed in the following pages and ask each group to discuss the questions within 20 minutes and complete a report that summarizes the discussion in the following 10 minutes. 3. Toease the flow of working in group, ask each group to elect a reporter to report the discussion and a leader to be in charge of the discussion. During the discussion, make sure that each member of the group has the opportunity to speak and share opinions. 4, Explain to all the groups to review all the information given in the manual to answer each issue given to their group. 5, At the end of the session, ask each group to present their report. Time given for each group is 2-3 minutes. Discussion Questions 1. Amarried woman came for a HIV antibody test. What information has to be collected and what is the information to be passed up in order to help her? 2. Ateenage boy had a sexual relationship with a prostitute 3 weeks ago. The ‘teenager came for a HIV antibody test, What information has to be collected and what is the information to be passed up in order to help him? 3. Ahusband has been infected with HIV through sex outside of his mariage came for advice. What information has to be collected and what is are the information to be passed up to him? 4, Apair of Muslim man and woman came to see you feeling disappointed because they have been forced to take HIV test before they are allowed to marry. What is ‘your opinion of this situation and what information can you give this couple? Manual On HIV/AIDS tn Islam | 25 1P ACeetindd 25 & easeon 7sstomaToPIc3 FREQUENTLY ASKED QUESTIONS ON HIV/AIDS . HIV is a virus that weakens and destroys the immune system in the What is HIV? | human body andit is the cause of AIDS. HIV isa type of virus called retrovirus which infects the human cells and uses the energy and nutrients stored in the cell to develop and reproduce. What is AIDS? AIDS (Acquired Immunodeficiency Syndrome) is a condition where the body's immune system no longer functions to fight infection known as “opportunistic infection” as well as other diseases which took the chance of the weakened immune system. ‘When apersonhas been infected with HIV, the virus enters the body and thrives especially inthe wnite blood cells. The white blood cell protects us from diseases. One of the symptoms of HIV infection is the gradual loss of specific immunity cell which is T-Helper cell or CD4 cell, As the virus reproduce, it destroys and kills this cell as well as other cells which weakens the immune system. This exposes the person to all kinds of opportunistic infection and diseases from pneumonia to cancer. ‘The Center for Disease Control and Prevention (CDC) in the United States defines a person as having clinical AIDS diagnosis if they are HIV positive and comply with one or beth of the following condition: 1 Suffers one or more diseases or infection related to AIDS. 2. The CD4 cell count has fallen to less than 200 per cubic millimeter pf blood (also known as (CD4 cell count). For a healthy individual, the CD4 count varies between 450 to 1,200/mm3. How Long Does It Take for Someone With HIV to Develop AIDS? For certain individual, the decline of CD4 cells and opportunistic infections that signifies AIDS occurs not long after being infected with HIV. Most people do not present any sign for 10-12 years and a small number of them do not display any sign for a longer period. Just as other diseases, early medical treatment may help prolong a person's life, How Many People Have Been Infected With HIV/AIDS? Joint United Nations Program on HIV/AIDS (UNAIDS) estimated at the end of 2002, there are more than 42 million people suffering from HIV and AIDS globally. Most people were unaware of their HIV status and may have transmitted it to other people. In Malaysia, by December 2002, more than 51,000 people were infected with HIV. In South Asia and South East Asia, up to 6 million adult and chikiren has been infected and in the sub-Saharan region, 29.4 million people has been infected in 2002. AIDS has surpassed Malaria and tuberculosis as the most dangerous infectious disease among adults and is the fourth main cause of death in the world. More than 13 million children are orphaned due to this epidemic. 28 | Manual On HIV/AIDS In Islam (GP ACeeindd 26 & easeon 7sse7maHow Does HIV Spread? ‘A person infected with HIV carries the virus in certain bodily fluids which includes blood, semen, vaginal ‘secretion and mother's milk. The virus can only be spread if the infected fluid enters the blood system of anather person, Direct admission may occur 1) through vaginal, rectum, mouth fining and opening at the point of the penis; 2) through intravenous injection with the syringe; or 3) through broken skin ike a cut or sore, Usually, HIV is spread by: 1. Unprotected sex with a person infected with HIV. Women have a bigger risk of infection in vaginal sex compared to men though, the virus can be spread from men to wornen. 2. Unprotected oral sex with a person infected with HIV. The number of infection from oral sex is ‘ar smaller than vaginal or anal sex. However, oralgenital contact has @ risk of transmitting HIV especially when elacuiation ocours in the mouth cavity. The tisk is higher when the partner has cuts or sores ike the ones caused by sexually transmitted diseases (STD) ‘which allows the virus to enter the blood stream. 3. Sharing needles or syringe with a person infected with HIV. A person injecting drugs should not reuse or share needles, water or drugs preparing tools. This includes needles used to inject illegal drugs like hercin as well as steroids. Other syringe like those used in piercing and tattoo may also contain HIV. 4, Pregnant women or planning to get pregnant who fear they might have been exposed toHIV even ifit happened a few years ago have to take the HIV antibody test and counseling. The ‘transmission between mothers and babies has deciined in Malaysia when pregnant wornen are tested for HIV and those who came up positive were given the medication to prevent ‘transmission of infection and were advised against nursing their bables, What Are The Things That Will Not Spread HIV? 1. HIV does not transmit easily between people. 2. _Itisnot spread through food or air (coughing or sneezing for example). 3, There has never been a case where a person is infected by member of the household, relatives, colleagues or friends from casual contact like sharing food containers and bathroom or ftom hugging and kissing. 4. You'will not get HIV from donating blood at the blood bank or any official blood collecting centers. 5. Sweat, tears, vomit, feces and urine may contain a small amount of HIV virus. However, HIV cannot be transmitted through these. 6 Mosquitoes, bed bugs and other insects do not spread HIV. Can You Tell If Someone Has HIVIAIDS? ‘You wil never know if a person has HIV or AIDS just merely by looking. Infected person may seem to be healthy however, someone with HIV can spread it even when no symptoms are displayed. Manual On HIV/AIDS In Islam | 27 1P ACetetindd & eaxeon 750mHow Do | Know If | Have Been Infected With HIV? ‘Once infected, some people may have subtle signs like persistent fever, cold or swollen glands. The person may look and feel healthy but the infection has already taken place, The only way to find out your HIV status is by taking the HIV antibody test, which is a type of protein produced by the body to fight off infection. Usually, a blood sample is needed for the test. The blood of infected person might contain HIV antibody, Do! Have To Take The Test? I you think you have been exposed to the infection, you have to take the test as soon as possible. is due to the fact that: Thi 1 In the early stages, even if you take the precaution to take care of your health for the long run, if you don't take the medication immediately, a regular check-up with doctors who are experienced in HIV/AIDS treatment will help you make the best decision on how to start the treatment before you start getting il, An active approach in HIV management may help you add a few healthy years in your life. 2. If you are HIV positive, you may take the precautions to protect other people from the infection 3. If you are HIV positive and pregnant, you may take the medical treatment and precautions to reduce the risk of infecting your baby inclu How Do | Take The HIV Antibody Test? 19 to avoid nursing your baby. What is WINDOW PERIOD? Most people take the test in private clinics, labs and government hospitals. However, the most importantthingistotakethetestwhere counseling onHIV and AIDS related matter is also provided. Counselors will be able to give answer on risky activites and will make recommendations to protect yourself and other people in the future. They too can help you understand the meaning behind the result and references on AIDS around your neighborhood. There is also viral load test ‘which will show the presence of virusin the blood in three to five days after the infection: as well as the saliva test which is very accurate and very similar to the HIV antibody test. However, not all health centers provide these two tests, 28 | Manual On HIV/AIDS In Islam You have to remember that even though most blood tests can detect HIV infection within 4 ‘weeks after the infection, sometimes it might take three to six months for the antibody to develop to the point that it can be detected. This is the "Window Period’. During this time, HIV cannot be detected in the blood. This is due to the fact that the presence of the virus is needed for it to be detected inthe test, As mentioned before, window period is between three weeks to six monthsFree HIV Test In Full Confidentiality at Public Hospitals Where Can | Kuala Lumpur General Hospital + (03) 2602 1044 Malaya University Medical Center #(03) 7956 4422 Take The Tunku Puan Rahimah Hospital (Klang) 1 (03) 3372 3333 Test? Incurred) Pantai Hospital (Bangsar) Pantai Hospital (Cheras) ‘Subang Medical Center ‘Tawakal Medical Center HIV Test In Full Confidentiality at Private Hospitals (Charges Wil be :(03) 2282 5077 3(03) 9132 2022 (03) 5634 1212 2 (03) 4023 3589 You may also contact AIDS Officers at state Medical Department for further information at the nearest hospitals or clinics in your neighborhood at these lines: STATE TELEPHONE FAX 4. Johore Medical Department o7-2245188 | 07-2236203 2. Malacca Medical Department 06-2828344 | 06-2864764 3. Negeri Sembilan Medical Department 06-7625231 | 06-7638543 4, Selangor Medical Department 03-65186001 | 03-55126605 5. Perak Medical Department 05-2533499 | 05-2423137 6 Kedah Medical Department 04-7336633 | 047314936 7. Penang Medical Department 04.2625533 | 04-2613508 8 Perlis Medical Department 049773333 | 049760764 9. Kelantan Medical Department 9-7483288 | 09-7441333 10. Terengganu Medical Department 09-6222866 | 09-6236001 11, Pahang Medical Department 09-5161366 | 09-5135526 12, Sarawak Medical Department 082-716535 | 088-217740 18. Sabah Medical Department 088-716535 | 088-217740 14, Federal State Medical Department 03-26938742 | 03-26938760 15. DBKL Medical Department os-ezs45166 | 03-92857295 Manual On HIV/AIDS In Islam | 20Is HIV Related To Any Other Sexually Transmitted Disease? Do Certain People Have Higher Risk Than Others To HIV Infection? The risk of getting infected and transmitting HIV is higher if you have STD. Thisis true either you have sores or ulcer on the skin (like sypi herpes and canoroids) or not (like Chlamydia and gonorrhea). When there is a cut in your skin, HIV can come out and enter the body easily. If your skin is unbroken, STD may cause biological changes which enable HIV infection. Researcheshave shown that people who have HIV as well as other STDs are 3-5 times more likely to spread the virus through sex. Are Women More Vulnerable To HIV? HIV does not discriminate. HIV infection do not ‘occur because of who you are but rather, what ‘you did. Although estimates for Malaysia show that most cases involve drug abusers, it does not give the bigger picture of the HIV epidemic in the country. Globally, sex is the most common method of HIV transmission. There is no reliable method to determine how much HIV is spread through sex in Malaysia. Most Malaysian who have been infected were UNAWARE THAT THEY HAVE BEEN INFECTED. Does Younger Generation Have Higher Risk Of Getting HIV Infection? In the West, women are 4 times more likely to be infected with HIV through vaginal sex with infected men compared to men. This biological vulnerability is made worse by social and culture factors which tend to undermine women's ability to resist sex from a HIV positive partner or demanding them to use condoms, What Is The Treatment For HIV/AIDS? Every year, half of new HIV cases in the world are people who are younger than 25. Estimates show that by the age of 19, at least 10% of people in this country already had sex and most ofthe time, it was unprotected. A lot ofthe were also involved in drug abuse and drinking which ‘exposes them to other high risk act For quite a few years, there not been any one effective treatment for HIV/AIDS. Now, Malaysians may get drugs to treat HIV infection and AIDS. Some of these drugs are given to treat opportunistic infections other diseases suffered by HIV/AIDS viotim. Other than that, there are a number of drugs sed to restrain HIV virus from reproducing and destroying the immune system. 1 Reverse Transcriptase Inhibitors attacks the HIV enzyme called reverse transcriotase. These drugs, among them are zidovudine (AZT), lamivudine (3TC), didanosine (ddl), stavudine (d47), zaiticabine (ddC), efavirenz, nevirapine, abacavir and delavirdine 2. Protease inhibitors attacks the protease enzyme from HIV and among them are indinavir, ritonavir, saquinavir, amprenavir and nelfinavir Most HIV victims take a few of these drugs in combination which is a regime called Highly Active Antiretroviral Treatment (HAART). If successful, the combined therapy or “cooktail’ may reduce HIV ‘count in the blood to the point that it cannot be detected and may cause the CD4 immune cells to come back to normal levels. Researchers are working on creating new drugs called fusion inhibitors or entry inhibitors which prevent HIV from attaching to or infecting human immune cells. There are also efforts to revive broken immune system to fight back HIV and other diseases which attacks HIV victims. 90 Manual On HIV/AIDS In Islam 1P ACeetindd 0 & easeon 7sso7mCan HIVIAIDS Be Cured? As for now, there is no cure for HIV/AIDS. Although new drugs help some patients to live longer healthily with HIV/AIDS, there are some drawbacks to this effort 1. Current treatments are not effective to some HIV/AIDS patients. 2. Some anti-HIV drugs are highly toxic and may have serious side effects like anemia, kidney stones, liver failure and so on. 3. HIV is always going through mutation. Up to 40% patients who stick to HAART, HIV have mutated into anew virus strain which is extremely resistant to the current drugs and up to 10% of people with new infection suffer from the strain which is drug resistant. 4. Due tothe complicated and inconvenient treatment regiments, some patients did not take their medications, Failure to take anti-HIV drugs on schedule and in the fixed dose may encourage the formation of new strains of virus resistant to new HIV drugs. 5. __Even for patients who show positive development with the treatment, HAART does not eliminate HIV. The virus is replicating at a lower level and will always be hidden in their “lai” like lymph nodes and brain. More importantly, about 95% of all HIV/AIDS patients live in developing countries where antiretroviral treatment is not available. In the United States, HAART made an enormous contribution to the decline of number of death related to AIDS between 1996 and 1998. Can HIV Be Prevented Through Vaccination? Despite the continuous intensive research, experts believe we need at least another decade to develop safe, effective and cheap HIV vaccine. Even when the vaccine has been developed, we still need a few years to immunize millions of people with high risk to HIV infection. Unti the time comes, other HIV prevention methods like practicing safe sex and using sterile syringe has to be practiced Where Can | Find Further Information On HIV/AIDS? ‘There are a few important sources which provide information on HIV/AIDS: Important Numbers AIDS Council Malaysia Important Lines on Other Information and Support 24-hour Interactive Information Line on HIV/AIDS: (03)7807 7007 PT Foundation (03) 4044 5455 or (03) 4044 5466 ‘Treatment Information Line: 1 800 881 848 ‘Confidential Information on HIV/AIDS. (Monday-Friday, .30am-5.30pm) (Monday-Friday, 7.30 pm -9.30 pm) (03) 7956 8145 (Kuala Lumpur) (05) 547 7833/547 (Ipoh) (04) 281 5161/281 1108 (Penang) (06) 284 2500 (Malacca) AIDS Action Research Group (04) 656 5084 «Penang) Manual On HIV/AIDS In Islam | 34 1P ACetetiadd 2 & easeon 752mMODULE 2 FACTS AND FIGURES ON HIV/AIDS MODULE 2 ~ INTRODUCTION TO HIV/AIDS Purpose Module 2 provides basic information on statistics and the effects of HIV/AIDS both in Malaysia and international level. The main purpose is to take immediate action to control the HIV/AIDS epidemic, The reason for this action is to moderate the negative effects of HIVIAIDS as what had happened in other countries across the globe. Objective 4. To explain the situation of HIV/AIDS pandemic as well as socio-economic consequences at intemational level. 2, Toinform of the HIV/AIDS situation and to explain its effects in Malaysia. 3. Tolan and take the appropriate action to control the HIV/AIDS pandemic in Malaysia, i 1, The number of HIVIAIDS victims worldwide. Main Areas | > he number ot deat fom AIDS. 3. The number of infected people in Asia Pacific region. 4. The number of infected people in Malaysia. 5. The number of infected people according to ethnic groups in Malaysia, 6. Women and HIV/AIDS in Malaysia, 7. The number of infected people according to age groups in Malaysia. 8, HIV/AIDS socio-economic consequences. 9. Things we can do. 92 Manual On HIV/AIDS In Islam tP ACuetiadd & easenn 7ssermaae) ot ES oa CEES ‘Summary of Global HIV/AIDS Epidemic Number of people living with HIV in 2009 Total 3 33.3 million Adults 30.8 million Women 188 million Children < 15 years 2.5 million New HIV cases in 2009 Total : 26 million Adults 2.2 million Children <15 years old 370,000 ‘The number of death related to AIDS in 2009 Total ; 1.8 million Adults 4.6 milion Children < 15 years old 260,000 Graph 4 : Distribution of people living with HIV in the world in 2009 ‘108i. REPORT Adults and children estimated to be living Abe — tt Bla a ae K Total: 33.3 million [31.4 milion - 25.3 milion] (2ie- Coetitd 98 © HIV | 2009 33Global HIV trends, 1990 to 2009 Source: UNAIDS, ‘Number of people living with HIV MILLIONS Ta ee ee te Te ee eee te ot solst 2 93) 4 9596 9796" 99 00 or ors us 05! 06 uy 08 | 09 Global prevalence of HIV, 2009 Source: UNAIDS, Hodis <3% TRS MSR MTR 94 Manual On HIV/AIDS In Islam tie Acautinds 34 ® anaoont 7385794HIV prevalence in Asia HIV prevalence among adults aged 15 — 49 yearsold in Asia, 1990 to 2009, sO a No data <1% 1%-<5% 5% -<1% ME 1%-<15% M15%-25% Source: UNAIDS, HIV trends in Asia ‘Source: UNAIDS. ‘Number of people living with HIV MILLIONS 9091 92 93°94 95 96 97 989900 OT 02 OS Oh OS HE O78 09 Manual On HIV/AIDS In Istam | 35 ti Acautindd 38 ® anaoon 72002904HIV in Malaysia Since 1986 to end of December 2010, there was a cumulative number of 91,362 people with HIV infection and 14,298 AIDS related deaths; hence the number of PLHIV is 77,064, have been reported to the Ministry Of Health, Malaysia. There was a cumulative number of 16,352 AIDS cases reported during the same Period. ‘The annual number of reported new HIV cases by the Ministry Of Health has been on a steady decline ‘from a peak of 6,978 in 2002. There were 3,652 new cases reported from January to December 2010. This ‘igure is almost hatf of what was reported in 2002. The netification rate of HIV also continues to decline from 23.4 cases per 100,000 in 2005 to 12.9 cases in 2010. Currently, there are 10 new reported cases of HIV each day with the ratio of 2 females for every 8 males reported and an average of 5 persons acquired HIV through injecting drugs while the other 5 were infected sexually Graph 4 : Distribution of HIV, AIDS and AIDS — related Deaths, and Cumulative cases of HIV, Malaysia, 1986 — 2010 iz 3 iz Graph 2 below shows the number of HIV screening tests and the notification rates of HIV from year 2000 to 2010. it shows that the trend of HIV is decreasing despite of increasing number of people screened for HIV. Graph 2 : Notification rate of HIV (per 100 000 population) and Number of screening tests, Malaysia, 2000 - 2010 s= Noof HIV screening tests HIVNotffeation Rates "No.of screening test "2000 2001 2002 2008 2004 2005 2096 2007 2008 2009 2mn0 Year ‘br Kaman aan a 2010 98 | Manual On HIV/AIDS In Islam iP ACeetindd & easeon 7ssormItwas noted that Johor had notified the most number of HIV cases, followed by the states of Selangor and Kelantan in the period of 1986 to end of December 2010 as shown in Graph 3 below. Graph 3 : Distribution of eases by gender and state, Malaysia, 1986 ~ 2010 Sabah Pale lumen Women seca Melaka Penang Kedah Perk i “s we Topnu Pahang Kelantan Selangor Johor 0 2000 + 4000.» 600-000-0000 1200014000 16000 Number of Cases. ‘Sumber: KerenteranKesihatan Malaysia, 2010 The above graph also shows that there were nearly 80% of all notified HIV cases were men however, the annual percentage of women with HIV is increasing steadily (Graph 4), Graph 4 : Percentage of HIV Cases by gender, Malaysia, 1986 - 2010 100 90 80 7 E gz 50 3 #0 30 2 10 ° PELLE LLLP ILLIL EEL ELLE LS ean i Scremaie li %maie ‘Sumber: Kementerian Kesihatan Malaysia, 2010, Manual On HIV/AIDS In Istam | 37 (iP ACetetindé 7 & easem 7ssiomGraph 5 : Distribution of percentage HIV Cases by Malaysia, 1986 - 200 k Factors, | Unknown 1m Vertical (m Heterosexual IH Injecting Drug User ml Homo/Bisexual 100.00 900 700 600 400 300 100 00 FEFIIIEEFI ESE E PE LES ‘Sumber: Kementerian Ketfhatan Malaya, 2010, ‘The main tisk factor for the transmission of HIV in Malaysia is sharing of injecting drugs equipments (ranging from 65-80% of all notified cases per year), however, the sexual mode of transmission especially the heterosxual mode is relatively increasing each year. About 48.5% ofall notified cases in 2010 were noted to be contracted the disease through sexual mode. Graph 6 : Distribution of HIV cases by Age groups, Malaysia, 1986 — 2010 (sada Maklumat sm SOtahun ke atas 540-49 abun 130-39 tahun §20-29tahun 13-19 tahun ‘urang der 13 tahun 988 987 988 999 990 991 982 998 994 995 996 997 998 999 000 001 002 008 008 005 006 007 008 009 2010 Super: Keren Keshztan Maly, 2010 ‘The above chart (Graph 6) shows that the main age group linked to the HIV cases is 30-39 yers followed by the 20 ~ 29 years of age. 38 | Manual On HIV/AIDS In Islam 1P ACeetindd & easeon essereWoman and HIV, Malaysia 1986-2010 The first woman with HIV was notified in 1988. Since then the percentage of HIV cases among ‘women has been steadily increasing fom less than 2% in 1988 to 18.3% in 2010, as shown in Graph 7 below. The cumulative number of HIV among women (all age groups) was 8,759 (9.6% of all Notified HIV cases in Malaysia from 1968 - 2010) and 1,871 cases of women with AIDS and 1,201 of these cases has died of AlDS-+related diseases during the same period Graph 7 : Percentage of woman with HIV (all age groups) Malaysia, 1988-2010 250 Women (all age groups) HIV. ——Women fall age groups) AIDS 150 100 50 PERCENTAGE OF TOTAL CASES: 1989 950 199" 1952 1993 1994 1995 1956 1997 1959 199° 2009 2001 aoq7 2003 299¢ 20052906, 20072999, 200° m9 ‘Sumber: Kementerian Kesinatan Malaysia, 2010 Facts on Women with HIV + tis noted that the main mode of transmission of HIV among women cases were heterosexual and only about 20% were due to sharing of injecting drug equipments. + Majority of women with HIV are housewives. + The rate of HIV infection among antenatal mothers remains low between 0.04 — 0.06% annually (as shown in Graph 8 below). Manual On HIV/AIDS In Islam | 30 1p ACeetindd © & eaxeo 7suoomGraph 8 : Antenatal HIV Screening, Malaysia, 1998-2010 an 2o0s00 }@) No.of Antenatal mothers § 3 & Pareontage postive 100,000 ot o oo SS cent | oer | zam| mee | sen | ara sre| so smacz| soar | save) swe | enae| aim ve | vex | xm | see | see | ors | srooe | soma | seer | arr | sexe) sce | om sis —rxoatt | oom | oom | ome | coz | oom | vow | om | om | coe | oc | eos | cos | ousr ‘Sumber: Kementeran KasIatan Malayst,2010 © tumber oF tv positive mothers Antenatal coverage 2010 = 99.6% © Number of Hiv positive babies 40 Manual. On HIVIAIDS In Islam 1P ACeetindd 0 & easem 7suoemaMODULE 3 PREVENTION MODULE 3 ~ PREVENTION Purpose This module is aimed at giving accurate information to the participants on HIV preventive measures and activities for them to apply the given information to solve problems according 40 the realities of the society. This module also contains information on changing behaviors including the Istamic approach and introducing the basics of behavioral changing, are alo PREVENTION - HOW AND WHY Objective 1, Toexplain the need to prevent HIV infection 2. Toexplain the methods to prevent HIV infection 1. Why HIV infection has to be prevented. i 2. Methods of prevention. Main Areas | 3 iiniomation people need to know to protect themselves from HIV infection, 4, Crucial information for HIV positive people to prevent transmitting HIV to other people. 5, Universal precautions necessary due to exposure to bodily fluids, & easeo rasaWhy HIV Infection Has To Be Prevented? HIV can be prevented. HIV has no vaccine or cure. Most people with HIV cannot afford the cost of antiretroviral drugs. 30-40% of people with HIV in Malaysia are within the age of 13-29. This fact may bring heavy socio-economic implications. + Prevention may control the spread of HIV/AIDS from victims to other people. What Are The Preventive Measures? 1 Isfigamah as a Muslim in the daily life. Allah SWT commanded in Surah al-Fussilat Verse 30 VBS Sen teil oe Kes pce anc Pe colt Oia uk § ‘ucts bess Meaning: 30. Those who confirmed their faith say? Our Lord is Allah? And then they stand straight and steadiiast on the straight way, the angels will descend on them from time to time (to give inspiration)? Let nothing alarm or grieve you. Rejoice in the Paradise which you have been promised. 2. Never committo wrongful sexual acts like adultery, sodomy and lesbianism. The best ‘way to protect yourself from sexually transmitted diseases like HIV is by avoiding adultery and sin Allah SWT commanded in Surah al-Isra’ Verse 32 CP cscs ees ccs Meaning 32. And nor draw near to adultery, for it is a shameful deed and an evil way (leading to destruction). 42] Manual On HIVIAIDS In Islam 1P ACeetiadd @ & easem 7ssoemaAllah SWT commanded in Surah al-Mukminun Verse 1-11 reg SZ Ba sist pelea hal gaeTiils ENS 60 ppd AO ahs a 4 HO I BAS I HO Coat Hb pA REO S pnt Fels SB GD GAS pasts cyst GAG ase (4 Ost es HLA OEIAII O44 Meaning 1, Successful indeed are the believers. 2. Thats, those who are humble in their prayers. 3 And who avoid futile deeds and vain talk. 4. And those who strive to keep their possessions pure (by paying the alms-fax on them). 5. And those who guard their chastity. 6. Except with their wives or the slaves that their right hands possess(1059), for then they ave free from all blame: 7. But those whose desires go beyond these are transgressors; 8. And thase who are true fo their trusts and pledges; 9. And thase who strictly guard their prayers; 10. They are the heirs- 11. Who will inherit Paradise; they shall abide in it forever. 3. The use of condoms (al-a’zil). + Only for legitimate couples. + Condom is classified as a medical tool which provides physical barrier during sexual intercourse by preventing the contact with fluids like semen and vaginal secretion. + Condoms are usually used to prevent inherited sexually transmitted diseases like hepatitis + Researches have shown that condom use is only 80% effective against HIV and it is nota solution but a proven way to slow down the spread of HIV infection. 4. Never share needles and syringe. * Drug abuse is forbidden in Isiam. It may cause HIV infection when combined with sharing needles. + Needles, syringe or any other tools which can be used to inject or puncture the skin cannot be shared with other people. Manual On HIV/AIDS In Islam | 43 1P ACeetiadd 0 & eaxem 7sssomNecessary Information For People To Protect Themselves From HIV Infection : Get counseling and HIV antibody test if you have been involved in risky sexual behavior. : Protect your spouse from semen or vaginal secretion or blood during intercourse byusing condoms if you have been involved in such risky behavior, : Do not commit to adultery if you are not married. : For women, get counseling and HIV antibody test before conceiving. : For drug abusers, never share needles. Seek professional help for treatment and rehab. Necessary Information For People With HIV To Prevent Transmission To Other People : Get continuous counseling for accurate information. . Protect your spouse from semen, vaginal secretion or blood during intercourse by using condoms, : Inform your spouse about your HIV status and encourage them to get counseling and voluntary testing, . For drug abusers, never share needles and seek professional help for treatment and rehab. : Never share shaving blade, toothbrush and other personal belongings. : Clean any bodily iquid with bleach : For women, avoid getting pregnant. : Ifyou are pregnant, get counseling to reduce the risk of transmitting the disease to the baby. : Never donate blood or organs. Universal Precautions Needed Due To Exposure To Bodily Liquid : ‘These steps are common for anyone regardless of HIV status. : Clean your hands immediately if you came in contact with blood or liquids. : Cover all sores and cuts before touching blood or secretion from other people : Put on rubber gloves which can be disposed right after use. : Clean the surfaces exposed to the secretion like tables, ficor and toilet with bleach. Recommended Activities For Workshop Explain the information provided in the next page and distribute to participants, ‘Ask the participants if they have any question regarding the information. Break the participants into five groups. Provide the problems in the following pages to the participants and ask each group to discuss one problem and suggest a solution. Inform the participants that the answer needed to solve the problem has been provided in the hand-outs given to them. Also, inform them that all the problems were taken from realiife stories in the community 6. Ask each group to present their answer to everyone, 7. Discuss each response with other participants. Refer to answers given in the following pages so that all relevant issues have been brought up. Peps o 44] Manual On HIVIAIDS In Islam (GP ACutetindd ut & easeon passaProblem Solving 1, lama30 year-old wife. | have never had sexual relationship with anyone but my husband However, my husband has been cheating on me and | know for a fact that he has been intimate relationship with another woman. My husband may have a relationship outside the marriage but he has never used condoms. My husband sfill insists on having sex but each time | asked him to use a condom, he got upset and said that | was a sinner for refusing a husband's advances and that gave him the right to cheat on me. What can | do to protect myself from sexually transmitted diseases like HIV? 2. am a 50 year old man. | was a drug abuser. | have quit and repented. By the will of God, | have now a steady job and live a comfortable life with my family. | am thankful that | didn't get HIV infection when | was using drugs because | never used needles. However, | was never around to take care of my family and my teenage Kid is now an addict. | begged him to stop taking drugs and | have tried everything to lead him to the right way but he is too high and won't stop his addiction. What can | do to protect my child from HIV? 3. 1am 21 years old and | am a student. | have a boyfriend on campus and we have been together for 2 years, Last month, my boyfriend proposed and | agreed to marry him. We have set the date next year right after our graduation. We never had sex before but lately, he has been begging me to do it and said that it would not be a sin because we would be getting married anyway. | love him so much and | want to make him happy as the future wife. So, l agreed and we had sex a few times, However, what's been troubling me is a rumor that my boyfriend's ex who is also a student here has been infected with HIV. | tried to stop from having sex with him, it feels so hard to quit. What can | do to protect myself from HIV? 4. 1am working at a school and my son is student there. A mother to my student told me her child is HIV positive but she didn't want me to tell the Principal for the fear of discrimination against her child. However, | know that her son sometimes plays together with my son in the school playground and | fear that my son will get infected. How do | protect my son without exposing the status of my student? 5, lam a25 year old prostitute. | am the eldest of 7 siblings in my family and we come from a fishing community. My father is a fisherman but he is also a drug addict, My mom has been selling Malay cakes to support us. | quit school at 16 as my family couldn't afford to support my siblings’ school expenses and | went to Kuala Lumpur to work. | don't have a lotof qualficaton and therefore, my income is too low to help my mom make ends meet. We are desperate, so | chose to be a prostitute and | have been one for the past 10 years. Although | feel empty and | know | have been committing sin, | would do anything for the needs of my family. Now, ali my younger brothers and sisters are in school and | have been saving to send my mom to Mecca for her haij next year. My mom never knew Ihave been working as a prostitute. | am going to quit next year as soon as | have saved RM50,000. | have heard of HIV and | took the test but I have not been infected. What can | do to protect myself? Manual On HIV/AIDS In Islam | 45 1P ACeetindd & & easeon pausePROBLEM-SOLVING GUIDES Problem 1 Problem 2 1. Adultery by husband is a big sin and he has torepent and quit the habit. 2. High-risk behavior by the husband- counseling and voluntary HIV antibody test to determine his HIV status. 3. Counseling from an Islamic bodyfinstitution to stop adultery 4, Discussion between husband and wife on the use of condom during intercourse. 5. The wife's rights to refuse sex, 6. HIV infection risks to children. Problem 3 4. Advice on not to share needles when using 2. Provide new and clean needles and syringe. 3. ial help for treatment and 4, High risk behavior-counseling and voluntary HIV antibody test to determine status. 5. Counseling from Islamic body/institution to alter the behavior, 6. Contact relevant NGOs for further Information. 7. Seek for support groups, 8. Parents should give moral and emotional support to encourage effective behavioral change. 9. Discuss the implications to the child ifparents ignore them or do not seek help. Problem 4 1. Adultery by both peopleritis a sin and need to repent immediately. 2. High-risk behavior by both people- counseling and voluntary HIV antibody test to determine HIV status, 3. Counseling from Islamic bodyfnstitution to encourage the stop to adultery. 1. Contact relevant NGOs for further information. 2. Ask for the NGO to make presentation at the school on HIV so that everybody has the accurate information on how the disease is spread and the universal precautions. 3. Encourage the PTA to organize a HIV awareness program and related issues like stigma and disorimination. Problem & 1. Suggest for an alternative source of income. 2. The role of Baitulmal to give financial suppart to the family. 3. Islamic counseling to quit the job as a prostitute. 4 High-risk behavior-counseling and voluntary HIV antibody test required as well as the need to change behavior. 46 Manual. On HIVIAIDS In Islamel dere Wo aol el =) Objective 1. Toexplain the basics of behavioral change. 2 Toexplain behavioral change in the examples of Rasulullan SAW. ¥: 1, To explain that behavioral change is due to a number of Main Areas |" jStoe s 2, To know that the wrong impression on behavioral change has to be corrected. 3, To know the steps in behavioral change. What Influences Behavioral Change? + Behavioral change is influenced by many factors. + Humans are sensitive to changes in the environment, needs and stimulation. + Factors which influence behavioral change depend a lot on the environment and not just by the will of people alone. + Everyone has environmental factors which influence their behavior as follows: RELIGION - ECONOMY « SOCIAL » CULTURE « LAW + POLITIC Goneral Perception On Behavioral Change Programs which encourage behavioral change are often developed based on the belief that human responds rationally to the information given to them like the following PEOPLE WHO APPLY UNHEALTHY OR RISKY WAY OF LIFE. PROGRAM INTRODUCES NEW BEHAVIOR TO THEM. THE PEOPLE MOVE ON TO AHEALTHIER AND SAFER WAY OF LIFE. & easeon 7sronmMain Problems With General Perceptions Are: 1 It assumes thet behavioral change only happens once but in reality, humans don't change just once. They change constantly in every direction as a reaction to every factor that influences them. 2. It assumes that people are always willing to change but people are not always ready to change at the right time for the change to take place. 3. _ It assumes cther people are best suited to determine the decision and the changes needed instead of the persons concemed. An effective change has to start from the individual and supported by other people and not vice versa. 4 It assumes that people will not return to the previous behavior. Humans have many flaws and changing them isnot a quick and easy fix. 5. lt assumes that people are able to continue to move on with the new behavior for the long run but people generally loathe changes and changes cannot take place within a short time. STEPS IN BEHAVIORAL CHANGE AWARENESS EMOTIONAL NEEDS REFLECTION ONISSUES ‘SEEKING FOR ALTERNATIVES CHOOSING TO ACT MAKING COMMITMENT TO CHANGE GETTING THE SUPPORT TO CHANGE TRUSTING OTHER PEOPLE SELF CONTROL DEVELOPING SELF CONFIDENCE LOOKING AT MORE ALTERNATIVES HIVIAIDS In Istam 1PACeetindd & eaxeon osrormaAci ity No 1 Recommended For Workshop “for TOT, not at the mosque 4. Distribute hand-outs with information on behavioral change on the following pages. 2. Explain the basics of behavioral change. 3. White down the statement “Behavioral Change Cannot Happen In @ Short Time” on. the blackboard or chart. 4, Break the participants into smaller groups. 5. Ask them to discuss if they agree or not with the statement and provide point of view. 6. Ask each group to present their opinion and discuss it with everyone ity No 2 Recommended For Workshop 1, Break the participants into smaller groups. 2. Distribute hanc-outs with Discussion Questions on the following page. 3. Ask each group to answer and discuss the questions in 20 minutes. Ask them to pick 5 main characteristics which represent the character and moral of Rasulullah SAW which encourage behavioral change in people, according to their answer and discussion 4, Ask the groups to present their answer and § main characteristics and why they picked them 5, After the presentation, try to identify if there are any similarities in the characteristics mentioned by the groups and write them down on the blackboard 6. _A\so, suggest these characters: LOVING + PATIENCE + KINDNESS * MODESTY + CARING 7. Ask if the participants agree the reason Rasulullah SAW was successful in changing the behavior of thousands of people because he led with character which represents all the good qualities he wanted to show to his ummah, 8 Ask the participants if they also agree that the people of Rasulullan SAW managed to change their behavior because they loved and admired him and Allah SWT and ‘hat this love had been the main drive for them to change. 9. Distribute the hand-out on page 164 which contains notes on lessons to be leamed from Rasulullah SAW. Manual On HIV/AIDS In Islam | 49 1PACetatindd © & eaxeon osname