PrEP is not a 'licence to abandon condoms,' experts caution amid surge in use

SHAH ALAM – Addressing public concerns that pre-exposure prophylaxis (PrEP) may lead to riskier behaviour, Malaysian AIDS Council (MAC) executive director Jasmin Jalil stressed that PrEP is not a licence to abandon condoms or engage in unsafe sex.

“PrEP is one layer of protection. It does not replace condoms and it does not protect against syphilis, gonorrhoea, HPV or pregnancy. From a cultural and Islamic perspective, PrEP is a medical intervention intended to protect life, not encourage risky behaviour," he said.

This caution comes as new Health Ministry figures reveal a significant surge in uptake, with over 9,000 Malaysians now using the HIV prevention medication, a growth credited to the coordinated national strategy involving government clinics, non-governmental organisations (NGOs) and trained community navigators.

Jasmin said the expansion was intentional and reflects a clear national commitment to reducing new HIV infections.

"The growth in PrEP use is not accidental. It is part of a deliberate strategy led by the Health Ministry, supported by MAC and the Malaysian AIDS Foundation, implemented together with community networks,” he said.

PrEP, he said, was now available at a growing number of government clinics under the Differentiated HIV Services for Key Populations model, which relies on community engagement to bring PrEP directly to people who need it.

"This model ensures that anyone at risk can be linked to PrEP quickly. It’s a system built on trust, support and continuity of care,” he added.

However, the rapid surge was still facing caution due to persistent misconceptions and cost barriers.

Former Health Ministry Director of Disease Control and Harm Reduction Action Network (HaRAN) founder Dr Anita Suleiman said PrEP usage was rising in urban centres but Malaysia has yet reached the coverage levels needed to substantially reduce HIV transmission nationwide.

“Usage is increasing especially in urban areas. More clinics now offer PrEP but affordability remains an issue.

“Government clinics subsidise it but capacity is still limited. Private-sector prices can be too high for students and low-income groups.

“Making PrEP cheaper and easier to access at scale would protect more people," she said.

Dr Anita added that Malaysia has so far avoided a trend seen in some other countries, where people on PrEP abandon condoms entirely.

"In some countries, PrEP users developed a false sense of security and stopped using condoms completely. But this hasn’t been the trend in Malaysia.

"Our PrEP programme consistently reinforces the importance of condom use and we’ve actually seen higher condom uptake in the first six months among people on PrEP," she said.

Dr Anita noted that public understanding remains a challenge, as many Malaysians still misunderstand PrEP's protective scope.

"PrEP prevents HIV only. It doesn’t stop other Sexually Transmitted Infections or unwanted pregnancy. Regular testing and condom use should continue," she added.