20.4 per cent in 2015.234 Previously, intravenous drug users were most at risk of contracting HIV, but sexual transmission is currently responsible for almost 80 per cent of new infections. Among young people who bear disproportionate burdens of HIV, those most at risk include MSM (men who have sex with men), transgender youth, young people who inject drugs and young sex workers. Since 1990, the profile of the HIV epidemic in Malaysia has progressively shifted, with the proportion of female/male infection increasing from 1:99 in 1990 to 1:4 in 2013.235 In 2014, 0.08 per cent of young women aged 15-24 were living with HIV.236 There is also likely a link between the lack of knowledge of and access to SRH information and services and child marriage (discussed in section 5 above) and teen pregnancy. Whilst the adolescent fertility rate in Malaysia is comparatively low for South-East Asia, there has been a steady increase since 2008.237 Childbearing at a young age leads to school dropout and low employment opportunities and is also connected to reproductive health issues. According to data from the National Registration Department, out of the approximately 532,158 children born to unmarried parents between 2010 and 2015, making these children vulnerable to being unregistered; 16,270 were born to teenage mothers.238 In addition to providing adolescents with knowledge in relation to reproductive health, comprehensive sexuality education provides information on safe sex, issues of consent, respect for others’ choices and also how to identify signs of sexual abuse. In respect of the last point, a poll conducted in 2017 found that almost 50 per cent of adolescents believed that teenagers were being pressured to have sex, a further 38 per cent responding that teenagers were ‘maybe’ pressured into having sex.239 The poll found a variety
of concerns raised by respondents including sexual abuse/rape (including by a family member), grooming and threats/requests for sexually explicit photographs. A vast majority (95 per cent) responded that there was a need for education to protect against sexual abuse. Some efforts have been made to improve SRH education and services, and the Government has expressed commitment to improving SRH education in schools.240 For example, in 2009, a National Adolescent Health Plan of Action (20062020), a National Policy on Reproductive Health and Social Education and an associated Action Plan were introduced. SRH was integrated into the National Service Training Curriculum in 2011 as well as into schools (the PEKERTI programme aimed at 12-15-yearolds), and by 2016, more than 300,00 teenagers had received training on SRH. Further, there are currently 17 youth-friendly centres, known as kafe@TEEN, which have provided access to SRH information and services to over 1.2 million youths.241
6.3 Mental health According to the NHMS, rates of depression and anxiety among adolescents increased between 2012 and 2017. The prevalence of depression among Malaysian adolescents aged 13-17 was around 20 per cent in 2017.242 The state of Selangor reported the highest rate at 22.6 per cent, and depression was slightly more prevalent among males than females (18.9 per cent compared to 17.7 per cent) and more prevalent among those of Indian ethnicity at 33.1 per cent.243 Around 40 per cent of adolescents suffered from anxiety, with higher rates among girls than boys (42.3 per cent compared to 37.1 per cent). Those of Indian ethnicity and Bumiputera Sabah ethnicity reported the highest rates at 47 per cent, and anxiety was more prevalent in Sabah than other states. Stress affected around 10 per cent
234 Tey, Nai P. ‘The State of the Youth in Malaysia’, Population Statistics Malaysia 2018, Population Studies Unit (PSU), 2019, p. 130-131. 235 Ibid. 236 Asadullah, M. Niaz, ‘The Changing Status of Women in Malaysian Society‘, Population Statistics Malaysia 2018, Population Studies Unit (PSU), 2019, p. 109. 237 See the main Situation Analysis of Women and Children in Malaysia. 238 See Ruxyn, T., ‘More than 530,000 innocent children are labelled as ‘illegitimate’ in Malaysia’, Says, 11 November 2016: https://says. com/my/news/more-than-530-000-illegitimate-children-registered-with-jpn 239 UNICEF, ‘Teen Relationships: Adolescents’ Poll 2017. 240 See ‘MOE urges schools not to take sex education lightly’, Malay Mail, 22 February 2019: https://www.malaymail.com/news/ malaysia/2019/02/22/moe-urges-schools-not-to-take-sex-education-lightly/1725789 241 Tey, Nai P. ‘The State of the Youth in Malaysia’, Population Statistics Malaysia 2018, Population Studies Unit (PSU), 2019, p. 145. 242 Based on DASS (Depression and Anxiety Stress Scale)-21 Scoring. 243 Institute for Public Health, Ministry of Health, National Health and Morbidity Survey (NHMS) 2017: Key Findings from the Adolescent Health and Nutrition Surveys – Infographic Booklet, April 2018, p. 22.
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