Recently, there has been a rise of conservative sentiment with regard to a preventive medicine against HIV transmission: pre-exposure prophylaxis (PrEP). Dr Rafidah Hanim Mokhtar, a lecturer of the Faculty of Medicine & Health Science at Universiti Sains Islam Malaysia (USIM), has been dangerously advocating for the prohibition of providing PrEP to the gay community at unprecedented levels from talking on Facebook Live via the account of a mainstream news outlet, Sinar Harian, on the 16th of September 2022 to making public statements on the topic. The Malaysian Aids Council (MAC), along with a few other organisations, Malaysian Aids Foundation (MAF) & Malaysian Society for HIV Medicine (MASHM) have since then come together issued a joint statement refuting Rafidah’s points. Still, by then, the damage had been done. We now observe a growing right-wing ideology impacting not only the minds of conservatives but even Jabatan Mufti Negeri Selangor (JMNS), which openly declared that providing homosexual couples PrEP is prohibited.
Dr Rafidah’s actions have continually endangered the LGBTQIA+ community, but the most recent message that she perpetuates is dehumanising. Her act of actively discriminating against the community spreads dehumanising ideas devoid of a scientific basis. She even practises dishonesty in her narrative, claiming that the Ministry of Health (MoH) should not provide PrEP but instead focus on promoting abstinence as if they have not always been doing so. In the infamous Sinar Harian panel , Dr Anita Suleiman, Head Sector (HIV/STI/Hepatitis C) at MOH often clarified that abstinence has always been the main message of the campaign by MoH. The utilisation of PrEP is only a safety net because human behaviour cannot instantaneously change. She asserts that through the provision of PrEP by MoH, there would be more opportunities for them to be in continuous dialogue with the receivers to medicate their sex addiction. Thus, the promotion of abstinence should not come at the preventable cost of HIV spreading among people. Pemuda Sosialis would also like to clarify that we only consider sex addiction an illness to be medicated. Homosexuality and other forms of sexuality are not conditions that require correction and, thus, should be affirmed by medical practitioners. As per the Hippocratic oath, they have an ethical responsibility to not discriminate between their patients, even if their personal beliefs deny the humanity of a specific group of people.
On the prohibition provided by JMNS, Pemuda Sosialis believes that it should be disregarded for several reasons. Firstly, despite coming from an institution responsible for providing rigorous responses to questions about religion, there is a sore lack of exhaustive research on their part. A proper fatwa would encompass citations from the rich tradition of Islamic jurisprudence and consider the input of professionals from relevant fields to arrive at a fair and informed conclusion. However, the one-paragraph answer provided by JMNS makes no reference to any Islamic scholarship, nor does it even attempt to, at the very least, give a Quranic verse to support the prohibition. Secondly, the prohibition is neither coded into the Federal Constitution nor the Shari’ah Law of Malaysia. Therefore, the fatwa has no legal power to forbid the provision of PrEP to any individual or community. Thirdly, the simplistic approach of the fatwa is dehumanising as it fails to consider the harm it perpetuates. Within the framework of the Shari’ah, there are a number of maxims which revolve around the elimination of harm (darar) which threatens the safety of the five essential values (al-daruriyyat al-khamsah), namely faith, life, intellect, property, and lineage (Esack et al., 2009). A ruling which poses and promotes harm to a people is therefore un-Islamic and antithetical to the spirit of the Shari’ah.
Although there seems to be a lack of Islamic scholarship on PrEP, one can refer to the permissibility of condoms, an older preventive measure, within the Shari’ah. The use of condoms to prevent HIV can be accepted by choosing the lesser of two evils (ikhtiyar akhaff al-dararain). As Malik Badri wrote, “…we could make the use of a condom obligatory for a fornicating Muslim who might expect HIV infection from his promiscuous practice. Fornication is a major evil but endangering another person is definitely a much greater evil.” (Esack et al., 2009) This opinion should be applied to the use of PrEP as it is pragmatic and compatible with human behaviour when dealing with an infectious medical condition. Besides that, Badri emphasises that a Muslim is expected to exercise compassion. “Islam very clearly preaches mercy, brotherly love, sympathy, and an optimistic attitude. Visiting sick people, praying for them, and raising their morale and hopes for improvement is one of the deeds very highly recommended by Islam in the blessed hadith and practices of the Prophet Muhammad (peace be upon him).” (Esack et al., 2009) Thus, any form of stigmatisation against the LGBTQIA+ community and People Living with HIV (PLHIV) should be condemned by Muslims. Dr Rafidah’s promotion of such stigma in her attempt to deny healthcare to LGBTQIA+ people contradicts an Islamic approach to HIV prevention.
In conclusion, Pemuda Sosialis strongly condemns the efforts of bigots like Dr Rafidah in enforcing a barrier within healthcare for LGBTQIA+ people. We should not tolerate any blatant act of dehumanisation and discrimination. LGBTQIA+ people are humans like anyone else in this country and deserve to be treated as such. Everyone has the right to health, and any form of deprivation of the right violates human rights.
Ayman Hareez Bin Muhammad Adib & Audrey Chan
Biro Gender dan Seksualiti
Pemuda Sosialis
07 February 2023
References
Badri, M. (2009). The AIDS Crisis: an Islamic Perspective. In F. Esack & S. Chiddy (Eds.), Islam and AIDS: Between scorn, pity and justice (pp. 28–42). essay, Oneworld.
Kamali, M. H. (2009). The Shari’ah and AIDS: Towards a Theology of Compassion. In F. Esack & S. Chiddy (Eds.), Islam and AIDS: Between scorn, pity and justice (pp. 76–87). essay, Oneworld.