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Sexuality education in Malaysia: perceived issues and barriers by professionals

Khalaf ZF, Low WY, Merghati-Khoei E, Ghorbani B

Asia Pac J Public Health, 2014 Jul;26(4):358-66.
PMID: 24489084 DOI: 10.1177/1010539513517258

This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia.

Matched MeSH terms: Sex Education/organization & administration*
Gender as a moderator of the relation among social support functions and life satisfaction in older Malaysians

Kooshair H, Yahaya N, Hamid TA, Abu Samah A

J Women Aging, 2014;26(1):22-38.
PMID: 24483281 DOI: 10.1080/08952841.2014.858550

The aim of this study was to examine the moderating role of gender on relations among social support functions and life satisfaction in older Malaysians. The study sample was 1,800 older residents in a community; all were at least 60 years old. This study was a cross-sectional and corelational survey, and the data were collected by multistage stratified sampling. This study revealed that fewer social support functions, and therefore less life satisfaction, were available for females than for males. The results of moderated regression analyses demonstrated that gender interacted only on the relationship between positive social interaction support and tangible support with life satisfaction. Specifically, at a high tangible support level, females had lower life satisfaction when compared to a low tangible support level. There may be a need for new programs and services to provide other aspects of social support to older female adults to improve and maintain life satisfaction in later life.

Matched MeSH terms: Sex Factors*
Timeframes of speciation, reticulation, and hybridization in the bulldog bat explained through phylogenetic analyses of all genetic transmission elements

Khan FA, Phillips CD, Baker RJ

Syst Biol, 2014 Jan 1;63(1):96-110.
PMID: 24149076 DOI: 10.1093/sysbio/syt062

Phylogenetic comparisons of the different mammalian genetic transmission elements (mtDNA, X-, Y-, and autosomal DNA) is a powerful approach for understanding the process of speciation in nature. Through such comparisons the unique inheritance pathways of each genetic element and gender-biased processes can link genomic structure to the evolutionary process, especially among lineages which have recently diversified, in which genetic isolation may be incomplete. Bulldog bats of the genus Noctilio are an exemplar lineage, being a young clade, widely distributed, and exhibiting unique feeding ecologies. In addition, currently recognized species are paraphyletic with respect to the mtDNA gene tree and contain morphologically identifiable clades that exhibit mtDNA divergences as great as among many species. To test taxonomic hypotheses and understand the contribution of hybridization to the extant distribution of genetic diversity in Noctilio, we used phylogenetic, coalescent stochastic modeling, and divergence time estimates using sequence data from cytochrome-b, cytochrome c oxidase-I, zinc finger Y, and zinc finger X, as well as evolutionary reconstructions based on amplified fragment length polymorphisms (AFLPs) data. No evidence of ongoing hybridization between the two currently recognized species was identified. However, signatures of an ancient mtDNA capture were recovered in which an mtDNA lineage of one species was captured early in the noctilionid radiation. Among subspecific mtDNA clades, which were generally coincident with morphology and statistically definable as species, signatures of ongoing hybridization were observed in sex chromosome sequences and AFLP. Divergence dating of genetic elements corroborates the diversification of extant Noctilio beginning about 3 Ma, with ongoing hybridization between mitochondrial lineages separated by 2.5 myr. The timeframe of species' divergence within Noctilio supports the hypothesis that shifts in the dietary strategies of gleaning insects (N. albiventris) or fish (N. leporinus) are among the most rapid instances of dietary evolution observed in mammals. This study illustrates the complex evolutionary dynamics shaping gene pools in nature, how comparisons of genetic elements can serve for understanding species boundaries, and the complex considerations for accurate taxonomic assignment.

Matched MeSH terms: Sex Chromosomes/genetics
Odontometric sex variation in Malaysians with application to sex prediction

Khamis MF, Taylor JA, Malik SN, Townsend GC

Forensic Sci Int, 2014 Jan;234:183.e1-7.
PMID: 24128748 DOI: 10.1016/j.forsciint.2013.09.019

Information about the sex of individuals is important for human identification. This study was conducted to quantify classification rates of sex prediction models for Malaysians using odontometric profiles. Mesiodistal (MD) and buccolingual (BL) crown dimensions of the permanent dentition were studied in 400 young adult Malaysians, giving a total of 28 tooth size variables. The sample consisted of three major ethnic groups, the Malays, Chinese and Tamils, since the aim was to assess sex dimorphism in Malaysians as a whole. Results showed that the mesiodistal diameter of the lower canine was the most sexually dimorphic dimension in Malaysian Malays and Tamils. Univariate analyses showed that the magnitude and pattern of sex dimorphism varies between these three ethnic groups, with Malaysian Chinese and Tamils being more dimorphic than the Malaysian Malays. Stepwise discriminant functions were generated bearing in mind their application in practical forensic situations. The range of classification rates was from 70.2% to 78.5% for the composite Malaysian group, and 83.8%, 77.9%, 72.4% for Malaysian Chinese, Malays and Tamils, respectively. The 'Area Under the Receiver Operating Characteristic Curve statistics' indicated good classification rates for three prediction models obtained using a combination of all tooth size variables, mandibular teeth, and mesiodistal dimensions in the composite Malaysian group, and for all tooth size variables in each ethnic group. The present study provides strong support for the value of odontometry as an adjunct scientific method for sex prediction in human identification.

Matched MeSH terms: Sex Characteristics*
Total testosterone and sex hormone-binding globulin are significantly associated with metabolic syndrome in middle-aged and elderly men

Chin KY, Ima-Nirwana S, Mohamed IN, Aminuddin A, Ngah WZ

Exp. Clin. Endocrinol. Diabetes, 2013 Jul;121(7):407-12.
PMID: 23765753 DOI: 10.1055/s-0033-1345164

Testosterone and sex hormone-binding globulin (SHBG) have been shown to be associated with metabolic syndrome (MS) in men. This study aimed at validating these relationships in a group of middle-aged and elderly men and assessing their strength of association to MS. A cross-sectional study of 332 Malaysian men aged 40 years and above was conducted. The blood of subject was collected under fasting condition for determination of testosterone, SHBG, glucose and lipid levels. Their medical history, smoking and alcohol consumption status, waist circumference (WC), body mass index (BMI) and blood pressure (BP) were recorded. All testosterone and SHBG levels were significantly reduced in MS subjects compared to non-MS subjects (p<0.05). Testosterone and SHBG were correlated significantly with most of the MS indicators without adjustments. In multiple regression analysis, the triglyceride level was the only MS indicator that was significantly, inversely and independently associated with all testosterone measurements and SHBG (p<0.05). Waist circumference was significantly and negatively associated with SHBG level (p<0.05) though not independent of BMI. Total testosterone and SHBG were significantly and inversely associated with the presence of MS. Testosterone and SHBG are potential intervention targets for the prevention of MS in men.

Matched MeSH terms: Sex Hormone-Binding Globulin/metabolism*
Islam, sexuality, and the marginal positioning of Pengkids and their girlfriends in Malaysia

Wong Y

J Lesbian Stud, 2012;16(4):435-48.
PMID: 22978284 DOI: 10.1080/10894160.2012.681267

Drawing on the lived experiences of the Pengkids and their girlfriends in the deprived district of the capital city of Malaysia, Kuala Lumpur, this article examines transgender practices and women's same-sex desires within the local contexts of urbanization and political Islam. This article questions the assumed marginal positions of transgender practices and same-sex desires in society, and provides a nuanced understanding of the politics of identity, gender, sexuality and religion involved in a Muslim country. While the Muslim-Malay sexual minorities are increasingly subjected to the threats of moral policing in Malaysia, Pengkid has become a new identity marker for the marginalized sexual subject framed by the Islamic discourse of this country.

Matched MeSH terms: Religion and Sex*
Waist circumference percentile curves for Malaysian children and adolescents aged 6.0-16.9 years

Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail MN, McCarthy D

Int J Pediatr Obes, 2011 Aug;6(3-4):229-35.
PMID: 21668385 DOI: 10.3109/17477166.2011.583658

BACKGROUND: The prevalence of obesity is increasing rapidly and abdominal obesity especially is known to be a risk factor for metabolic syndrome and other non-communicable diseases. Waist circumference percentile curves are useful tools which can help to identify abdominal obesity among the childhood and adolescent populations.
OBJECTIVE: To develop age- and sex-specific waist circumference (WC) percentile curves for multi-ethnic Malaysian children and adolescents aged 6.0-16.9 years. Subjects and methods. A total of 16,203 participants comprising 8,093 boys and 8,110 girls recruited from all regions of Malaysia were involved in this study. Height, weight, WC were measured and BMI calculated. Smoothed WC percentile curves and values for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles were constructed using the LMS Method.
RESULTS: WC was found to increase with age in both sexes, but boys had higher WC values at every age and percentile. Z-scores generated using the UK reference data shows that Chinese children had the highest WC compared to Malays, Indians and other ethnicities. Comparisons with other studies indicate that at the 50th percentile, Malaysian curves did not differ from the UK, Hong Kong and Turkish curves, but at the 90th percentile, Malaysian curves were higher compared with other countries, starting at 10 years of age. The 90th percentile was adopted as the cut-off point to indicate abdominal obesity in Malaysian children and adolescents.
CONCLUSION: These curves represent the first WC percentiles reported for Malaysian children, and they can serve as a reference for future studies.

Matched MeSH terms: Sex Factors; Sex Distribution
Gender discrimination in the influence of hyperglycemia and hyperosmolarity on rat aortic tissue responses to insulin

Wong NL, Achike FI

Regul. Pept., 2010 Aug 9;163(1-3):113-9.
PMID: 20434492 DOI: 10.1016/j.regpep.2010.04.003

Hyperglycaemia initiates endothelial dysfunction causing diabetic macro- and micro-vasculopathy, the main causes of morbidity and mortality in diabetes mellitus. The vasculopathy exhibits gender peculiarities. We therefore explored gender differences in comparing the effects of hyperglycaemia (50 mM) per se with its hyperosmolar (50 mM) effects on vascular tissue responses to insulin. Endothelium-intact or denuded thoracic aortic rings from age-matched male and female Sprague-Dawley rats were incubated for 10 min or 6 h (acute versus chronic exposure) in normal, hyperglycaemic or hyperosmolar Krebs solution. Relaxant responses to insulin (6.9x10(-7)-6.9x10(-5) M) of the phenylephrine-contracted tissues were recorded. Endothelium denudation in both genders inhibited relaxation to insulin in all conditions, more significantly in female than in male tissues, suggesting the female response to insulin is more endothelium-dependent than the male. Acutely and chronically exposed normoglycemic endothelium-intact or -denuded tissues responded similarly to insulin. Chronic hyperglycemic or hyperosmolar exposure did not alter the endothelium-denuded tissue responses to insulin, whereas the responses of the endothelium-intact male and female hyperosmolar, and male hyperglycemic tissues were enhanced. The results show that insulin exerts an endothelium-dependent and independent relaxation with the female tissue responses more endothelium-dependent than the male. The data also suggest that hyperosmolarity per se enhances aortic tissue relaxant responses to insulin whereas hyperglycemia per se inhibits the same and more so in female than male tissues. These effects are endothelium-dependent.

Matched MeSH terms: Sex Characteristics*
Fulltext Rapidly shifting sex ratio across a species range

Hornett EA, Charlat S, Wedell N, Jiggins CD, Hurst GD

Curr Biol, 2009 Oct 13;19(19):1628-31.
PMID: 19747825 DOI: 10.1016/j.cub.2009.07.071

Sex ratios are subject to distortion by a range of inherited parasites. Although it has been predicted that the presence of these elements will result in spatial and temporal variation in host sex ratio, testing of this hypothesis has been constrained by availability of historical data. We here determine spatial and temporal variation in sex ratio in a interaction between a butterfly and male-killing Wolbachia bacteria by assaying infection presence in museum specimens, and from this inferring infection prevalence and phenotype in historical populations. Comparison of contemporary and museum samples revealed profound change in four of five populations examined. Two populations become extremely female biased, associated with spread of the male-killer bacterium. One evolved from extremely female biased to a sex ratio near parity, resulting from the infection losing male-killing activity. The final population fluctuated widely in sex ratio, associated with varying frequency of the male killer. We conclude that asynchronous invasion and decline of sex-ratio distorters combines with the evolution of host suppressors to produce a rapidly changing mosaic of sex ratio. As a consequence, the reproductive ecology of the host species is likely to be fundamentally altered over short time scales. Further, the study demonstrates the utility of museum specimens as "silent witnesses" of evolutionary change.

Matched MeSH terms: Sex Ratio*
Fulltext Improvements of knowledge and perception towards HIV/AIDS among secondary school students after two hours talk

Jahanfar S, Lim AW, Loh MA, Yeoh AG, Charles A

Med J Malaysia, 2008 Oct;63(4):288-92.
PMID: 19385486 MyJurnal

Malaysia is confronted with an increasing incidence of HIV and AIDS among adolescents and young adults. The effectiveness of various programs offered to school going teenagers is unknown. The objective of this study is to measure the effectiveness of two hours talk on sex education offered by a non governmental organization (NGO) in improving youngsters' knowledge and perception towards HIV and AIDS. A cross sectional study was conducted among the adolescent students from a secondary school in Ipoh, Perak, a province of Malaysia. A total of 182 students participated in the study. A standard questionnaire consisting of demographic data, knowledge and perception towards HIV/ADIS were distributed before (pre-test) and after the intervention (post-test). Performance of participants was compared to establish the effectiveness of the intervention. Our findings suggests that there was a significant increase in participants' knowledge and perception after the intervention (p = 0.000). Knowledge improvement was found in both genders however, improvement in perception was higher among female students. Interestingly, 80% of participants disagree that sexual education will encourage sex among youngsters. NGOs are playing a supplementary role in providing sex education programs in schools. This program although of short duration but it is effective in enhancing adolescence awareness about HIV/AIDS.

Matched MeSH terms: Sex Education*
The fetal sex ratio and metabolic, biochemical, haematological and clinical indicators of severity of hyperemesis gravidarum

Tan PC, Jacob R, Quek KF, Omar SZ

BJOG, 2006 Jun;113(6):733-7.
PMID: 16709219

The association between female fetal sex and hyperemesis gravidarum is well established in European and North American populations. The association between female fetuses and severity of hyperemesis remains uncertain. A retrospective study based on case notes review of 166 Asian women hospitalised for hyperemesis was performed. Female fetuses were significantly associated with hyperemesis in our population (P= 0.004, OR 1.6, 95% CI 1.2-2.2) as well as associated with severe ketonuria and high urea. When both severe ketonuria and high urea were present at initial hospital admission for hyperemesis, 83% (95% CI 66-93) of the fetuses were female.

Matched MeSH terms: Sex Factors; Sex Ratio
A case of sexual abuse by a traditional faith healer: are there potential preventions?

Chan LF, Tan SM, Ang JK, Kamal Nor N, Sharip S

J Child Sex Abus, 2012;21(6):613-20.
PMID: 23194137 DOI: 10.1080/10538712.2012.719597

Adolescent sexual abuse is not an uncommon phenomenon in Malaysia. It is a traumatic experience that complicates the psychosocial development of young people on the threshold of adulthood. This case report highlights the psychosocial sequelae of adolescent sexual abuse by a traditional healer and discusses management issues in the context of unique cultural and belief systems.

Matched MeSH terms: Sex Offenses/prevention & control*
Sex reassignment technology: the dilemma of transsexuals in Islam and Christianity

Ishak MS, Haneef SS

J Relig Health, 2014 Apr;53(2):520-37.
PMID: 23187616 DOI: 10.1007/s10943-012-9656-z

The birth of people with confused or ambiguous sex makeup as a biological fact since the annals of history has posed the challenge of accommodating them within the binary gender of sociocultural systems. In this process, the role of religion as a defining factor in social engineering has been paramount. Major religions, such as Islam and Christianity, have addressed this issue within the frame of their God-ordained laws by devising a set of moral and legal imperatives specific to the "third gender." Modern developments in medicine and biology, however, have made sex reassignment possible for this category of people, today called transsexuals. The question is: How do Islam and Christianity respond to it. After presenting an analytical view of both Muslim scholars and Christian religious authorities on the legitimacy of sex reassignment for transsexuals, this paper attempts to explore if such a dilemma can be resolved.

Matched MeSH terms: Sex Reassignment Procedures*
Fulltext "I feel it is not enough…" Health providers' perspectives on services for victims of intimate partner violence in Malaysia

Colombini M, Mayhew S, Ali SH, Shuib R, Watts C

BMC Health Serv Res, 2013;13:65.
PMID: 23419141 DOI: 10.1186/1472-6963-13-65

This study explores the views and attitudes of health providers in Malaysia towards intimate partner violence (IPV) and abused women and considers whether and how their views affect the provision or quality of services. The impact of provider attitudes on the provision of services for women experiencing violence is particularly important to understand since there is a need to ensure that these women are not re-victimised by the health sector, but are treated sensitively.

Matched MeSH terms: Sex Offenses*
Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border

Nunun W, Kanato M

J Med Assoc Thai, 2015 Jul;98 Suppl 6:S64-72.
PMID: 26434252

Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex workers participation on drug demand reduction at the Thailand/Malaysian border

Matched MeSH terms: Sex Workers/psychology*
Suboptimal HIV Testing Uptake Among Men Who Engage in Commercial Sex Work with Men in Asia

Jin H, Friedman MR, Lim SH, Guadamuz TE, Wei C

LGBT Health, 2016 Dec;3(6):465-471.
PMID: 26982598

PURPOSE: Men who have sex with men and are sex workers (MSMSW) are disproportionately affected by the growing and emerging HIV epidemic. As sex work and same-sex behavior are heavily stigmatized and often illegal in most Asian countries, HIV research focusing on MSMSW has been limited. The goal of this analysis is to examine HIV testing practices and identify correlates of HIV testing among MSMSW in Asia.
METHODS: The Asia Internet MSM Sex Survey, an online cross-sectional survey of 10,861 men who have sex with men (MSM), was conducted in 2010. Data on sociodemographic characteristics, HIV testing behaviors, and sexual behaviors were collected. Five hundred and seventy-four HIV-negative/unknown respondents reported receiving payment for sex with men at least once in the past 6 months and were included in this analysis. Multivariable logistic regression was conducted to identify independent correlates of HIV testing in the past year.
RESULTS: About half (48.6%) of the participants had been tested for HIV at least once within the past year, and 30.5% had never been tested. We also found that MSMSW participants who engaged in risky behaviors were less likely to be tested.
CONCLUSION: While one might expect a high HIV testing rate among MSMSW due to the risks associated with engaging in sex work, we found that HIV testing uptake is suboptimal among MSMSW in Asia. These results suggest that targeted HIV prevention and testing promotion among MSMSW are needed.

Matched MeSH terms: Unsafe Sex/ethnology
Vitamin D is significantly associated with total testosterone and sex hormone-binding globulin in Malaysian men

Chin KY, Ima-Nirwana S, Wan Ngah WZ

Aging Male, 2015;18(3):175-9.
PMID: 26004987 DOI: 10.3109/13685538.2015.1034686

OBJECTIVE: Cross-sectional studies in the Caucasian population have shown a significant relationship between vitamin D and testosterone levels, but data in the Asian population are limited. This study aimed to determine the association between vitamin D and testosterone levels in Malaysian men.
METHODS: Chinese and Malay men (n = 382) aged 20 years or above residing in the Klang Valley, Malaysia were recruited. Their fasting blood was collected for serum testosterone, sex hormone-binding globulin (SHBG) and 25-hydroxyvitamin D (25(OH)D) assays. Relationship between 25(OH)D and testosterone levels was analyzed using multiple regression analysis. Testosterone and SHBG levels among subjects with different vitamin D status were compared using univariate analysis. Confounders such as age, ethnicity and body mass index (BMI) were adjusted.
RESULTS: 25(OH)D was significantly and positively associated with total testosterone and SHBG levels before and after adjustment for age and ethnicity (p 0.05).
CONCLUSION: 25(OH)D is significantly associated with total testosterone and SHBG in Malaysian men but this association is BMI-dependent.

Matched MeSH terms: Sex Hormone-Binding Globulin/analysis*
Fulltext Teaching medical students how to take a sexual history and discuss sexual health issues

Ng CJ, McCarthy SA

Med J Malaysia, 2002 Dec;57 Suppl E:44-51.
PMID: 12733193

BACKGROUND: Taking a sexual history and discussing sexual health issues with patients form an important part of a medical consultation. These specific communication skills can be acquired through various teaching methods.
OBJECTIVE: This paper describes the communication skill workshops conducted for undergraduate medical students on how to talk to patients about sex.
METHODOLOGY: 198 medical students participated in a series of workshops conducted in the University of Malaya in 2001-2002. Pre- and post-workshop evaluations of the programme were carried out to find out the students' difficulties and to assess the usefulness of the workshop. The workshop consisted of a short lecture, role-plays and discussion.
RESULTS: Only 34% of the participants had received some informal training during their clinical years. The main barriers encountered were gender and age differences, language and choice of words, patients and doctors feeling shy, and cultural differences. The workshop was felt to be useful (mean score 4.38, maximum 5.0), most students felt comfortable during the workshop (mean score 4.10, maximum 5.0) and there was significant improvement in the "comfort level" when talking to patients about sex after attending the workshop (P < 0.001).
CONCLUSION: Gender, language and cultural differences were the main barriers in taking a sexual history and discussing sexual health issues among the medical students. Communication workshop was felt to be a useful and comfortable method of learning these specific.

Matched MeSH terms: Sex*
Advocacy and IEC strategies. Getting the most from the experience of others in promoting adolescent reproductive and sexual health

Adolesc Educ Newsl, 1999 Dec;2(2):2.
PMID: 12158254
Matched MeSH terms: Sex Education*
Fulltext Distribution of blood pressure in a national sample of Malaysian adults

Lim TO, Ding LM, Goh BL, Zaki M, Suleiman AB, Maimunah AH, et al.

Med J Malaysia, 2000 Mar;55(1):90-107.
PMID: 11072495 MyJurnal

We describe the distribution of blood pressure (BP) by age, sex and ethnicity in Malaysian adults. A national sample of 21,391 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BP was measured using an automated oscillometric device, Visomat. Percentile tables and curves by age, sex and ethnicity are presented. The systolic and diastolic BP distribution was right skewed and showed the expected increase with age. This was markedly so in Malay and other indigenous women; as a result they had most severe hypertension.
Study name: National Health and Morbidity Survey (NHMS-1996)

Matched MeSH terms: Sex Characteristics; Sex Distribution

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