Poor HIV-related Knowledge, Perceived Risks and Attitudes Among Urban-dwelling Malaysian Older Adults: Key Barriers to Zero HIV Transmission by 2030

Globally and in Malaysia, there are increasing rates of HIV infection among older adults but a corresponding decline in other younger age groups. We aimed to investigate the HIV-related knowledge, perceived risks, attitudes, and risk behaviours among multi-ethnic urban-dwelling older adults in Malaysia. A cross-sectional, questionnaire-based study was conducted among 320 adults aged 50 years and above residing in urban Klang Valley, Malaysia. Participants were recruited via convenience sampling in the community and in the outpatient clinics and pharmacy of University Malaya Medical Centre, Malaysia, from April 2021 to January 2022. The median (IQR) age of participants was 58 (55-64) and 42.5% were males. The median (IQR) knowledge score was 10 (8-12) out of 14. Significant knowledge gaps were noted and ethnic Chinese, higher education levels and better HIV-related attitudes were associated with better scores. The median (IQR) attitude score was 49 (41-55) out of 65. Ethnic Chinese and Indian, knowing people living with HIV (PLHIV), and better HIV-related knowledge were associated with better attitude scores. Many (43.8%) older adults were sexually active however rates of consistent condom use was low (19%) and the majority (89.9%) of participants had low self-perceived risk of HIV. These findings highlight underlying drivers for HIV transmission and delayed treatment among older adults in Malaysia and indicate a need for targeted HIV prevention programs for this population.