EVERY week, university students walk into public health clinics carrying a secret that weighs heavily on their shoulders – they have just been diagnosed with HIV. Some are only 18 years old.
“My clients are youths including students. The youngest I have handled is 18 years old,” said Winnie Veronica Bian, a specialist HIV/AIDS counsellor at a public health clinic in Kota Kinabalu.
She was among speakers at the Red Ribbon Talk 2025 organised by the Universiti Malaysia Sabah’s Faculty of Social Sciences and Humanities.
“Some come with sexually transmitted infections complaints, syphilis, gonorrhoea, warts and so on.
“When we find these signs, we immediately screen for other sexually transmitted diseases (STDs) including HIV. That is specifically how I get clients in addition to referrals from non-governmental organisations or private clinics,” she said.
Winnie sees a pattern in these young people’s reaction when they first learn of their HIV status, they all share the same crushing realisation that their lives have changed forever.
“They do not have knowledge about STDs. They face stigma. They experience emotional problems,” she said.
“But what troubles them most is the fear of exposure. They worry about their university finding out or their friend and especially family might find out,” she said.
These are not abstract fears. For students living in hostels, studying with peers who do understand HIV, the stakes feel impossibly high. One word in the wrong ear could upend their entire university experience.
“Early in treatment, they must come to the clinic every week. If blood results are not good, it is every two weeks. If still not improving, monthly visits become the norm.
“This causes them to always skip class. They will start worrying about how to inform their lecturers.
“Those who can accept it, they will follow the treatment instructions. Eventually, within four to six months, they reach a target we call not detected or undetectable. That is our target.
“At this stage, HIV becomes manageable like any other chronic disease. The key difference is that previously they did not depend on medication but now they depend on medication for life,” she said.
She noted, however, that not all students reach this point. Some struggle with internal stigma, the shame and regret that prevents them from accepting their diagnosis.
“Eventually they choose their own treatment. Some go for traditional medicine. But they come back to us after two years, because they have developed AIDS,” she said.
Winnie said among things that is driving HIV transmission among young people lies in their pockets – their phones.
“They are the IT generation, where everything is at their fingertips.
“When you look at the phone, pornographic ads are there. Remember, these are smart people that is why they entered university. But their intelligence has two sides, smart in finding good things and smart in finding things that (will lead them) astray.
“This curiosity, when not paired with strong values and religious foundation, leads students down a dangerous path especially when they start downloading certain apps.
“When I see my clients, I must ask ‘where did you meet your partner? Casual or steady partner?
“Some say they found their partners through dating apps. What apps? Grindr, Tinder, Blued, etc. You want a female partner or male partner? Just choose there,” she said, adding that the ease of connection is shocking.
“I also learn from my clients. They are in hostels. Maybe stressed from studying, wanting to release stress. So how to release stress? Just open the apps and within a 5km radius there are about 150 people waiting. Just choose which one.
“The proximity makes casual encounters almost effortless because they live in the same area, it is easy. The neighbour next door or the building next door. That is what contributes to this,” she said.
At the public clinic where she works, Winnie and her team have developed protocols to minimise discrimination. When doctors refer suspected HIV cases, they do not write “HIV” on referral forms. Instead, they use other words.
“It is one of the ways to reduce stigma and discrimination. Only me, the client and the staff know the word,” she said, adding that clients referred to her skip the normal triage system.
“The client will not meet any other doctor but directly with me. I will start the counselling process, exploring what I can do to help them,” she said.
She said this confidential pathway means fewer people know their status, reducing the risk of gossip and discrimination.
Despite the challenges, Winnie believes these young people can thrive if given proper support.
“Even though they are already classified as people living with HIV, if they are given the right knowledge and the right support, they can be treated. At least they can finish their studies and still have a future,” she said.
Not all HIV cases among students stem from university life. Some carry deeper wounds. Winnie has counselled clients whose first sexual experiences happened at age six.
“I apologise for touching on or revealing the real situation here. But I have had clients when I ask them “When was your first sexual experience?” Some answer six years old.
“It makes one think, how can you have sex at six-years-old? But it happens,” she said.
“Some clients say these early experiences happened when bathing with an uncle or a cousin. He sucks mine, I suck his.
“Some were manipulated by family members. They were abused. Touched. Stimulated. Sometimes they were made to have sex. When their family member has sex in an unnatural way, they think it is like playing marbles.
“Parents also did not explain that at a certain age, no one can touch certain parts of their body. Lack of parental guidance.
“Our Generation X download apps and we are blind. Parents do not always see what is happening under their own roof.
“When children come home from school, Form 2, Form 4 and go into the room together, ‘we are studying’. For their parents, they are studying. But inside the room, they are practicing what they have explored on their phones.
“At kindergarten age, you should start guiding them. I hope after this, one of the things we can do is to educate our parents about this,” she said.
