Respectful Handling Of Remains Of Deceased HIV/AIDS Patients

Mohd Shazni Abdullah still vividly remembers what happened on a quiet morning not long ago at Universiti Malaya Medical Centre (UMMC) here. A patient in his 50s, who was living with HIV and was from the transgender community, had passed away.

For the UMMC Islamic Affairs Department head, the focus was not on who the deceased was but on ensuring the remains were handled with dignity, respect and compassion, free from stigma or prejudice.

He described the atmosphere in UMMC’s forensic room that day as deeply solemn, broken only by the sounds of hospital equipment and the footsteps of staff.

“His (deceased’s) closest relatives refused to approach the body, but we still performed the prayers with his friends who were present,” he told Bernama when met recently.

Days like that stand as a reminder to Mohd Shazni and his colleagues that managing the remains of the deceased – regardless of religion or background – is an opportunity for them to uphold dignity and respect, and to demonstrate true compassion.   

In his 10 years of working at UMMC, Mohd Shazni has handled the bodies of between 80 and 100 HIV/AIDS patients.

Despite ongoing stigma in society, Malaysian medical and religious institutions ensure that HIV (human immunodeficiency virus) positive individuals are treated with the same dignity and honour in death as anyone else.

ADDITIONAL PROCEDURES

Elaborating, Mohd Shazni said managing the remains of Muslims with HIV/AIDS is essentially the same as that of any other Muslim: the body is bathed and shrouded, and prayers are performed before being handed over to the family for burial.

However, he added, for safety reasons, those handling the remains of a person with HIV/AIDS must follow several additional procedures.

Mohd Shazni Abdullah.

“When a death occurs in the hospital, the body is taken to the mortuary, where the family identifies it. After that, if the family chooses to manage the remains outside the facility, the movement and transfer of the body will be arranged in compliance with safety procedures,” he said.

If the hospital is required to manage the body of a person with HIV or a confirmed infectious disease, such as tuberculosis (TB), the remains will be kept in the forensic room for the safety of all staff.  

He added that the safety procedures for managing such remains are a combination of the standard operating procedures (SOPs) of the Ministry of Health (MOH) and the Department of Islamic Development Malaysia (Jakim).

“Jakim emphasises preserving the dignity of the deceased and fulfilling the fardu kifayah responsibility, while MOH focuses on safety and infection prevention,” he said.

According to MOH’s ‘Guidelines for the Transport and Disposal of Dead Bodies Due to HIV Infection/AIDS’, the handling of remains of individuals with infectious diseases must follow strict preventive measures. These include wearing double gloves, face masks, waterproof aprons and protective footwear, and using water mixed with bleach to clean contaminated surfaces. All these steps are aimed at ensuring safety without diminishing respect for the deceased.

“The MOH regulations also require the body to be first wrapped in clear plastic before being covered with the shroud.

“After the shrouding process is completed and before the face is covered, the family will be invited to view the deceased one last time. However, they will be advised not to hug or kiss the body to reduce any risk of exposure,” he said.

He added that once the body is fully shrouded, it must be placed in a body bag before being transported to the cemetery for burial.

“Indeed, the remains of someone with HIV/AIDS must be taken directly for burial; they are not allowed to be brought home or to any other location to ensure compliance with safety SOPs,” he said.

For the team handling the remains, after completing the washing and shrouding process, they must immediately clean all exposed parts of their body that came into contact with the remains.

FAMILIES

Contrary to the common perception that the remains of HIV/AIDS patients are often rejected by their families, Mohd Shazni said only a small number of families behave this way.

“Most families come and accept the remains. They are involved in the burial. However, it cannot be denied that some relatives do not come forward, even after being informed of the death of their family member. In such cases, we manage the remains and proceed with the burial,” he said.

Virus HIV. Pix credit Shutterstock.com/ Raj Creationzs

He also said communication between the funeral management team and the family is also important, so as not to add emotional stress.

“We need to explain to the family the additional safety procedures we follow, such as using water mixed with bleach (usually Clorox) to clean surfaces that were exposed, like the washing area, floor and equipment used.

“The same applies to the use of plastic. We need to explain why the body must be wrapped in plastic and so on,” he added, noting that the plastic wrapping is necessary to prevent contamination from bodily fluids.

Regarding the sharing of information or images of HIV/AIDS patients’ bodies on social media, Mohd Shazni said such a thing is strictly prohibited in Islam.

He acknowledged that their bodies are often in a very fragile state, requiring careful handling to protect the dignity and privacy of the deceased.

“Sometimes, the closest relatives refuse to approach the body due to stigma or its condition, but we still fulfil the fardu kifayah responsibility by washing and shrouding the body before performing prayers. No matter what condition the body is in, the deceased’s dignity must be preserved,” he added.

On the unclaimed bodies at UMMC, he said the remains are handed over to the Federal Territory Islamic Religious Department.

SAME SAFETY PROCEDURES FOR NON-MUSLIMS

The same safety procedures also apply when handling the remains of non-Muslims with HIV/AIDS.

According to Jackson Wong Yew Choong, district service director at Nirvana Sungei Besi, in cases of HIV/AIDS and other infectious diseases such as TB, safety protocols are further enhanced.

The same safety procedures are also applied in the management of non-Muslim bodies, including wrapping them in plastic before placing them in body bags before taking them to the body management centre. Pix credit: Jackson Wong Yew Choong.

“If the death involves an infectious disease, we (team handling the body) must wear full personal protective equipment. The body must be placed in a body bag before being put into the casket,” Wong explained, adding that the casket is also tightly sealed with silicone.

“Throughout this process, MOH personnel will monitor the procedures,” he added.

Despite the strict safety measures, Wong said the family is still given the opportunity to view the deceased one last time in a controlled manner.

“The family is placed in a mirrored room for the final identification before the casket is closed,” he said.

According to MOH, HIV infections in Malaysia are concentrated among four main groups: people who inject drugs (PWID), female sex workers, transgender individuals and men who have sex with men (MSM). In the 1990s, the highest infection rates were among PWID, accounting for 70 to 80 percent of total cases. Since the 2010s, however, the landscape has shifted toward sexual transmission.

Recent MOH data show that 3,185 new HIV cases were recorded among PWID in 2024, with young men aged 20–30 accounting for three-quarters of the total. Of these, 90 percent were linked to same-sex sexual activity.

Commenting on the HIV/AIDS infection trend among young men, Nik Mohd Irwan Nik Pa, chief HIV/AIDS counselling nurse at the Universiti Sains Malaysia Specialist Hospital, said the main cause is unsafe and same-sex sexual activity.

Nik Mohd Irwan Nik Pa.

“We advise high-risk groups to use condoms and avoid risky behaviour. We also encourage them to remain faithful to their partners and undergo regular HIV testing,” he said when contacted by Bernama.

He added that in the context of the rise in same-sex sexual activity, parents play a critical role in monitoring their children, who are exposed to unsafe smartphone applications.

“There are now too many dating apps, including for same-sex couples, that are unregulated and easily downloadable. Young people are curious and end up getting involved. This is the reality today,” he said.