I mean, if something is running as a background service, then yes, you either need to manually stop the service or reboot. I guess I don't tend to think of anything running as a background service as malware, although I suppose opinions could differ on this. This could potentially be due to my using Linux as my primary OS though; on OS X, manually managing services is not as common from what I've seen.
[0] (Yes, I know launchctl obviates the need to reboot, but their instructions say reboot and that's what we are commenting on here).