Never assume that people do or do not have HIV because of their nationality, gender, sexual orientation or lifestyle choices. No one comes with a label, so always practise safer sex. It is essential that educators and parents alike transmit this message when talking about HIV.
Since the beginning of the epidemic, more than 70 million people have been infected with the HIV virus and about 35 million people have died of HIV. Globally, 36.7 million people were living with HIV at the end of 2015. Almost 30,000 newly diagnosed HIV infections were reported by the 31 EU and European Economic Area countries in 2015. Although there have been impressive gains in reducing the number of AIDS diagnoses during the last decade, the burden of HIV infection remains unacceptably high in Europe.
In Malta over a 10-year period, from 2004 to 2014, 300 new cases of HIV were notified. In 2015, there were 61 new cases and in 2016 there were 63 new patients notified. These include 58 cases of HIV and five cases of AIDS.
There is good evidence on what works to effectively prevent and control HIV. The actions focus on prevention, testing and treatment. HIV prevention, both in terms of coverage and uptake, especially initiatives targeting men who have sex with men, migrants and people who inject drugs. HIV testing is to be encouraged for the early pick-up of cases and to ensure early linkage to care for people living with HIV.
There is a proportion of people in Malta who are living with HIV without knowing about it
Those tested need to be referred for urgent treatment. It is important to ensure that the proportion of people living with HIV with an undetectable virus in their blood is increased, both for their personal benefit as well as to reduce future HIV transmission.
In Malta, the Sexual Health Policy and Strategy outlines actions to support encompassing good sexual health practices and the prevention of infectious diseases including HIV. The definition taken is that outlined by the World Health Organisation: “Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.”
A specific website is available at sexualhealth.gov.mt which targets various audiences. Prevention efforts focus on promotion of safer sexual health practices and training of professionals to support diagnosis and management of cases. Training also focuses on prevention, including youths to act as peer leaders. Testing is encouraged for people at various settings, including the community and the GU clinic.
There is a proportion of people in Malta who are living with HIV without knowing about it. Such an infection could do significant harm to themselves and to others. Stigma and discrimination are the reasons why people are reluctant to get tested for HIV despite the fact that there are anti-retroviral treatments available in Malta which give the opportunity to people to live longer and healthier lives. Onward transmission of HIV is also reduced when the person is receiving treatment. HIV people are offered free treatment by specialists at the HIV clinic.
The Maltese presidency of the European Union of the Council, in collaboration with the European Centre for Disease Prevention and Control, held a technical meeting in Malta focusing on HIV. The aim was to get together leading experts on HIV prevention and control from across the EU to discuss how Europe can improve its response to HIV and achieve the targets outlined in the Sustainable Development Goals, the actions agreed at the UN High-Level meeting on HIV/AIDS and those adopted in the Global Health Sector Strategy at the World Health Assembly.
The experts discussed practical evidence-based interventions and strategies, shared achievements and examples of good practices and identified solutions to common challenges. The priority areas where the EU Member States agree they should scale up their efforts were discussed and the proceedings of the meeting translated into a technical Malta Declaration. This covers areas of prevention, early diagnosis, treatment and ensuring an enabling environment.
Stigma, which is also covered in this declaration, was given priority as it is very commonly associated with HIV since this is a serious, life-threatening infection. Some people do not know how HIV is transmitted and therefore fear that they might get infected through social contact.
Others hold strong views about sexual behaviour thus viewing sex as something wrong. We still find some people who hold negative views regarding certain groups of people, like drug users, LBGTI individuals, immigrants and coloured people. Stigma needs to be managed through educating the public. HIV is a condition that could be kept under control by using treatment.
For more information, call the Health Promotion and Disease Prevention Directorate on 2326 6000 or the GU Clinic on 2122 7981.
What is safer sex?
Safer sex is having sex with the decreased risk of acquiring or transmitting infections such as HIV, syphilis, chlamydia, gonorrhoea, trichomonas, herpes, hepatitis B and warts (HPV).
How can you have safer sex?
▪ Insist on condom use for all kinds of sex (vaginal, anal and also oral sex).
▪ Limit the number of sexual partners.
▪ Get tested and suggest the same to your partner before engaging in sex.
▪ Avoid the use of excessive alcohol and recreational drugs.
▪ Non-penetrative sex like body rubbing and mutual masturbation can still transmit infections such as HPV, herpes, scabies and lice, especially when there are open sores/cuts, prolonged contacts and warts.
▪ Get vaccinated for preventable infections such as hepatitis A, B and HPV.
Dr Charmaine Gauci is Superintendent of Public Health, Ministry for Health.