As the world focuses on battling COVID-19, HIV activists warn of another crisis in Malta: sexual health.

On World AIDS Day, celebrated on 1st December, the HIV support group called for a watertight strategy to tackle the crisis head-on, starting with a “long-needed” upgrade at the GU clinic, which they described as a “ticking time bomb”.

Less than 2% of people in Malta got tested last year at the national GU clinic. Meanwhile, STDs are on the rise with five people a month diagnosed with HIV.

COVID-19 has halted regular testing for sexual diseases, it warned, but problems of over-stretched resources and a low-head count at the clinic existed before the pandemic, despite a pledge by Health Minister Chris Fearne to double the amount of GU clinic staff.

In order to battle the crisis, which includes the HIV epidemic, Malta should follow the ambitious 90:90:90 target set by UNAIDS. It aims to make sure 90% of people with HIV to know their status, 90% of those people to receive medication and 90% of those on medication to be undetectable and untraceable.

“In local terms, we can achieve this only if we strengthen three important pillars, increase access to testing at the GU Clinic, improving the medical regimen and ensure that preventative treatment is readily available,” the group said.

But with such low testing rates, the true figure of those with HIV and other sexual diseases is unclear. And while more testing would consequently mean more diagnoses, diagnoses remain high despite fewer people getting checked. 

“Even with reduced testing in 2020, Malta saw 78 new diagnoses of which at least one was an AIDS diagnosis,” HIV Malta warned.

Meanwhile, Gozo still doesn’t have its own sexual health clinic.

In terms of medicine, a new HIV treatment that replaces the current outdated cocktail of drugs has arrived in Malta, but it has not yet been distributed to patients.

“We acknowledge that it was entirely opportune to dedicate our excellent consultants and medical professionals, who have decades of experience in handling HIV, to the COVID- 19 pandemic”

“Nevertheless, here too, a plan is needed to resume focus on HIV. Medication that is available needs to be distributed if we want to regain control of this virus,” the activists said.

For the last pillar, the group said Malta must ensure preventive treatment is readily available for the population most vulnerable to HIV. Treatment currently exists in the form of PrEP (pre-exposure prophylaxis), which is a pill that when taken regularly by someone who is not already living with HIV reduces the risk of transmission by more than 99%.

A preventative strategy, including access to PrEP and condoms, would mean everyone is better armed against STIs.

However, protecting yourself can be costly. PrEp, for example, costs €57 a month and must be taken daily. Contraceptive pills cost around €20 a month. These are currently unavailable to those who can’t afford them because there is no state-sponsored scheme for such medicines.

All in all, the most important course of action is outreach and education, the organisation told Lovin Malta.

“We need to seriously talk about sexual health without being vulgar or offensive. It’s the only way to reduce fears about getting tested or defeating stigmas on positive patients.”

Issues of poor resourcing of the GU clinic, sexual education and more affordable medicine could all be addressed in a fresh sexual health policy to replace the current decade-old one. 

While there are little signs of progress this year with all arms on deck to fight COVID-19, a new sexual health policy is expected to be published as early as March 2021.

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