Continuous follow ups, education, and training to Health care professional and patients with a main focus on adherence could be outsourced to the private sector, a spokesperson from the Ministry of Health said.

Following a story on a €1 million investment in modernized HIV therapies was published in The Malta Independent, a number of questions were sent to the Ministry of Health regarding the specifics of the Request For Participation (RFP) from the Central Procurement and Supplies Unit (CPSU) for companies, joint ventures and consortiums to put in place the aforementioned guidelines.

This whilst the CPSU wished to provide an integrated service offering a variety of treatments, follow-up services and even education.

“The main elements to be considered in this HIV patient cohort is to secure optimum treatment that could guarantee a better quality of care and reduce risk of cross infections through consistent monitoring.”

The Ministry representative maintained that the reason for outsourcing the aforementioned services to the public was due to the fact that working with the private sector in this area could eventually lead to “better well being and increase in treatment compliance through continuous follow-ups, education and training to Health care professional and patients with main focus on adherence”.

“In this regard, the strategic partners that will submit their interest to this call are being given the opportunity to propose alternative services with their offer leading to relevant negotiations through a cost sharing agreement.”

This newspaper also asked whether the PrEP treatment is going to be made available as part of the investment, and whilst the main scope of this request for participation is for treatments of HIV, it was explained that the Government is not excluding that the bidders may also offer other services such as the PrEP as part of their treatment models.

The PrEP treatment, or pre-exposure prophylaxis, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day.

“Currently, we do not wish to speculate further as the process is still active and we need to allow the procurement process to be finalized since its governed by rules and regulations that have to be respected.”

There are currently 450 HIV patients being monitored by the HIV Clinic at Mater Dei, 362 of whom are receiving the treatment currently available.

According to statistics from the World Health Organisation (WHO), the year 2017 saw another year of disturbing numbers of new HIV diagnoses in the WHO European Region. Rates of HIV diagnoses have increased by 50 per cent in Malta, alongside countries such as the Czech Republic, Hungary and Poland.

This could potentially be attributed to increased public awareness and people being encouraged to be tested for HIV, although nothing can be ruled out.

Health Facts in Malta

In 2008, 28 HIV cases were reported, whilst in 2017, this number had increased to 45.

Statistics show that the number of men who were diagnosed with HIV is higher than women. In 2017, 35 men were diagnosed, of whom 23 were diagnosed as a result of same-sex activity. The number the previous year was 51. HIV diagnoses in people infected through heterosexual contact was only 17 people.

The report also goes into further details regarding the age of those who were diagnosed with HIV in 2017. The youngest person to be diagnosed was a female in the 20-25 years age group. The 25-29 group included one female and three males. The number of males increases in the age group 30-39, with 13 males and five females having a positive HIV diagnosis. There were two females and nine males in the 40-49 age group whilst in the 50+ group there was only one female and nine males.

HIV does not discriminate

Last November, The Malta Independent on Sunday spoke to Clayton Mercieca, Community Manager at Allied Rainbow Communities (ARC), who had taken matters into his own hands and posted an educational video of him using the HIV self-testing kit.

He said that the stigma attached to HIV in Malta means that discussing it is still an issue. Many of those who are HIV positive are too scared to talk about it for fear of being labelled or judged.

Apart from improving awareness of the self-testing kit, Mercieca said that there is a lack of education regarding sexual diseases and the procedure of PrEP. As a rule, HIV does not discriminate and everyone, regardless of sexual orientation, should test themselves. Mercieca and ARC have approached the Health Promotion and Diseases Prevention Services regarding the fact that there needs to be more focus on HIV which, unlike other sexually-transmitted diseases (STDs) that can be treated, is a life-long condition for which long-term care is expensive.

At present, ARC continues to provide information and help to those who request it and Mercieca hopes that the video will inform others regarding self-testing, especially those who are unaware of the kit itself.