It is well-known that Caritas (Malta) is a stakeholder in the battle against the spread of HIV/AIDS. Mostly reputed to be a sexually transmitted viral infection, the Human Immunodeficiency Virus Infection (HIV) that can lead to the onset of AIDS (Acquired immunodeficiency Syndrome), is most commonly spread through unprotected sexual intercourse with a partner whose HIV status is unknown to the other person engaging in the sexual encounter.

The virus can also be spread through what has come to be termed as the “sharing” of contaminated needles by drug-abusers. This happens when people inject themselves using a needle that had been already used at least once before by a companion drug-abuser. Should any such “companions” be HIV positive, injecting drug-abusers would inevitably thereby render themselves vulnerable to contracting this illness.

Although by far much rarer in developed countries, it is still technically possible, most especially if the condition is left untreated, for a mother to transmit the virus to her unborn child. Breast-feeding offers another potential mode of transmission, should the mother have contracted the HIV virus.

Various methods of preventive efforts have been suggested in medical circles. These include barrier methods and the prescription of microbicides – substances that kill microbes – that are intended to be effective against the AIDS virus. Such microbicides are under development and are still at a relatively preliminary stage of human trials.

However, there is no doubt that the safest way to prevent the onset of AIDS via the sexual transmission route is to restrict sexual intercourse to one partner, and for the partners to remain faithful to one another.

Caritas offers a series of programmes that are oriented to preventing AIDS within a holistic framework of promoting Christian values. It recommends that sexual practice should be restricted to a man and a woman who are joined together through the sacrament of Holy Matrimony.

By no means does this prevent Caritas, however, from reaching out to all those who, for whatever reason, may be vulnerable or may be placing themselves at risk of contracting this disease. Certain people feature as high-risk groups precisely because they engage in high-risk sexual activity.

This is not so much a matter of sexual orientation as it is a matter of partner selection. If a person has more than one sexual partner, swaps sexual partners, or is promiscuous, then, it almost goes without saying that such a person is placing himself or herself at risk of contracting the HIV infection. The risk of contracting the virus is higher for the receiving partner, precisely because this person is at the receiving end. In heterosexual sex, the female is therefore at a higher risk than the male.

What happens when a person becomes infected with HIV is that the virus targets certain cells of the immune system, which is the body’s natural defence against disease. As the immune system weakens, a person living with HIV becomes increasingly vulnerable to a wide range of illnesses known as “opportunistic infections,” (OIs) because they take advantage of the undefended body.

OIs are caused by bacteria, parasites, viruses and fungi, which are commonly found in the environment and which pose little threat to people with normally-functioning immune systems. An HIV-positive person is diagnosed as having AIDS when they have at least one of the OIs that indicate severely suppressed immunity. There are a number of ways people living with HIV can reduce their vulnerability to OIs, including the use of particular medications for some conditions.

When someone, as a result of medical tests, is informed that s/he is HIV positive, and therefore is a candidate for contracting AIDS, this is usually taken as a big shock. A lot of work is undertaken with such people, to empower them to live with the condition without placing either themselves or anyone else at further risk and to further develop their coping skills. Today, the illness is seen more as a chronic infection than as the death sentence it was taken to be when it was first discovered and no treatment was available.

The shock of an HIV-positive result is not only felt by the individual, however. Sometimes, this result may introduce marital strain. On another note entirely and, unfortunately, this possibility is sadly there – there is a possibility that eventually families may lose a beloved breadwinner, a mother, a father, a brother, a sister, an uncle or an aunt. Someone may lose a friend.

At the wider community or national level, the impact is also felt, as in such cases, the loss in human resources may not be easily compensated for. The seriousness of the impact depends not only on the numbers infected and directly affected by HIV, but also on the resources available to cope with the situation. It is well-known that some poorer countries are ill-equipped to deal with their HIV/AIDS problem.

Since the first cases were diagnosed in 1981, the number of AIDS victims has grown to almost 40 million people worldwide in 2004. The vast majority of these people are aged 15-49 and in the prime of their working lives. This implies that the ratio of wage earners to dependents is growing alarmingly in the worst affected countries as workers die of AIDS. In some places, economic necessity is putting pressure on children to work and older people to return to the labour force. Although the situation in Malta is not as alarming, this does not imply that it is not essential for people to be adequately informed – as prevention is better than cure – in virtue of the suffering that is wrought by this illness.

With the aim of preventing the further spread of this illness, Caritas (Malta) offers different services that are oriented to empowering people through providing them with accurate and up-to-date information and knowledge. The first is an active education campaign that is conducted in schools and that lays emphasis on life skills such as decision-making, communication and negotiation.

In an open manner, young people attending these sessions are encouraged to discuss concepts of risk behaviour, such as unwarranted sex and the use of alcohol and drugs, the possible consequences of such behaviour, and why and how to avoid engaging in such behaviour in the first place.

Through weekend encounters that it also organises for young people, Caritas engages in peer education, in which young people are trained to spread messages and promote responsible behaviour among their friends and peers.

Caritas also offers a pre-test and post-test counselling service. It offers this in recognition that people who are infected or closely affected by HIV need information, advice and support in coping with their situation. Through offering such counselling, it recognises that people who wish to learn their status need to be psychologically prepared for the result, whether positive or negative, and to understand the implications for behaviour of either result.

Anyone who thinks that he/she is at risk of having contracted the HIV virus, is invited to phone Caritas on 2590-6600 or 2123-3933 during office hours. Strict confidentiality is adhered to.

Damian Spiteri is a social worker who, alongside with other Caritas team-members, carries out HIV/AIDS pre-test and post-test counseling at Caritas (Malta)