HIV Malta

  • HIV, or the ‘human immunodeficiency virus’ is the virus that causes an HIV infection. If left untreated HIV can lead to AIDS (acquired immune deficiency syndrome). HIV acts by attacking and destroying the body’s CD4 cells which form an important part of the body’s immune system designed to fight infections. This means that, if left untreated, HIV makes it difficult for the body to fight off infections, and it is at this point that the condition becomes known as AIDS.

  • HIV is spread, or transmitted, only through contact with certain body fluids from a person who has a detectable HIV viral load.

    The body fluids include:

    • Blood

    • Semen (Sperm/Cum)

    • Pre-Seminal Fluids (Precum)

    • Vaginal Fluids

    • Rectal Fluids

    • Breast Milk

    HIV can be transmitted through:

    • Anal or vaginal sex with someone who has HIV without adequate protection.  Remember that there is a higher risk of transmission in anal sex since the mix of blood in tears within the anal wall and semen lead to possible direct transmission if either partner has HIV

    • Sharing injection drug equipment such as needles with people who have HIV

    • Pregnancy, childbirth and breastfeeding if the mother or child-bearer has HIV

    • Oral sex (by putting the mouth on a penis, a vagina or anus), while at low risk for HIV transmission, increases in risk if there is presence of fluids such as semen from an ejaculation or vaginal fluids;

    • Pre-chewed food, by a person with HIV who also has oral hygiene issues that therefore introduces blood in the food.  Similarly, deep, open-mouth kissing where both partners have sores or bleeding gums, that would allow HIV to enter the bloodstream. 

  • In the past few years, you may have started to come across the word ‘undetectable’, and it is a very important word for those living with HIV. 

     When we speak of ‘undetectable’, we would be referring to the viral load, which is the quantity of the virus that is detected by standard blood tests.  Most people who are living with HIV and who are adhering to the antiretroviral treatment over a period of at least six months will find that their viral load has become undetectable.  When this is confirmed by a health professional, then there is zero risk of transmitting HIV sexually.  That is why undetectable = untransmittable. 

    Three large studies undertaken between 2007 and 2016 have shown that there was no single case of HIV transmission from persons with an undetectable viral load.  These important studies have confirmed that serodiscordant couples, or couples where one partner is HIV-Positive and one partner is HIV-negative can have a healthy relationship, including a full sexual relationship.

    The ‘viral load’ is the amount of HIV present in the blood.  It cannot be known what the viral load is, unless it is measured by a healthcare professional who would be assessing how well the antiretroviral treatment is working.    Keep in mind that the body takes time to adjust to new medicines, and that is why being on treatment does not automatically mean that the virus is undetectable.  There is also a chance that the viral load may fluctuate, but that usually occurs when a new treatment regime is started, or if the person is not taking treatment as indicated.

     An ‘undetectable’ diagnosis would be one where the HIV levels in the body are under 40 copies/ml. Obviously it cannot be known whether your levels are below or above this level without professional support.  This is why it is recommended that your viral load is monitored every 2-4 months by a healthcare professional to ensure that you are, and remain undetectable.

  • The current HIV treatment in Malta consists of Antiretroviral Therapy (ART) which can vary from person to person. This medication works by preventing HIV from multiplying, thus reducing the viral load, which is the amount of HIV present in the body, to a minimum.

    The aim of the treatment is for the viral load to be so low, that it becomes undetectable by a viral load test. People with an undetectable viral load have no risk of transmitting HIV to their HIV-negative partners through sex. This is where the concept Undetectable = Untransmittable or U=U comes into play.

    What does the treatment consist of?

    After you receive your diagnosis, you will be referred to Medical Outpatients 4 (MOP4) at Mater Dei. There should not a long wait between diagnosis and your first appointment, but it is normal to feel a lot of emotions during this time. If you wish to talk to someone get in touch with the Rainbow Support Service who will give you the support you need.

    Your treatment will consist of a combination of ARTs which are taken daily. What the treatment will do, is reduce the amount of HIV in the body. This is because having less HIV in the body (a lower viral load) gives the immune system the time it needs to recover. A low amount of HIV allows the immune system to be strong enough to fight and protect the body. Very importantly, a viral load that is low enough becomes undetectable.

  • This is great news! This means that you are able to maintain treatment and remain undetectable.  It also means that you do not have to worry about passing HIV on to your sexual partners.  Importantly, it also means that your immune system is healthy and defending your body.

    Now that you know that the viral load is undetectable, do not take your treatment for granted.  It took hard work to become undetectable, so following your treatment is now more important than ever.

    If you are not certain whether or not you are undetectable, speak to your healthcare professional about your viral load, and establish what success has been achieved using your medicine. If you have been following your treatment as advised for a period that is longer than 6 months and you are still not undetectable, speak up and ask for better medication. It is your right to receive the healthcare that you deserve.

  • If you have recently found out that you have HIV, you may have some questions about what treatment is available, and what exactly it does.  HIV treatment is called Antiretroviral Treatment, or ART.  ART is really good at keeping the level of HIV in the body (often referred to as the ‘viral load’) to the lowest possible levels.

    The treatment nowadays is advanced enough to lower the viral load to ‘undetectable levels’.  And that is great, because as you may know, Undetectable = Untransmittable, meaning that once the viral load is that low, it does not affect the person’s health and it is also not transmittable.  In order to maintain such a low viral load, it takes some discipline with medication, and it is important to follow your healthcare professional’s advise.

  • HIV Medication for Maltese Nationals living in Malta, who are HIV Positive is free. Most healthcare services are offered at Mater Dei Hospital (MDH), known popularly as simply Mater Dei, located in Msida. EU Nationals who travel to Malta for a period that does not exceed three months should carry their European Health Insurance Card that gives you access to medically necessary, state-provided healthcare during a temporary stay in any of the 27 EU countries, Iceland, Liechtenstein, Norway and Switzerland, under the same conditions and at the same cost (free in the case of Malta) as people insured in that country. Personal importation of up to 3 months of medication for personal use should be ok, especially if it is accompanied by a physician’s prescription for the medication in the name of the traveler.

    EU nationals staying in Malta for more than three months may still qualify for free healthcare, but they would need to have an E121 form, which can be obtained in your home country. The form has got to be registered with the Malta Health Department Entitlement Unit.

    If you are from a Non-EU country, download this document where you find information in English, Spanish & French.