I refer to the reply by the Equality Ministry ‘LGBTIQ action plan’ (September 20) to my comments in ‘HIV treatment in Malta archaic, activist warns’.
In its reply, the government focuses on the LGBTIQ Action Plan when the main focus of my comments was on the archaic treatment still prescribed to people living with HIV in Malta. Of course, this ties up nicely with the availability of PrEP and accessibility of PEP in Malta. My questions and comments raised remained unaddressed.
The government argues that there is nothing wrong in framing HIV prevention and treatment within an LGBTIQ Action Plan. I argue that there is.
It’s common knowledge that many still associate HIV with the LGBTIQ community and vice versa. In framing HIV within an LGBTIQ action plan, one is only reinforcing the stigma that members of the LGBTIQ community are the only ones who are at risk of acquiring the virus.
Any person, irrespective of gender and sexuality, is at risk of acquiring HIV when engaging in high-risk behaviours.
HIV does not discriminate. Even though, “in Malta, men who have sex with men (MSM) continue to be disproportionately affected by HIV”, it is a non sequitur that campaigns, or strategies are solely targeted for MSM.
The government is leaving behind other key populations like Injecting Drug Users who are considered at high risk of contracting HIV, for example. Globally, there are over 36 million people living with HIV; more than half are women. Such a measure reinforces stigma towards the LGBT community and towards those who live with HIV.
It also inadvertently sends out the message that if one does not belong to the LGBTIQ community, one need not get tested for STIs including HIV, and that Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) are not for them. This rationale, and the government would definitely agree, would be a public health disaster.
Any person who engages in high-risk behaviours should get tested; PEP should be accessible to any person who satisfies the criteria established in international guidelines and PrEP is for everyone, men and women, gay or not.
Living in an era where one gets to find and read enough wrong information online, the least one would expect from a sexual health policy is for it to be drafted holistically, targeting all members of society.
May I also take this opportunity to point out that Post Exposure Prophylaxis, the 28-day course which can reduce the risk of acquiring HIV after a potential exposure to the virus, was introduced in Malta back in 2013 and is currently priced at around €600 making it inaccessible for most. Subsection 3.6.5 of the action plan reading ‘the introduction of Post Exposure Prophylaxis’ is void.
Furthermore, it would have been a case of better space used if the government actually answered the question which I posed in my comments in this newspaper, which I shall reiterate over here: “One wonders why the unnecessary delay? Is it the lack of human resources, the lack of funds, hesitation from public health authorities or the plan to use the introduction of PrEP to get the pink vote in the next general election? Any government is subject to criticism; Malta’s is no exception.
Mark Josef Raya is founder of PrEPing Malta https://www.prepingmalta.com and member of the European AIDS Treatment Group, Manchester.