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No single prevention method or approach can stop the HIV Epidemic on its own. However, there are several methods a person can take in order to very effectively reducing, and even eliminate, the risk of HIV transmission. Furthermore, condoms also reduce the risk of unintended pregnancies

Condoms

The most basic, cheapest, and some of the most efficient methods of protection are condoms.  Condoms act as physical barriers, that are made of materials that do not allow HIV to pass through them.  If used correctly and consistently, condoms not only reduce the risk of HIV but more importantly, also provide protection from other sexually transmitted infections, including syphilis and gonorrhea.

What does it mean to use a condom well?

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  • Find a condom that fits - Too large or too small and it won’t work well

  • Store the condom in room temperature - Condoms stored in wallets, purses or pockets should be replaced regularly

  • Condoms expire - Make sure that you know your condom is still safe to use

  • Don’t use damaged condoms - Get rid of condoms that have damaged packages, and be careful not to tear it when opening it

  • Condoms are single use, obviously -  Once used, throw them away.

  • Use the condom for the entire act of sex -  Put it on as soon as you start and make sure you’re wearing one (the same, or replaced when necessary) until the very end

  • Use sufficient lubricant (lube) - Always apply sufficient water-based lubrication, especially during anal sex. You can never use enough lube. AVOID petroleum jelly (such as Vaseline) at all costs since it weakens the condom and increases the risk of infection. It is also messy and uncomfortable, so “water-based” is what you should be looking for.

  • Be careful when removing the condom - Once finished, hold on to the condom while pulling the penis out of the vagina or anus, and then carefully pull the condom from the penis only when there no longer is contact with the partner’s body.  Make sure that no semen spills out

  • Dispose of the condom safely

Pre-Exposure Prophylaxis (PrEP)

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You probably have heard of PrEP, but we want to make sure that you get all the facts right.  Pre-Exposure Prophylaxis (PrEP) is a pill consisting of a combination of two drugs, which when taken correctly by HIV Negative people, is very effective in the prevention of HIV.  This is not a new or experimental drug, and although it has only been made available from local pharmacies lately, the drug has been credited for a drop in the rate of new HIV cases elsewhere in the world.  A study by The Kirby Institute in 2019 has shown how Australia saw a drop in rate to a five-year low (a decline of 23%) as a result of commitment by government, healthcare, the community and research sector, in amongst others, promoting PrEP among gay and bisexual men. 

REMEMBER - PrEP is effective only in the prevention of HIV.  It does not prevent Gonorrhea, Syphilis, Chlamydia and any other STI, all of which are on the rise in Malta.

Post-Exposure Prophylaxis for Sexual Encounters (PEP or PEPSE)

PEP is a combination of 3 anti-HIV medications that can be used in emergency situations, where someone is at risk of HIV transmission.  PEP must be started within 72 hours after a recent possible exposure to HIV but ideally within 24 hours of encounter. Every hour counts. The sooner it is started the better the protection from acquiring HIV. PEP is taken for 28 days and it is not side-effect free, so it should be a treatment of last resort. PEP currently costs between €450 and €600 depending on the treatment prescribed.

If you think you’ve recently been exposed to HIV during sex or through sharing needles head to the GU clinic at Mater Dei straight away (preferably within 24 hours, but maximum 72 hours) to obtain PEP treatment. If the GU clinic is closed then attend the Emergency Department (A&E) for a prescription. PEP must then be purchased from one of the following two pharmacies:

The GU Clinic recommends PEP in cases where:

  • A sex partner was HIV Positive and not on treatment

  • The partner belongs to a high risk HIV group.  This includes people who are from Central or SouthEast Asia, Sub-Saharan Africa, MSM (men who have sex with men) or Intravenous Drug Users (even if you did not engage in drug use yourself)

  • Anal sex and vaginal sex without condom

  • You shared an injecting needle with someone.

Once started, the GU clinic will follow-up to make sure that the HIV status remains negative.  It is important to state that PEP decreases the chances of HIV transmission, but does not guarantee a 100% success rate especially if the doses are missed or if treatment is not started soon enough.

What have we been doing?

We feel that preventive treatment is essential in ending the HIV epidemic. This is why we we feel that there should be no barrier to acquiring preventative treatment, such as PrEP and PEP. It is for that reason that we are campaigning to reduce the price of PrEP, and increase availability locally. With respect to PEP, against our best advise, this treatment carries a hefty cost of €450 to €600 depending on the treatment prescribed.  We are constantly trying to negotiate this price down, and have been pushing for it to be free of charge. But until then, please keep this cost in mind.

Last Updated: 22 August 2023 - Update on PEP