Treatment for HIV
The current HIV treatment 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 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. As you will read later, Undetectable=Untransmittable, meaning that your partner is not at risk once the viral load is undetectable.
Your Relationship with your Healthcare Professional
The most important word that describes the relationship with your healthcare professional is HONESTY. They have seen many people, and have heard many stories. You will not be judged. Giving them the right information will help them make the right decisions for your own health and safety.
Your sexuality, gender identity, drug and alcohol use history and other health conditions will be kept secret and in strict confidentiality. They cannot, and will not, disclose any of it to your family, the police or anybody else.
How do I start Treatment?
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.
Side effects, interactions and drug resistance
Your healthcare professional will discuss potential side effects and interactions before prescribing HIV medicine.
Side Effects
There may be some side-effects from ART and they vary from person to person. Nevertheless most side effects are manageable and only few can be serious. Keep in mind that the side effects of ART treatment outweigh both the benefits of ART and the effects that untreated HIV can have on the body’s immune system. Luckily, HIV Medicine keeps improving, reducing side effects.
Drug Interactions
Like any other medicine, HIV medicine can interact with other medicines, and this includes vitamins, supplements and herbal products. It is important to discuss your lifestyle and any other drugs being taken with your healthcare professional in order to ensure that the ART regime is working effectively.
Drug Resistance
Every virus has the ability to change, and make variations of itself. That is the case with HIV as well. When this happens, there is a chance that HIV could become resistant to the medication. This happens mostly when there is a poor drug adherence, which means that the medication is not taken exactly as prescribed, every day.
Recreational Drugs and Alcohol
Drugs and alcohol may weaken the immune system and thus make it harder for the body to fight off infections and certain cancers. They also have an effect on the liver which makes it difficult for the body to remove toxins.
Recreational drugs may interact with HIV medication, and increase the risk of side effects. It is also statistically seen that PLHIV who use drugs and alcohol struggle more to stay healthy and to stick on their HIV regime.
Access to HIV Treatment
Will I need to pay for HIV Treatment?
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.
I am an EU national and have received a job offer in Malta. Do I have to pay for HIV Medication?
EU Nationals who work in Malta will have a National insurance number, and pay local National insurance contributions. This entitles you to access the Maltese health service, on the same level as Maltese citizens. Once you have your NI number and your residency card in Malta you can register for the local health service by applying to the Entitlement Unit . Occasional drug substitution may need to take place. The aim will be to approximate as close as possible the treatment regimen you may already be on.
Is it possible for HIV+ persons from a non-EU country (third country nationals), to live and work in Malta?
It is possible for a third country national to get a work permit however a health insurance policy may be required. Keep in mind that health insurance premiums may be affected by HIV status. Access to free health care depends on whether the Maltese government has any bilateral arrangements with the country of origin. Health screening is carried out and documentation is collected by Identity Malta. Please refer to Identity Malta’s guidelines here for a full list of all processes and documentation required.
Should I come to Malta without a stable job guarantee?
HIV treatment is not free for those who are not legally employed in Malta. Please visit Travelling to Malta for more details about this.
Sources
Last Updated: 26 February 2023
