Times: Male prostitution seen as a major cause in HIV increase

http://www.timesofmalta.com/articles/view/20150726/local/male-prostitution-seen-as-a-major-cause-in-hiv-increase.578120
Sunday, July 26, 2015, 12:01



The number of HIV cases confirmed so far this year has already reached the annual average, with drug abuse, male prostitution and migration highlighted as major causes.

Figures compiled by the Health Ministry show that while an average of 30 HIV cases is diagnosed each year, 31 cases have already been confirmed since January.

Sources at the government’s Disease Prevention Department said the situation could get worse, as the figure was expected to increase throughout the summer months.

Normally, the figures show that around 70 per cent of HIV cases are foreigners. This year, however, more local HIV sufferers were diagnosed than foreigners – for the first time since 2008. Around 85 per cent of the cases are male. In 2009, HIV-positive cases quadrupled – from between seven and 10 cases a year – to about 30, a spike believed to coincide with the migrant influx at the time.

Despite making up just one per cent of the population, 40 per cent of HIV cases in the past three years involved migrants.

Public Health consultant Anna Vella said there was a link between HIV and male prostitutes, who were more likely to have unprotected sex and were even being paid more to do so.

“This is a reality. Gay prostitution is more promiscuous and more dangerous,” she said.

Dr Vella said male prostitutes were often recipients in the sexual act, which often put them at risk of physical violence.

“If you look at diseases like Hepatitis C, we reached a point when there was a large enough pool for it to spread rapidly. If that happens to HIV then it could spread very quickly,” she said.

Still, HIV spread had not yet reached critical mass and could be contained, she said.

Narcotics expert and policy consultant Michael Grima pointed towards intravenous drug abuse as a major factor behind the spread. “Although we have an immensely successful free syringe disposal system, the indirect problems linked to syringe use that persist in spite of our efforts,” he said. Dr Grima said that while most drug users were not sharing needles, they shared substances that could lead to the contraction of diseases. “If an infected person sticks his used syringe back into the heroin spoon, he risks contaminating the entire batch,” he said, adding that he had encountered a few of these cases over the year.