The Malta Association of Public Health Medicine congratulates The Maltese Association of Dermatology and Venereology & The Genitourinary Clinic at Mater Dei Hospital for having selected Women’s Sexual Health as their conference theme this year.
Tackling sexual health should be a key public health priority for Malta in the coming years. Whilst Malta is progressing well towards the attainment of the health-related sustainable development goals (SDGs) on many indicators, a poor score was registered for the SDGs targeting reducing HIV incidence and adolescent birth rates. The Malta Association of Public Health Medicine recalls that in 2011, the first National Sexual Health Strategy for the Maltese Islands was launched with the aim of developing a holistic approach towards sexual health.
Since then, Malta has experienced a number of social and cultural changes. Examples of such changes are the legalisation of divorce, the licensing of the sale of the emergency contraception “morning-after pill” and major changes in legislation pertaining to lesbian, gay, bisexual and transgender (LGBT) rights.Malta has also experienced increased immigration over the past decade.
Findings from the European Health Interview Survey carried out locally in 2015 indicate that 8% of adults report having had their first sexual intercourse by the age of 15 years. Compared to previous surveys the average age of first sexual activity in women has gone down from 21 to 18 years over the past decade.
Only 33% of males and 39% of females aged 15-24 report using contraception every time they have sex. Contraceptive use is more common amongst those with higher levels of education and lowest amongst individuals with the lowest level of education. Furthermore, women with lowest education levels use the withdrawal method as the commonest form of contraception, while the condom is the most commonly used contraceptive method in women with higher levels of education.
Only 33% of males and 39% of females aged 15-24 report using contraception every time they have sex.
All of the above has led Malta to experience a changing picture when it comes to various sexual health issues. The seriousness of the situation is clearly reflected in the sharp and steady increase in the number of reported sexually transmitted infections (STIs) such as Chlamydia, Gonorrhoea, Syphilis and HIV as well as the emergence of highly resistant Gonorrhoea. In 2016, 58 newly diagnosed persons infected with HIV were reported compared to the 17 new cases reported in 2010.
Whilst teenage pregnancies have been declining for the past decade, the rate of teenage deliveries is significantly lower in independent and church schools, when compared to state schools and overall, remains relatively high when compared with other EU countries.
MAPHM is, therefore, proposing an urgent call for action to increase awareness of STIs and HIV infections and ensure that high-risk individuals are tested and treated
MAPHM is, therefore, proposing an urgent call for action to increase awareness of STIs and HIV infections and ensure that high-risk individuals are tested and treated. There is also the need to reach out to non-Maltese nationals through education and access to free testing. MAPHM also calls for an evaluation of the 2011 National Sexual Health Strategy and for a new sexual health action plan to be issued for public consultation. Priorities in this action plan should be based on the best available local epidemiological data on the burden of disease. Measures and actions regarding health promotion, health care service provision and research/surveillance should be selected for implementation on the basis of the strength of international evidence on cost-effectiveness, the extent to which they address inequity and their cultural appropriateness in the current Maltese context. The need for investment into human resources is urgently needed as well as government commitment to a longer-term plan.
MAPHM wishes to highlight the immediate need to identify, target and support women in vulnerable situations including those with low educational attainment and who are neither in employment nor in full-time education. Empowerment of young women through health literacy programmes and easy access to contraception may go a long way to prevent STIs and unwanted pregnancies.