The recently launched National Sexual Health Strategy 2025-2030 presents comprehensive actions to improve sexual and reproductive health (SRH) in Malta. This strategy aims to address gaps in sexual health services, promote inclusivity, and ensure equitable access for all individuals, especially vulnerable groups. The proposed actions are set against the backdrop of Malta’s evolving social, demographic, and health realities.

• Demographic Changes: Malta’s population is becoming increasingly diverse, with over a quarter of residents being foreign-born, many from countries with different sexual health norms. The influx of migrants, particularly in urban areas, and the annual presence of over 2 million tourists further complicate the sexual health landscape.
• Legal and Social Reforms: Over the past decade, Malta has implemented significant legal reforms, including lowering the age of sexual consent from 18 to 16 years and advancing gender equality through the introduction of marriage equality and non-discrimination laws. Despite these advancements, sexual violence and intimate partner violence remain pressing issues that require continued focus.
• Health Behaviours and Attitudes: The National Sexual Health Survey (NSHS) revealed that many young people in Malta begin sexual activity between 16-19 years old, with significant gaps in the use of protection. About 40% of respondents use condoms during their first sexual experience, but this is lower for oral or anal sex. Additionally, contraception methods are not uniformly used, and a concerning number of individuals do not disclose information about their sexual health choices.

Proposals for Sexual and Relationship Education (SRE)

• Age-appropriate Education: The strategy advocates for expanding Sexual and Relationship Education (SRE) across schools, providing students with evidence-based, comprehensive education that spans emotional, physical, and social aspects of sexual health. Special emphasis will be placed on creating inclusive curricula for students with disabilities and from diverse cultural backgrounds.
• Youth Awareness: With 30-40% of adolescents sexually active by the age of 16-19, it’s crucial that they have access to the right knowledge to make informed decisions. The government plans to use schools, community outreach, and digital media to reach young people, providing them with the necessary tools to prevent STIs and unwanted pregnancies.

Improving Access to Sexual Health Services

• Contraceptive Access: One of the key proposals is to ensure universal access to contraceptive methods, including barrier methods like condoms and long-acting reversible contraceptives. The strategy also aims to make emergency contraception widely available.
• HIV and STI Testing Expansion: The strategy seeks to increase the availability of HIV and STI testing by expanding community-based services and integrating self-testing kits. With rising rates of STIs like chlamydia, gonorrhoea, and syphilis, testing services will be scaled up to reach key populations more effectively.
• Treatment for HIV and STIs: For people living with HIV (PLHIV), free access to antiretroviral treatments (ART) will continue, with efforts to expand PrEP (Pre-exposure Prophylaxis) and PEP (Post-exposure Prophylaxis) to high-risk groups.

Addressing Vulnerable Groups and High-Risk Populations

• Migrant and LGBTIQ+ Support: The strategy recognises the unique challenges faced by migrants and LGBTIQ+ persons, who may face cultural, social, and linguistic barriers to accessing sexual health services. Tailored services will be designed to meet their specific needs, with a focus on harm reduction for those at high risk of HIV, such as men who have sex with men (MSM) and people who inject drugs (PWID).
• Sexual Violence and Abuse: The document highlights the prevalence of sexual violence and intimate partner violence, expanding on the need for stronger prevention measures and support services for victims. The strategy aims to integrate sexual violence awareness into educational programmes and ensure victims have access to timely medical and psychological care.

Integration of Health Services

• Decentralisation of Services: To ensure that sexual health services are easily accessible, the strategy proposes decentralising genito-urinary (GU) services to primary and secondary care settings. This will help alleviate pressure on hospital services and reduce waiting times.
• Telemedicine and Digital Health: As part of improving service delivery, the strategy promotes the use of telemedicine and other digital health tools. This will particularly benefit individuals in remote areas or those who may face challenges accessing in-person services.

Gender and Sexual Rights

• Non-discrimination: The strategy affirms the government’s commitment to upholding the sexual and reproductive rights of all individuals, including those from marginalized groups. It stresses the importance of gender equality and non-discrimination in all aspects of sexual and reproductive health.
• Transgender and Gender-Diverse Care: Special attention is given to transgender and gender-diverse individuals, ensuring access to gender-affirming care and services. The strategy seeks to foster an inclusive environment where all genders can access the care they need.

Research, Data Collection, and Monitoring

• Ongoing Research: To ensure that services are continuously improved, the strategy calls for regular national surveys and research into the sexual health behaviours, attitudes, and needs of the population. This will help inform future policies and ensure that interventions are evidence-based and responsive to emerging challenges.
• STI and HIV Surveillance: Enhanced surveillance systems will be implemented to monitor trends in STI and HIV rates, ensuring that public health responses are effective and resources are allocated where they are needed most.

Żgħażagħ Laburisti has expressed its strong support for the launch of the public consultation. In a press release, they held that the strategy’s holistic approach, which covers areas such as accessible medical services, family planning, education, and prevention, will have a lasting positive impact on the health system. They also stress the importance of having an open and inclusive dialogue on reproductive rights, contraception, and sexual education to address misconceptions, promote informed decision-making, and empower individuals to make choices that align with their personal values. Żgħażagħ Laburisti calls on the public, especially young people, to actively participate in the consultation process and share their views to help create a system that works for everyone.

You can have your say here and access the consultation document here.