Six intravenous drug users have tested positive for HIV, figures from the Disease Surveillance Unit show.

Three of the men are Maltese and the other three are foreigners living in Malta. One of the Maltese citizens is living abroad.

The statistics obtained by The Times show that one of the Maltese, aged between 50 and 55, has died. The unit had been notified of the case in 2005.

HIV became a statutory notifiable disease in January 2004. That year the Disease Surveillance Unit was notified of one case of HIV among an intravenous drug user - a male foreigner aged between 25 and 30 living in Malta.

The following year the unit was notified of another case, this time the Maltese man who has since died.

This year the unit was informed of two cases of HIV among injecting drug users; both men were foreigners living in Malta, one in his late 20s and the other in his early 40s.

Earlier this year the unit was informed that two of the people who had tested positive for HIV before 2004 were intravenous drug users. Both were Maltese men aged between 30 and 35. One of them was living abroad. The unit does not have information whether the Maltese living abroad is still alive, a spokesman for the unit said.

Contacted for comments, a spokesman for Sedqa said it was difficult to establish where, when and how a person who exposes himself to risks on a regular basis had contracted HIV.

"Diagnosing someone with HIV locally does not imply that transmission of the virus happened locally. This applies to both the foreign and Maltese cases of HIV among local intravenous drug users," the spokesman said.

However, she said, the agency's impression is that the local injecting drug users who are HIV positive did not contract the virus through sharing needles. "This is based on information collected from the HIV positive individuals in contact with Sedqa."

The spokesman said the presence of HIV among intravenous drug users is of concern because it is known that these people tend to indulge in risk behaviours - both sexual and through needle sharing - more frequently than the general population.

"For this reason Sedqa workers incessantly educate those making use of our services about the importance of adopting healthier behaviours and practices and Sedqa's philosophy of service delivery includes harm reduction."

While applauding the free service of needle dispensing from government health centres since the early 1980s, Sedqa would like to see an improvement in it.

"We would like to see needle dispensing being improved to needle exchange, whereby, in a confidential way, individuals collecting needles are educated about the importance of returning used needles for their proper disposal. This would be a system which cares for the individual as a person rather than a craving drug addict just wanting to inject him/herself."

The spokesman said patients visiting the agency's detox centre are regularly seen by the physician. Blood tests - not solely for HIV - are carried out when it is indicated and routinely once a year. However, routine testing is not compulsory.

"But it is not testing which is most important - the most important thing is that people act responsibly toward themselves and others. This applies to everyone, not only to drug users."

Sedqa believes that most intravenous drug users are aware of its service and most manage to establish contact and engage with the service without much difficulty.

"We are however concerned about certain special populations, such as foreigners whose cultural background makes them perceive our services as not being relevant to their needs. Much work needs to be done to reach out to these individuals." This year, until the end of October, a total of 20 tests resulted positive, figures presented in Parliament this week showed. A total of 7,853 tests have been carried out this year.

The Disease Surveillance Unit has been notified of six cases of HIV-positive intravenous drug users:

2006 male 25-30 years foreigner
male 40-45 years foreigner
2005 male 50-55 years Maltese (died)
2004 male 25-30 years foreigner
pre-2004 male 30-35 years Maltese
male 30-35 years Maltese