OPINION: PrEP needed today, not tomorrow

Published: 06 June 2016 Tags: condoms, hiv, prep By John Walding

Rob Cookson, Deputy Chief Executive of LGBT Foundation shares his personal views on the recent decision by NHS England not to commission PrEP - the drug that could halt the spread of HIV...

Imagine the scene. It’s the year 2030 almost half a century since the world first became aware of the destructive powers of HIV/AIDS and for the first time ever there have been no more newly acquired HIV infections. HIV is not being transmitted from person to person, we have effectively stopped HIV in its tracks. HIV, an infection which around 37 million people across the globe are living with; of which there are over 100,000 people living with HIV in the UK.

Imagine that day in 2030 when finally we hear the news that we have all been waiting for , the war on HIV is being won. No more newly acquired HIV infections. We have begun to turn the tide around and we are winning our battle with HIV, one which so many people have fought with bravery, talent, determination and friendship for so long.

Could this ever happen? Well, PrEP has the potential to make this day possible for all of us.

What is PrEP?

PrEP stands for pre-exposure prophylaxis. It’s a way of preventing HIV infection by taking a pill on an ongoing basis before sex. It’s taken by someone who doesn’t have HIV, to prevent them from acquiring HIV. Last week, NHS England made the announcement that they do not have the legal power to commission PrEP. They say they can’t legally commission PrEP as it is a prevention intervention (as opposed to treatment).

All of this means that PrEP isn’t going to happen any time soon. We aren’t going to win the battle against HIV as we had hoped.

Why does this matter?

It matters because 17 people every day in this country are newly diagnosed with HIV. Whilst there are lots and lots of people living with HIV who are leading happy, healthy and successful lives, there is often a word which crops up in conversation certainly when I’m talking to my mates who are living with HIV: Stigma. It’s a short, simple word, but can have devastating effects on people’s lives; treating people living with HIV as if they are sub-human, lesser mortals, even worthless.

It is also far too easy to forget that people still die of AIDS-related illnesses. Sometimes we don’t hear that enough and maybe we need to say that much more loudly? Did you know that in 2014, 613 people in the UK died of AIDS-related illnesses? Across the globe, since the beginning of the epidemic almost 71 million people have acquired HIV, and about 34 million people have died of AIDS-related diseases. Stigma and death - two powerful reasons why we all need to keep talking about HIV and finding new, additional ways to prevent HIV transmission.

What about condoms?

So where does PrEP come into all of this? It’s correct to say that there are mixed views about PrEP.

Follow conversations on social media and it is easy to see that some people say that PrEP is an excuse for people to have unprotected sex. A question I often get asked is ‘Why don’t gay men just use condoms?’ There’s an easy response – many gay men already do. Correct and consistent condom use remains a key way of preventing HIV, but we also need to give men who have sex with men, and other higher risk groups, all the tools at their disposal to end HIV. Condoms are effective at preventing HIV and other Sexually Transmitted Infections but more needs to be invested to ensure that the health of our communities is the best that it can be and that we are not putting further burden on the NHS through waiting for people to get ill before we treat them, in effect shutting the stable door after the horse has bolted.

PrEP isn’t the magic bullet. On its own, it won’t end HIV. But, if used correctly, it is proven to prevent HIV by almost 100%. At school I was never great at maths but PrEP provides a simple equation which means that ending HIV is now possible: testing + condoms + PrEP = an end to HIV. It will help to kick stigma into touch. It will help to stop people getting sick and dying.

Maybe NHS England needs to go back to school and have a maths lesson?

Prep is needed today, not tomorrow.


Further Info

Prepster: Educating and agitating for PrEP in England and beyond.

The latest thinking on HIV prevention from National Aids Trust.

Further background information regarding PrEP.