One argument you see amongst those critical or worried about the introduction of PrEP is that it will result in big increases in STIs as gay and bisexual men (and indeed others at risk of HIV) throw away their condoms. But does the evidence support such fears? And as importantly, what do those fears tell us about our views of HIV and gay sexual health?
NAT responds to the Government announcement of a NICE Evidence review on PrEP
Jane Ellison MP, Parliamentary Under-Secretary of State for Public Health, announced on Tuesday 7 June in the House of Commons a NICE Evidence Review to look into the case for PrEP, and in particular its cost-effectiveness. The review should report in advance of the previously announced £2m pilot towards the end of the year, and will apparently feed in to that pilot.
In March, NHS England announced it was pulling the plug on an 18 month process to decide whether or not to fund pre-exposure prophylaxis (PrEP) for HIV.
Rarely has a u-turn, rarely has a breach of trust, been so misleadingly announced. Reading NHS England’s press release, ‘Update on commissioning and provision of PrEP for HIV prevention’ (21 March 2016), you would think the NHS were simply clarifying progress to date and the well understood responsibilities for the commissioning of PrEP. In fact this press release was the announcement of a shocking U-turn as NHS England suddenly abandoned its own process for the approval of PrEP, just before its conclusion, with nothing to replace it bar some loose change found down the back of the sofa.
Recently-released official statistics show that last year, there were just over 85,000 people accessing HIV treatment and care in the UK. Almost all (91%) of this group were on antiretroviral treatment (ART) and 95% of those on ART had achieved ‘viral suppression’ – this means HIV can no longer be detected in their blood and they can consider themselves ‘non-infectious’.
Last year saw a record number of gay and bisexual men diagnosed with HIV in the UK. 1 in 17 gay men aged 15-59 are now living with HIV, rising to 1 in 8 in London. This compares to 1 in 360 of the UK population as a whole.
Last week the US Centre for Disease Control (CDC) issued the first formal guidelines on pre-exposure prophylaxis (PrEP), a promising new way of preventing HIV transmission. PrEP involves people who do not have HIV taking a daily dose of one or two of the drugs that are used to treat HIV. Studies suggest that this can prevent transmission if the user is exposed to HIV.
