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PrEP Is Nothing Short Of A Game-Changer, Now It's Time For NHS To Do The Right Thing

10/11/2016 15:36
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Every day 17 people are diagnosed with HIV here in the UK. I was one of these people in 1996.

Today I am healthy and will live into older age, but I'm on treatment for life and the virus is still stigmatised in a way that many other health conditions aren't. Meanwhile the HIV epidemic has not gone away in the UK.

Pre Exposure Prophylaxis, or PrEP, is nothing short of a game-changer for HIV - a HIV drug taken by HIV negative people to stop infection. This is something I could only dream about twenty years ago. If used alongside condoms, regular testing and treatment, it could be the vital piece of the puzzle to help end the HIV epidemic here in the UK for good.

That's why here at Terrence Higgins Trust we're relieved that the Court of Appeal upheld a High Court judgement which ruled NHS England has the legal power to fund PrEP.

Two courts have now ruled that NHS England has the legal power to fund PrEP. It's time for NHS England to do the right thing and respect its legal duty to consider funding this highly effective treatment.

No doubt there will be a great deal of public and media commentary surrounding this latest development in what continues to be a hard-fought battle to see PrEP available to those at risk.

But it is vital to listen to the voices of those who could benefit the most - people who, without PrEP, may have become HIV positive.

Randeep, a former biology teacher who now works for a health tech startup, is one of the people here in the UK who knows the power of PrEP. He told me that the fear of HIV has always hung over him, but being on PrEP as part of the PROUD trial gave him the reassurance he wasn't going to become HIV positive. He told me, 'PrEP and condoms aren't mutually exclusive - condoms can break. PrEP offers another layer of protection for those most at risk.'

Randeep know knows he cannot acquire HIV, or pass it onto others, and won't need lifelong HIV treatment from the NHS. For him, PrEP was for a year. He's now in a relationship and doesn't need PrEP, but in the future he may need to protect himself again.

This is a powerful reminder that this isn't about replacing condoms, or offering PrEP for everyone, for life - it's about protecting people for as long as they're at risk.

It is also important to recognise the personal and active decision that people are taking by accessing PrEP. Far from being irresponsible risk-takers, people who take PrEP are acting responsibly to protect themselves and others against HIV.

People like Jamm, who lives in Brighton and who has taken control of his sexual heath by buying generic PrEP from the internet from India. He describes himself as 'lucky' that he can afford to protect himself this way, but many can't.

The NICE review has pointed to reassuring evidence from major trials which shows PrEP did not lead to increased sexual risk taking. In the PROUD trial, there was not a statistically significant increase in other STIs.

Deeming people as 'promiscuous' for taking control of their sexual health is reminiscent of how women were treated in the 1960s for taking the contraceptive pill - this is unacceptable.

The reality is that many people taking PrEP have told us they are more aware than ever of other STIs and their overall sexual health has improved, as they more regularly attend sexual health clinics. This is backed up by World Health Organisation guidelines which say that PrEP increases opportunities for access to other sexual health services.

And as Jamm put it, PrEP 'mathematically makes sense' - it's using prevention to stop people becoming HIV positive will save the NHS money. The longer PrEP isn't available, the more money the NHS has to spend.

Today, after two years of confusion and buck-passing, we finally have clarity on who has the power to fund PrEP. The next stage in the process will see PrEP have a fair chance of being considered for funding as part of NHS England's specialised commissioning process. This requires leadership from NHS England and from Gilead, the manufacturer of PrEP, to make this prevention both available and affordable.

So we're still some way off PrEP being made available to those most at risk; but thanks to today's ruling, we are now one step closer to a world without HIV transmissions.

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