When NHS England stated that they wouldn’t routinely fund PrEP earlier this year, stating that local councils are responsible for providing preventative health services (and provoking a debate about the issue), the National Aids Trust decided to take them to court.
Today, they won the High Court case, and the NHS has officially been given the legal green light to provide PrEP, yet it has appealed the court’s decision.
PrEP, which stands for pre-exposure prophylaxis, involves people who are HIV-negative taking the anti-retroviral drug Truvada every day to prevent future infection (just like taking the contraceptive pill to prevent pregnancy). It is highly effective, as using PrEP carefully has been proven to reduce the risk of HIV infection to almost 0. In a San Francisco study published last year where 600 people took a daily dose of oral PrEP for a 32-month period, not one of them contracted HIV.
The American CDC (Center for Disease Control and Prevention) advised that PrEP should only be taken by those who are most high-risk of contracting HIV, which includes those who have an ongoing sexual relationship with an HIV-positive partner, gay or bisexual men with a history of not using a condom and of STI infection, or heterosexual people who are in sexual relationships with high risk partners. In the UK it is MSM (men who have sex with men) who are most at risk and who will therefore benefit the most from taking PrEP.
The push to administer PrEP on the NHS hasn’t been without controversy. There are many who complain that the NHS should not have to fund those who could simply be using a condom during sex, arguing that the public would effectively be paying for their ‘hedonistic’ lifestyle.
However, not only is PrEP cheaper than HIV treatments (so it actually saves us money in the long-run), but it was previously estimated that if the NHS provided PrEP, we could prevent 10,000 new cases of HIV by the end of the decade.
As the NHS has appealed the court’s decision and will not be forced into administering PrEP regardless of the case’s outcome, the future doesn’t look too hopeful. But we’re hoping for a U-turn. Having PrEP available on the NHS would be a massive step towards tackling HIV in the UK, and would shape and change so many lives. It’s all in the hands of the NHS.