NHS should prioritise cancer care over risky gay sex
by Jane Kelly, The Conservative Woman:
On Tuesday 2nd August a High Court judge ordered the NHS to provide daily pills to 10,000 gay men who don’t have HIV but are at high risk of being infected through unprotected sex. It will cost taxpayers in England £400 a patient, about £20 million a year.
The drug, Truvada, pre-exposure prophylaxis, known as PrEP (Prep) is given to high-risk groups, mainly young promiscuous men. It’s currently used in the US, Canada, Australia and France to help protect the most at-risk gay men. Alex Craddock who runs a website called, ‘I Want Prep Now,’ told Channel 4 News that he currently orders a generic version of Prep online from India at £45 a month.
NHS England which funds drugs for cure, rather than prevention, had refused to prescribe Prep. It argued that because it is a preventative medicine, it should be funded by local councils. It also stated that spending on Prep might mean they couldn’t afford other treatments; such as drugs for children with cystic fibrosis, stem cell transplants for a rare blood cancer, and prosthetic knees for amputees. They were challenged by the National Aids Trust charity and the High Court ruled there was nothing to stop the NHS from paying.
Studies have shown Prep reduces the risk of getting HIV from sex by more than 90 per cent when used consistently. Among people who inject drugs, it reduces the risk by more than 70 per cent when used regularly. Those figures are what is achievable with responsible use and many of those most at risk are unlikely to take the pills regularly. The authoritative Cochrane Review was less reassuring. Results from four trials which compared the drug versus a placebo showed a reduction in the risk of acquiring HIV infection by about 51 per cent.
There is evidence of a dramatic fall in condom use among men taking the drug, leaving them exposed to other infections. A recent French study found that condom use declined to just 24 per cent among men taking Prep. There is a chance that the HIV virus may evolve to become resistant to Prep resulting in a much deadlier strain. Michael Weinstein, president of the AIDS Healthcare Foundation in the US, voiced concern ‘about the potential for overall spread of the virus as well as other sexually transmitted diseases for which Prep offers no protection.’ In February, doctors reported the case of a 43-year-old gay Canadian man who tested positive despite taking Prep for two years.
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