NHS England lags behind rest of UK for preventative HIV medication


A groundbreaking drug that prevents people from contracting HIV is still not covered by the NHS, despite the High Court demanding it does so.

Pre-exposure prophylaxis, more commonly known as PrEP, has been around since 2012 but was until recently only accessible at a premium cost.

But still, even with costs decreasing, NHS England refuses to foot the bill. Instead the service opted to run a PrEP Impact Trial, initially capped at 10,000 participants and now raised to 26,000 due to demand.

Through this, it intended to see what benefits the introduction of PrEP would have and how the service could roll it out on a larger scale across England.

But the benefits are already widely known. Countless studies have proven that, if taken correctly, it is almost 100% effective, meaning users will not be infected even when having unprotected sex with someone who is HIV positive.

But some religious bodies and media outlets have attempted to drum up moral outrage concerning the High Court’s decision.

The front page of the Daily Mail derided the court for funding a “lifestyle drug” and “promiscuity pill”, while a national television news programme led its coverage with a story on “free £20m drug for gays who won’t use condoms”.

It was suggested that tax contributions used to cover the costs of PrEP were tantamount to paying for gay men to have unprotected sex and would stop the NHS from paying for cancer treatment.

The idea that a drug will make people more promiscuous was also touted back in the ’60s, when the female contraceptive pill was introduced. The economic issue is also often wrongly argued, with NHS England saying it would be too costly to implement nationwide.

However, Ian Green, CEO of the Terrence Higgins Trust, says: “What we know is that [the] lifetime cost of treating someone with HIV is over £300,000.

“The cost of generic PrEP is now around £20 a month, so it is absolutely cost effective.”

The charity, which campaigns on and provides services relating to HIV and sexual health, has also launched a fund to supply the drug to 1,000 people on no or low incomes who cannot get on the trial or afford PrEP themselves.

They fear that, while the NHS delays the move to fund the drug, more and more people will become infected with HIV who should have otherwise been safe.

And while the trial is a positive step in the right direction, it still lags behind Scotland, where PrEP is provided on the NHS, and even in Wales where they have a large scale, uncapped trial.

Further critique surrounds the need for the trial at all, considering that countless international studies have already shown the benefits PrEP has for the LGBTI community, as well as the women and heterosexual men who are also at a higher risk of getting HIV.

But despite this all taking a long time, the increased use of PrEP in the UK has still helped lower the rates of new HIV cases in the UK.

The estimated annual number of new infections acquired by gay, bisexual and other men who have sex with men in the UK has more than halved from its peak around 2012 – the same year PrEP was introduced to the market.

This goes hand-in-hand with new medication which leaves HIV positive men with a ‘non-viral load’.

That means even though they have HIV, they are unable to spread it to anyone else, even if they have unprotected sex and the other person is not on PrEP.

There have been some outstanding medical discoveries surrounding HIV in the past decade; NHS England just needs catch up with it.

Lead Image by Dylan Lee courtesy of Terrence Higgins Trust