PrEP

As a debate rages about NHS funding for HIV-preventing drugs, Peter Swallow explains why he wants PrEP now.

Sex terrifies me. I’m a gay man – how can it not? I know the statistics.

Over 3,000 new transmissions of HIV for men who have sex with men in 2014 alone. One in 20 gay and bisexual men living with the disease – one in eight in London, where I live.

Condoms aren’t 100% effective and potential partners are most infectious when first exposed, when they don’t even know they’ve caught it.

Being HIV positive is nothing to be ashamed of, and it’s heartbreaking to see so much stigma attached to the condition.

Poz men can now expect to live long and healthy lives thanks to excellent new medications. But contracting HIV is still a very real threat for every gay or bisexual man, and not something I never want to do.

Thankfully, there’s a new HIV-preventing drug regime on the scene that could allay my fears – PrEP. Studies have shown it to be about as effective as condoms.

When used together, these methods could make it all but impossible for someone to contract HIV.

Although it should be used alongside condoms, PrEP (AKA Pre-exposure Prophylaxis) can also be the best solution for those who have sex under the influence of alcohol or drugs, as it can be taken before intoxication occurs.

The PROUD study looking into PrEP effectiveness saw an 86% reduction in HIV transmission rates from those taking it – and although it originally also used a ‘control group’ of people only taking placebos, the drug was so effective it felt compelled to switch the placebo group onto PrEP too.



I have been waiting for the drug to become available on the NHS for a long time now. And every time I think we’re about to get it, every time I think I’m going to be able to feel safe and confident about sex again, it’s taken away.

The PROUD study would be done to make sure it really worked to cut infections – fine, sounds sensible, I could wait.

Then the study reported, demonstrating that PrEP worked beyond any expectation! Even David Cameron said it could ‘make a difference’.

But NHS England, instead of rushing the drug through approval and making it available to at-risk groups, questioned its cost effectiveness and argued that they weren’t responsible for HIV prevention so shouldn’t have to offer it.

The battle was taken all the way to the High Court, where NHS England lost. But instead of accepting responsibility, and taking the opportunity to save thousands of people from HIV, they decided to appeal the case instead.

For me, this is a dereliction of duty.

The NHS is there to make us healthy, but it seems when it comes to the LGBTQ+ community, they aren’t interested.

Let me be very clear: I don’t want to take PrEP so I can get high, go to a sauna and enjoy bareback sex with a bunch of anonymous men – although I am aware that a small minority of gay men do enjoy that, and I don’t think we should leave them without protection.

PrEP isn’t a party drug for me. It’s not a ‘lifestyle drug’ or a ‘promiscuity pill’ as the Daily Mail so colourfully put it on their front page today, and I don’t see it as an invitation to throw out all my condoms either.



It’s a drug that will allow me to enjoy sex – something we all have – completely, without the constant fear that the condom might slip, bodily fluids might cross over, I might get infected.

It’s a drug that will allow us to really, for the first time ever, take the fight to HIV, substantially cut infections, and work towards a HIV-free future. It’s nothing short of a medical marvel.

So I will continue waiting, hoping, praying for PrEP. And meanwhile, whilst the NHS dithers and delays, hundreds more gay people like myself will contract HIV.

The human cost of this battle for protection.

Peter Swallow is a PhD candidate at King’s College London