‘At risk’ healthy gay men should be given daily pill to prevent HIV, says study

If healthy gay men were given antiretroviral human immunodeficiency virus  (HIV) medication, infection rates could drop by as much as 59%, with 10,000 less new cases of HIV by 2020, according to the calculations of a new study.

The study, published in The Lancet HIV, has called for the preventative method, known as pre-exposure prophylaxis (PrEP), to be offered on the NHS, which could have the possibility of reversing the epidemic.

The expensive PrEP two-drug pill known as Truvada is already being used with major success overseas, such as in the US and France, although there are worries the drug may result in more people not having protected sex with condoms.

Antiretroviral drugs cannot cure the HIV disease, but can keep the virus in check and stop it spreading around the body.

According to estimates in 2014, around 103,700 people are living with HIV in the UK, with 18,100 (17%) of people being undiagnosed and unaware they have the disease. Of the 103,700, approximately 43% were men who have sex with men, which was equivalent to 4.9% of gay men in this category aged between 15 and 44.

Therefore, health experts in England are considering the prospect of offering the £5,000-a-year pill to at-risk men. The £50million scheme could be available in clinics around the country this year, The Times has reported.

Last year, a UK test on 500 men assessed the effectiveness PrEP as a measure of preventative HIV transmission. The indications were that 1 case of HIV could be prevented for every 13 men given anti-HIV drugs during the course of a year.

This led to scientists from the London School of Hygiene and Tropical Medicine mathematically modelling the impact of introducing such a treatment nationwide across the UK. They calculated that there would be around 16,955 new cases of HIV in gay men by 2020.

However, by giving PrEP to the most sexually active 25% of gay men, this would help to prevent 7,399 infections (44%).

“Current prevention efforts in the UK that focus on correct and consistent condom use and regular HIV testing have been falling short,” Dr Narat Punyacharoensin, of the London School of Hygiene & Tropical Medicine, and the study’s lead author, said.

“Our results show that pre-exposure prophylaxis offers a major opportunity to curb new infections and could help reverse the HIV epidemic among men who have sex with men in the UK.”

As highlighted earlier, a major concern many people have with PrEP is whether men who are taking antiretroviral medication as a prophylaxis would then be more likely to take risks, such as having unprotected sex. However, the study suggests that there would still be benefits from a pre-exposure prophylaxis programme, if this was the case.

Professor Noel Gill, head of Public Health England’s HIV and STI department, who co-authored the report, says in a statement: “The findings imply that a pre-exposure prophylaxis programme could be an important addition to current efforts to prevent HIV transmission in England. Public Health England has provided much evidence to NHS England to help inform their decision analysis process. This evidence includes studies on the cost-effectiveness, the budgetary impact, and public health impact of a possible publically funded HIV pre-exposure prophylaxis policy.”

Dr Punyacharoensin added that there would need to be a 75% rise in unprotected sex in order to make the method counterproductive.