‘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.

FDA gives the green light for HIV preventive medication

HIV (human immunodeficiency virus) is one of the world’s most deadly infections. It starts by attacking the body’s immune system (our natural defence against infection and disease). If left untreated, HIV can then develop into AIDS, meaning the sufferer is at a very high risk of catching infections due to the weakened immune system and in particularly the risk of pneumonia or cancer is huge. The disease is primarily transmitted by unprotected sex, contaminated blood transfusions and hypodermic needles, or from an infected mother to baby during pregnancy or breastfeeding.

In 2010 it was estimated that 34 million people around the world have HIV. It is especially prominent in middle to low income countries, however even in the UK it is believed 86,500 people have HIV and in 2009 there were 6,630 new cases diagnosed. The disease is often described as a ‘pandemic’ and is one of a number of conditions that is a massive global issue for health authorities to try and tackle such as asthma, malaria, cardiovascular disease and obesity.

With all this in mind, a milestone may have been reached on Monday when U.S. health regulators the Food and Drug Administration (FDA) gave their approval to an existing medication to be used as a preventive measure, which could potentially drastically reduce the risk of contracting HIV. ‘Truvada’ as it is named, is a small blue tablet that is to be taken once daily. It has been manufactured by the Californian pharmaceutical company Gilead Sciences since 2004 for those who already have the virus.


Indeed one study conducted back in 2010 showed that Truvada reduced the risk of HIV in healthy gay men by 42% when used with condoms and the men were given counselling as well. Also in a clinical study involving heterosexual couples in Africa, a 75% decrease in transmission rates was evident. For this study, one partner had HIV, whilst the other did not.

Before receiving a prescription for the medication, patients must undergo a HIV test to make sure they do not already have the disease. There are concerns that the virus could develop a resistance to the drug, which those who are currently infected already take together with another drug. One major stumbling block for the average person will obviously be the financial aspect of the medication. Gilead Sciences say that just one year’s supply will set you back a whopping $13,900. Although financial assistance is available for HIV-positive patients, those testing negative will have to shell out for the entire cost.

Despite the promising signs shown in the clinical trials, there are those who are against the FDA’s ruling, fearing it could pave the way for a reckless attitude when it comes to sexual health. Michael Weinstein, president of the AIDS Healthcare Foundation in Los Angeles, told reporters in a conference call, “Today marks a catastrophe in the fight against HIV in America. If you look back five years from today, you will see this decision by the FDA will cause there to be more infections, not less.”

However, FDA officials have spoken out and counteracted Weinstein’s predictions. Dr Debra Birnkrant, FDA’s director of antiviral products, said, “What we found was that condom use increased over time and sexually transmitted infections either remained at baseline levels or decreased. So in essence, we don’t have any strong evidence that condoms were not used or there was a decrease in condom use.”

As highlighted by Dr Birnkrant’s statement, condom use in men is vital to absolutely minimising the risk of contracting HIV, or many sexually transmitted infections that are currently rife such as chlamydia, gonorrhoea, herpes and many more. Medical Specialists Pharmacy made the headlines on Gay UK News last year after we teamed with Mates Condoms to give away free condoms for one week to all men who obtained any erectile dysfunction medications such as Viagra. This was to promote World AIDS Day on 1 December, and you can read more about that within the ‘in the press’ section of our website. We also promoted World AIDS Day back in 2010 when we joined forces with Skins Condoms to give away condoms for one week.

If you do suspect you have chlamydia, Medical Specialists Pharmacy offer the Clamelle chlamydia test kit from just £24.85, which can be used in the privacy of your own home to avoid an embarrassing visit to your GP. Or, if you have been confirmed as having this or gonorrhoea, the antibiotic Azithromycin can prevent the spread of the bacteria so that your body’s natural defences can fight back and remove the infection from your system. We also have the medication Valtrex from as little as £3.50 per tablet, which works by slowing the spread of the herpes virus.