HIV lives matter: why PrEP is vital in our ever-stretched NHS


This month saw a monumental breakthrough in health rulings that will affect thousands of gay men across the country. The UK’s high court ruled that the lives of gay men – and those at risk of HIV – are worth saving.

The high court ruled that the NHS is responsible for funding a ‘game-changing’ drug that prevents the onset of HIV. And it works: one US study showed that the drug had up to a 92% effectiveness.

NHS England has previously denied any such responsibility, claiming it is the role of local authorities, who are responsible for providing health provisions for smoking and family planning. However, local authorities said they did not have the money to fund the drug and thus refused to provide the treatment.

NHS bosses also claimed that PrEP – short for Pre-Exposure Prophylaxis – was too expensive to be considered. The NHS has made it clear that the high court ruling is not the last we will hear of the matter, with statements confirming they plan on appealing the ruling.

Admittedly, at £400 a week per person, the treatment is not cheap. This amounts to £4,800 a year per person, which could make a dent of between £10 and £20 million in the NHS’ annual budget as it is estimated that around 10,000 – 15,000 people would need to receive PrEP treatment every year. In a time when the NHS is already stretched to its limits, many people are arguing that the National Healthcare Service simply can’t be affording to pay for a preventative treatment, when it already provides free condoms to try and stop the spread of HIV.

However, these arguments are flawed. While £4,800 a year per person a year may sound a lot, this is nothing in comparison to the £360,000 it costs to treat a person infected with HIV over the course of their lifetime. As there are currently around 103,700 people who are HIV positive in the UK, the drug would allow the NHS to save millions of pounds in the long run.

Money, therefore, has little to do with the real objections against the drugs. The real objections come from a wholly moral,  conservative standpoint.

The Times ran the headline ‘HIV drug puts other care at risk’, before going on to state that ‘children with cystic fibrosis will be refused a drug to help them breathe after the High Court ruled that the NHS is responsible for providing a daily pill to prevent HIV infection in gay men […] the cystic fibrosis drug is one of nine treatment, including stem cell transplants for a rare blood cancer and a prosthetic knee for amputees, that officials claim the NHS cannot now afford’. The Daily Mail chimed in by calling PrEP a ‘lifestyle drug’, as though it were akin to Cocaine or MDMA.

It should really go without saying that gay men are not responsible for the deaths of children with cystic fibrosis. Gay men are not responsible for denying stem cell transplants to cancer victims. Gay men are not responsible for denying amputees prosthetic knees. So let’s stop fuelling homophobic attitudes and suggesting they are.

‘I’m afraid the truth is’, Andrew Pierce a – gay – Daily Mail columnist writes, ‘that those gays clamouring for free PrEP do so because they want to have risky, unprotected sex.’

No, Mr Pierce, they just want to ensure their safety against a life-threatening illness.

In the real world – one that is filled with real life imperfect people and imperfect situations – condoms break. They’re not always effective. Sometimes, yes, sometimes people get a little bit too drunk and in the rush of it all, people forget to use a condom. Shock-horror. Yes, safe sex should always be promoted but, as PrEP Access – the organisation campaigning in favour of PrEP – found that men who currently take PrEP are not more likely to have unprotected sex.

It’s all well and good arguing that gay men should be more responsible and wear a condom; but when the number of people who were diagnosed with HIV rose from 2,860 in 2010, to 3,360 in 2014, our current tactic of tackling the HIV epidemic – painting HIV victims as deserving of their infection due to their ‘reckless’ behaviour – is simply not working. When something is as life threatening as HIV, which can lead to a line of mental health issues such as depression, once diagnosed with the illness, it is not a preposterous idea that people should want to be as protected as possible.

To demonise all gay men as ‘reckless’ is simply untrue and, most importantly, homophobic: in one study, up to 50% of young people – consisting overwhelmingly of heterosexual youngsters – admitted to have having had unprotected sex. Since 2013 alone, STDs like syphilis has risen by a staggering 76% and gonorrhoea has risen by 56%. You cannot single out gay men of being sexually ‘reckless’: the issue of safe sex is an issue we all – irrespective of sexual orientation – have a responsibility for.

Being gay is not a ‘lifestyle choice’. Having HIV is not a ‘lifestyle choice’. It’s a tragic virus that had been demonised as a ‘gay disease’ ever since the 80s.

What we have seen in the days following PrEP are the dangers of our overwhelmingly right-wing mainstream media.

Not everyone who uses PrEP is a gay man, yet it has been these people who are having to take the full brunt of the court ruling. In fact, there are 45,000 gay men who have HIV compared to 56,000 heterosexual people; more straight people are infected with HIV than gay. While proportionally, yes, gay men are substantially more over-represented in terms of HIV victims, the mainstream media has been responsible for the continuing stigmatisation of the virus over the past week – a virus that was once painted by the media as ‘a punishment for homosexuality’. PrEP is being scapegoated to push a conservative and homophobic agenda.

No, Mr Pierce, I am not a ‘militant gay’ (as you labelled anyone who supports PrEP) and nor do I have a ‘skewed sense of values’ for thinking that people deserve to live their life without the fear of contracting HIV. I am simply a person who has compassion towards people who are at greater risk of contracting HIV because of circumstances outside of their control.

Maybe if we had a mandatory sexual education system which was more willing to openly discuss sexual intercourse which doesn’t exclude gay, bi, lesbian and trans people from the equation, then maybe we would see a greater decline in STDs. Currently for homosexual youths, our education system fails them. If sex education is so important – important enough for it to be taught in primary schools – why do we leave young homosexual teens to learn about safe sex, STDs and protection to themselves?

Tuesday’s court ruling did not make it mandatory for the NHS to prescribe PrEP for free on the health service. It simply ruled it comes under the NHS’ jurisdiction to provide it if they feel necessary; ultimately, it will be up the NHS to decide whether to provide it. But as long as we have such a homophobic and conservative media, we will continue to live in a world in which homosexual men suffer institutionalised prejudice meaning they fail to receive the treatment – and live the lives – that they deserve.

Words by Juliette Rowsell

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