I’ve been slightly unprepared this week, I’m not used to saying “no” to people who want help raising awareness about HIV, but in the past seven days I’ve found myself doing it more times than in the whole five years I’ve been living with HIV. It probably won’t surprise many of you that this is due to a contentious issue… and that issue is PrEP.
In the past week a community statement on PrEP has been released with many people and organisations backing the call for the NHS to make it available in the UK asap and asking supporters to sign it.
PrEP is a sticky tape solution, a “that’ll do for now” or “for the time being”. And we’re rushing into it without considering the consequences because we’re running scared of the increasing prevalence of HIV in certain demographics, in the UK it’s MSM.
I’ve spoken before about a number of concerns I have with it but to quote the statement
“Research suggests that PrEP is as effective as condoms in preventing HIV transmission, as long as the pills are taken regularly, as directed”
They won’t be. How many of us start a vitamin regime, believing we will stick to it, then you miss a day, then another. Before long the bottle is gathering dust. Or those with strong will power you finish it, you say to yourself you’ll pick up some more on the way home, then you forget. It’s all well and good relying on data from a trial, but people are more likely to adhere when “someone’s watching them” and actively reminding them of the process due to the appointments, the surveys, the tests etc. It’s a different ball game when you’re going it alone.
“PrEP does not prevent other sexually transmitted infections or pregnancy”
What is the point in creating a prevention tool that only applies to one disease? What’s the use in it being as effective as condoms if it has ZERO effectiveness on combating syphilis, gonorrhoea, chlamydia etc? We all like to think of HIV as the ‘biggy’ but the others are still a danger to our health, how long until we have an antibiotic-resistant strain of one of the other viruses on our hands?
“Studies of PrEP have consistently reported that being on PrEP did not result in people adopting riskier behaviours”
As I mentioned above, a study or trial will tell you a wonder of things but that doesn’t necessarily mean that will translate the same in the real world. How many of us are guilty of lying to our doctors, knocking off numbers against alcohol units, numbers of sexual partners or adding them to hours of exercise or the fruit and veg portions we’re eating.
We need to know what’s driving the numbers up, we need to know why condom use is declining, why people are now more commonly and openly actively seeking out unprotected sex. I was talking to a HIV positive friend last week, roll back five years ago we could hardly remember anyone actually publically looking for unprotected sex, it was something that happened by accident, or spare of the moment. Granted an odd guy online or on apps would ask for it, but now it’s all too commonly sought out, like a fetish or a kink. It’s a personal choice for those people to make but why are we not asking them WHY? Yes it feels better to a lot of people – but why is this worth the risk to their health? Is it just online fantasy? Is it a lack of education, peer pressure, because it’s ‘wrong/bad/forbidden’ or is it because people think HIV is simply solved with a pill a day?
I don’t know. We don’t know. And PrEP isn’t going to provide the answer.