My response to The Irish Times PrEP piece

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On Thursday 20 April The Irish Times published an article Anti-HIV Drug Removes Personal Responsibility

This article was positioned as an opinion piece and one thing we can be sure of is that opinions have no place and hold no authority over facts based evidence. Presenting accurate facts and providing an opinion based on those facts is fully acceptable but this article failed to deliver that.

Several HIV experts and organisations including Professor Chloe Orkin for BHIVA and Dr Paddy Mallon for UCD School of Medicine have already highlighted the inaccuracies and errors in the very damaging statements made by the journalist.

I will be speaking from a community perspective. As co-founder of the world’s highest traffic and most widely used PrEP website, I am dismayed that a publication such as The Irish Times would run such a piece. As an advocate and activist who identifies as a gay man I accept that our community and its members will have differences of opinions on PrEP, HIV prevention and sexual health initiatives. It is concerning that rather than reach out and share learnings and experiences this journalist instead chose to write what appears to be a click bait vanity piece. This is not responsible. This is not community. This is not healthy. This is not contributing anything of worth to the debate.

Fear based messaging has never worked. It will never work. No one responds well to being judged, shamed or blamed. To further muddy the waters and confuse sound HIV prevention with moralising and toxic internalised personal issues is damaging and indicative of a lack of understand of self and of the complexities of gay life and sexuality on a community wide level.

“What I fear at the moment is a resurgence of the old “gay plague” rhetoric of the 1980s whereby gay and bisexual men are viewed as irresponsible and apathetic in relation to their sexual health.
What PrEP is in danger of promoting, in my view, is a policy of play now, pay later which the gay population can ill afford to embrace.”

We really need to work on deconstructing this concept that at some point we will “pay” for being gay. Being LGBT+ is not wrong. Living as our true authentic selves and all that comes with that, including enjoying the sex we choose is not something we are ‘afforded’ that must be charged back to us at some point. It is what we deserve. We are different as LGBT+ folk but we are not ‘less’. Different does not mean we aren’t equal.

Setting up arguments like these about “being responsible” creates a double bind. The notion that if I get HIV I’m irresponsible, if I try to prevent myself from getting HIV (using THE most effective method) I’m irresponsible.

And as if to clarify completely for anyone who is unsure: the journalist’s closing paragraph is a total contradiction in itself and of his entire ‘opinion’.

“The danger lies in transferring responsibility for risky sexual practices on to a tiny pill taken once a day rather than making informed choices and encouraging a culture of prevention rather than cure.”

I second Professor Chloe Orkin’s proposal below:

“I therefore propose that we [BHIVA] submit for publication a letter of clarification to better inform your readership of the latest evidence and guidance around PrEP.”

NHS to fund PrEP for 10,000 people

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I’ve been inundated with lovely, supportive messages and congratulations all night and all morning.

There are a lot of questions about this PrEP implementation study that people quite rightly would like answers to.

The leading question at the moment is “Why do we need another trial?”

It’s a very valid and justified question and indeed echos what I have been screaming most of this year. This study will investigate how we put PrEP to use in a real life setting as a national public health intervention. Previous studies like PROUD and IPERGAY helped us understand that PrEP works really well, if taken as instructed.

This trial is about how we roll PrEP out.

My initial reaction was: It’s a start.

It’s not ideal but it’s a start.

I welcomed the announcement but I feel the need to publicly ask more questions because ultimately it means that we still have no proper PrEP commission for 3 years and the rest of the world is looking to us so we need to keep them and their agendas in the equation too.

I want to see something built into this that really tackles and addresses inequalities and recruits those that really need PrEP but aren’t able to afford it or don’t know about it.

What inevitably will happen is a mass migration of PROUD study participants and those users currently self-sourcing or utilising PEP as PrEP to populate this allocation. I’m committed to not further perpetuating the health and HIV prevention inequalities of other at risk groups outside of London and urban MSM (men who have sex with men).

I want a dedicated focus on BAME (black and minority ethnic groups) and trans* people.

I also want a clearly laid out and confirmed willingness from NHS England and Public Health England to proactively review this trial after 12 months with a view to finding budget for an additional contingency of a further 5000 (or more) participants. What I don’t want is to find ourselves 18 months in and at our capacity and then having to get into the whole wrangle, negotiating, feet dragging and complacency yet again. That would really stall the momentum that we will have gathered.

I think 10,000 participants is better than what was originally offered in the spring but we can always do more. Australia have expanded their PrEP trials. This can be done.

As a result of this provision we are going to see the number of new HIV diagnoses drop, of that there is no doubt. What I don’t want to happen at that point is for the focus to then shift to those achievements and ‘laurel resting’ to begin. Instead it should be an incentive and motivation to do more.

This announcement feels like a change in gear. It feels like an investment in actually trying to end new HIV infections in the UK instead of what we have previously seen from our health care system which has been lack lustre firefighting and band aid prevention.

I want NHS England to commit to a full commission by the end of this trail now so that we don’t have a repeat of what we saw with PROUD and their participants being exited from a study with no further access to PrEP. This needs to be in place and functioning long before the end of this trial so we have a seamless crossover for participants.

Those are my initial thoughts. I am meeting with our steering group and the larger United4PrEP coalition group this week and we will have plenty to discuss. I will update you all with more information when it is available.

iwantPrEPnow and PrEPster are fully committed to working with NHS England and Public Health England to make the best of this opportunity and we hope to be closely involved with the planning and workings of this trial.

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Click here for NHS England statement

Twitter: @Greg0wen

 

PrEP 2015: a very blue year

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2015 has been quite a year. A brilliant year of developments on PrEP (HIV prevention) and deconstructing HIV stigma.

It hasn’t been an easy year by any stretch of the imagination and I’ve had a few personal curve balls thrown in for good measure. But such is life.

I want to take a moment to look back on our progress particularly in the PrEP arena.

At the start of 2015 there was a considerable amount of noise being made in the US by Damon L Jacobs and his facebook crew of PrEPsters in the PrEP Facts:Rethinking HIV Prevention group. This family of HIV prevention enthusiasts, users and advocates is currently sitting at a substantial tally of 12,500 people. The group’s significance within and contribution to the PrEP community even caught the attention of WHO (World Health Organisation) this year.

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But here in the UK it didn’t seem like we were making that much noise at all. There were a few random mentions from scene magazines and the odd share of an article here and there. I shared and posted as much as I could find and it was being well received as a concept.

I felt reassured that PrEP would catch on here in the UK when it was made available. I was perhaps a little too naive in making that presumption at that point. In hindsight, it was being well received as a concept because it was nothing more than that.
A concept. Not a practice or an option that was available or likely to be available in the near future.

I know this now…but I didn’t know it back then. Discovering hostility towards PrEP was unexpected and came with a hefty emotional price tag for me.

My own PrEP journey was a very short lived one indeed! Late one Tuesday evening (11th Aug). I managed to get hold of 2 months of Truvada from a HIV positive friend who had changed his meds. I decided that I would document my experience, every sexual encounter, chill out, sex party and screen for STIs every month for 6 months and write my Truvada Diary.

The next morning I hopped on a bus to Dean Street Express to have a HIV test to confirm that I was HIV negative (last tested negative Easter 2014) I had written the opening section of my PrEP journey by the time I had arrived at the clinic. 20 minutes later I was diagnosed as HIV positive. The irony! So that put an end to my PrEP diary. Instead I began writing my diagnosis diaries – This is Me part 1, part 2 and part 3.

My public disclosure on social media and the subsequent publishing of my diaries raised my visibility and awareness of PrEP and the immediate necessity for it so much that I just couldn’t cope with the amount of enquiries that I would receive on Facebook, Twitter and email.

This is when the option of importing generic PrEP was brought to my attention and really took hold. After a few
discussions with my buddy Alex Craddock and meetings some knowledgeable friends, the idea for www.iwantPrEPnow.co.uk was born.

We were going to build a website with all of the info you needed on PrEP and with links to buy genuine and legitimate generic PrEP from trusted sellers. We knew the website would take us about 4-5 weeks to build in our free time so we set about that with immediate effect.

What I identified I could do in the interim between that point and our launch was to raise awareness and test the waters. I want to gauge exactly what the feeling towards PrEP was.

We would be making access to PrEP a reality and not just raising awareness of some unobtainable new HIV prevention concept.

The reaction was not what I expected and not what I wanted to deal with at that time in my life but there wasn’t much choice.

PrEP was being smacked down quite regularly and quite aggressively.

Here I was, a very newly diagnosed HIV positive gay guy being berated and attacked for pushing for PrEP.

It was a little heartbreaking.

Why couldn’t these people see the potential of PrEP?

Why were they so averse to the idea?

I realised I had to reconcile that within myself and find a way to relate and connect to these people. The solution presented itself quite clearly and promptly. Just be honest. Just tell your story.

No one wants to catch HIV. There is a tool that is almost 100% effective at protecting you from HIV.

I managed to get hold of it. But I was a few months too late. Just state the situation and leave it there.

It seemed to work.

I was also aware that people don’t like to read pieces of text. Especially on something they are not too interested in. So I went with some very simple, very basic images. I am no graphic designer! These memes were created on an app on my iPhone. And here they are…

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It passed by without too much controversy. That wasn’t to last! Next up was a play on Apple’s incredibly irritating auto-correct of the work fuck to duck! If you use the word fuck as much as I do then this little text amend is DUCKING annoying…

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Again, I thought this was palatable. It’s a blue duck – who can have an issue with that? Quite a few people it would seem! Instantly the cries sprang up of

“Are you saying we should abandon condoms?”  

“This is totally irresponsible and reckless of you”

“You are sending out the wrong message here Greg”

“What about other STIs. PrEP doesn’t protect you from those”

I wasn’t really prepared for that reaction and I hadn’t formulated a response. Little did I know that a few short months later I would be so sick and infuriated by that ‘other STIs’ question that I would have lost my patience and found the balls to write an article titled ‘Fuck other STIs’. But at that moment it shook me a little so I tried to dampen the argument with this.

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It immediately silenced those critics. So we were learning and we were on to something. By introducing the word ‘extra’ into the positioning of PrEP we could get people to start thinking about PrEP itself and not what using it implied – ie abandoning condoms. I tested it out with the next image.

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This one went down really well! The very same people who were busting my ass over the barebacking rubber duck were now on board and thanking me for behaving responsibly with a healthy and inclusive message. So I took it a step further.

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Then I put PrEP in the tool kit.

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It seemed too simple but it really was that straight forward. Use the word ‘extra’. Make PrEP an additional tool and position it with condoms – not instead of. People stopped trying to run me out of town! But again, I had a feeling that would be short lived. We hadn’t introduced the sexual element yet. So I ran with this.

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As expected the pitch forks came out again.

What is it with people in the UK and the horror that sets in when something appears to be sexual? I’m still getting my head around that one.

But now the comments coming in were accusing me of trivialising safer sex by releasing the sexy Smurfs. In fact that couldn’t be further from the truth. PrEP is HIV safer sex. So is condomless sex with a HIV positive undetectable guy.

At that point I realised that I wasn’t ever going to be able to please everyone. So I stopped trying.

And that was liberating! For the sake of the objective at hand I decided to revert (temporarily) to inoffensive, non-sexual subject matter.

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The lightbulb was safe and for some reason people liked it. It’s one of my least favorites. I had given up trying to predict what would and would not be received well! The watch was up next.

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When this image went out on Twitter a good friend and colleague from a HIV charity tweeted me to say that he loved the image but that it was factually incorrect.

PrEP is not here as it is not accessible yet.

Little did he know that in a few weeks PrEP would be here and accessible through www.iwantprepnow.co.uk – admitedly not for free but it was here! The images were getting  a fair amount of attention now and I started getting requests. Here are a few of the requests.

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I know this tag line is from Sesame Street but it kind of worked here.

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Who knew gay men loved The Smurfs, The Muppets and Sesame Street?

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And it was no surprise that the Diva went down well!

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Then I changed the direction slightly as the reaction towards PrEP warmed.

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This next image has the wrong tag line again – my mistake. ‘You Got a Friend in Me’ is from Toy Story. The song from Aladdin is ‘You Ain’t Never Had a Friend Like Me’. I didn’t think it was that big of a deal until I happened to catch Aladdin on television a few days ago and watched Genie and Aladdin in that number and in fact – you ain’t never had a friend like PrEP!

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The set isn’t complete without drawing a little attention to slut shaming….

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And realising that the way a person chooses to protect themselves from whatever is and always should be totally their choice and they should be fully supported in the choices they make for themselves.

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Recently I have been able to release a few images that need no disclaimers or pacifiers.

It’s nice to see David Cameron get involved with PrEP…

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And push it real good…

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The website www.iwantPrEPnow.co.uk has even been discussed at BHIVA by Dr Mags Portman.

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At BHIVA’s European HIV Hepatitis Co-infection (EHHC) Conference by Dr Andrew Hill.

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And most recently Alex Craddock (iwantPrEPnow co-founder) featured on Channel 4 News alongside our PrEP siblings and their site PrEPster

In my opinion this year has seen the UK MSM community stop slut shaming and challenging the benefits of PrEP. In the summer most of my conversations about PrEP were loaded with shaming, ridicule, dismissiveness, divisive statements, fear, resistance and a lack of knowledge.

Today with just 2 weeks left of 2015 I can tell you that the amount of interaction and conversations I have with people about PrEP has more than doubled – perhaps even tripled.

Now those conversations are predominantly from people wanting PrEP now with well constructed questions on the finer details and specifics of being on PrEP or preparing to start PrEP.

This is amazing. We have turned a corner and the road ahead looks promising. 2016 is going to be a very exciting year. 

Merry Christmas and a happy new year!

Continue reading “PrEP 2015: a very blue year”

PrEP ain’t for you…or is it?

 

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Jake: I just wanted to ask a PrEP question.

Greg Owen: www.iwantprepnow.co.uk If it’s not on there I’ve failed. lol

Jake: You didn’t fail but I want an answer in slightly more detail. Event based PrEP. Say someone like me who never has unprotected sex… and I can’t remember the last time I slept with someone who didn’t know their qualified status… I don’t want or need to take PrEP. But say I wanted to try unprotected sex with my boyfriend or someone else on one occasion… so taking PrEP just when I needed it. Is this safe? Is it enough to stay neg. I just read all the options… and you say that taking a pill a day is the safest.

Greg Owen: I have a burden of responsibility to actively promote the safest – ie large study (PROUD) tried and tested daily method. That is why it is positioned like that on the site. The EBD (event based dosing) system has been trialled in France. It is called IPERGAY and yes – it is safe. Official figures suggest 86% reduced risk of HIV infection. However there are variables with this method and so therefore requires a conversation like this so that the PrEP user can be educated properly.

I don’t have capacity to do that with everyone and I really would want to because this method opens up the possibility of risks. I hate the word risk used alongside the word PrEP. The variables are the time between 1st dosing and actual sexual interaction (because studies and tests have found that there is not sufficient HIV protection in the anal tissue until about 8 hours after the 1st dose of PrEP) and you also need to address and fully understand doseage etc and by that I mean the number of pills taken, when and duration. And some people say that the study was based on the minimum amount of time and PrEP required for protection so you could expand on your protection by increasing the time between the 1st dose and sex and the length of time you dose after the sex.

The problem I have with this is that info gets relayed from gay to gay and gets muddled in the middle – a bit like chinese whispers. That makes me uncomfortable when the thing being jeopardised is a person’s HIV negative status.

Jake: I’ll refer other gays to your website – I promise.

Greg Owen: I don’t go into these details on the IWPN site for that reason. At the point when it becomes technical and requires someone of authority to advise on this method we direct our users to their local sexual health clinic to discuss it face to face with a clinician. You are a friend , someone I know personally which is why I am discussing it now.

Back to the point… with event based dosing you don’t have that 100% peace of mind that comes with daily PrEP. So in a way you are running the HIV gauntlet again and that negates one of the key benefits of PrEP. But EBD/IPERGAY is a tried and tested method and the whole point of what I do is to share information and although I don’t personally feel comfortable promoting this method of using PrEP, it still offers protection (up to 86% if used properly) that might very well work for someone and so I put it out there.

I guess it boils down to this – any HIV protection is better than none.

But for you Jake – I don’t think PrEP is perhaps the best thing. It’s people who are already involving themselves in high risk behaviour that need to think about it imminently.

If you like using a condom every time you have sex – stick with it. It’s working for you. 

Don’t muddle it. You have good condom adherence. I’m happy that is the case with you. I would be conflicted in advocating PrEP for you if it were to potentially diminsh your condom use.

Jake: Of course. That’s how I feel. It’s not an issue for me. But I’ve never had unprotected sex with my boyfriend. Just thought it might be nice to try. We both think that we’re negative and of course we both need to get tested. But it would be reassuring for both of us if we also did PrEP.

Greg Owen: I disagree. If that really is the case then you don’t need PrEP. Unless you – or you suspect your boyfriend is having BB sex and not being honest about it. If you aren’t and you trust he isn’t…get tested (full screening) and go for it. You really need to weigh up the landscape on a person (or couple) specific basis. If you don’t trust him and don’t wanna discuss that within your relationship there is another option. You can take PrEP on an EBD/IPERGAY system and just don’t tell him.

PrEP empowers the individual.

Jake: He’s not having BB sex. And he doesn’t lie to me. There’s absolutely no reason for him to lie because we’re totally open. That’s the sole purpose of having an open relationship, so that we don’t have to tell lies.

Greg Owen: If that’s how it works in your open relationship I’m happy for you. That is not the way it works in all open relationships.

Jake: Really?

Greg Owen: Yes – from my personal experience and from what I have ascertained through discussing sex and sexual behaviour with many different types of guys in various different situations.

Jake: Why not?

Greg Owen: I’m generalising now but here we go –

Gay men LIE (some not all)
Gay men take risks (most not all)
Gay men do not tell their boyfriends any of the above (some not all)

Also – I can’t imagine you would be too happy informing your boyfriend that you have had sex with me – a HIV positive guy. Protected or not, undetectable or not. You might not feel 100% comfortable telling him this and I understand that.

Jake: But that’s the structure of my relationship. We said we didn’t want any lies or games. So we’re open from the outset and we’re totally honest. It really works. I don’t understand being open and then lying about being open. Makes no sense.

Greg Owen: I agree Jake but you can only be accountable for yourself. You cannot control or dictate what another person does. Regardless if you have made an agreement or not. If your relationship is structured and works like that I am happy for you both. I’m just saying that some people find certain topics difficult to discuss with their partner. That’s why I mentioned the HIV thing as an example. You in effect removed his choice of introducing HIV into his sex life.

Jake: I totally don’t understand what you’ve just said to me. Introducing HIV to our relationship?

Greg Owen: My point is that some guys wouldn’t sleep with a positive guy and that is totally cool with me. If your boyfriend wouldn’t sleep with a positive guy – if that is just one of his sexual boundries and then you sleep with me as an extra in your open relationship, in effect you introduced HIV or more specifically a HIV positive sexual partner into the mix and I don’t think that’s 100% fair. You took a little bit of his choice away. Of course we are speaking hypothetically here as I don’t know your boyfriend or his opinions or prefernces on HIV positive sexual partners. But I find that when it comes to HIV – even though it’s ME that is positive and not you or your boyfriend, we all still need to mindful and considerate towards each other and that extends to how your boyfriend would feel about you having sex with a positive guy ie me. Regardless if you were at risk or not – which you weren’t because I’m undetectable and we wore condoms. I’m just saying some guys dont like it. And that’s not some strange manifestation of internalised HIV shame on my part. I have none. It’s just being considerate towards other people’s feelings. That’s all. I’m just trying to illustrate a point. Sometimes what we get up to in our sex lives isn’t always easy to discuss with one another for a lot of very understandable reasons.

Jake: Well, as I demonstrated. I’m not like that. But I might be introducing HIV every single time I have sex with another man. If I
sleep with a guy who doesn’t know his status though… which is more dangerous.

Greg Owen: Bingo! But an undiagnosed guy is not stigmatised. Even though 80% of new HIV infections come from undiagnosed ‘negative’ guys. You are preaching to the converted.

Let’s put it this way… when I was HIV negative I happily slept with HIV positive guys that I knew were undetectable and who I knew well enough to know that they took their meds regularly and I was even aware enough to try not to put myself in that position on the Tuesday after a Bank Holiday weekend when a HIV positive guy might have been out partying and high since Friday and not taken his meds for 3-4 days therefore resulting in a viral spike above the (generally accepted) 400 mark which starts to become HIV infectious again. I KNEW all of this stuff and I played by those rules ‘most’ of the time but I also slept with other ‘negative’ guys who were ‘definitely sure’ they were negative. I knew the risks and I took them. I’ve told you I can’t pin down the point when I contracted HIV but what I can categorically tell you is this….

I did not get HIV from a HIV positive guy…. I got HIV from a HIV negative guy!

Of course the exchange was from a person that had the virus in their system and technically was HIV positive but there is no doubt in my mind that he was still under the illusion that he was HIV negative.

So I get you. xx

Continue reading “PrEP ain’t for you…or is it?”

The Year of No Fear – HIV today

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What does it mean to be HIV positive today?  

I was diagnosed on 12 August this year and I was lucky. I was diagnosed in what I call ‘the year of no fear’.

Thanks to the PARTNER study and the PROUD study our HIV status, be it positive or negative has less potential to polarize and divide us. The PARTNER study showed that condoms were no longer needed to prevent HIV transmission so long as the HIV positive person had an undetectable viral load on HIV treatment (ART). The PROUD study showed that HIV negative men taking daily PrEP (Pre-Exposure Prophylaxis) were protected against HIV transmission, again even without condoms. For the first time in 30 years we truly have the opportunity to live and thrive as HIV equals.

So I was diagnosed as HIV positive and publicly disclosed my status immediately because I felt empowered by this knowledge and fearless because of these studies. Sure, there would be social hurdles but that’s the amazing part – I’m not a Scientist or a Doctor. They have done their bit by affording me these comforts. Now it’s my turn to do my bit. I’m just an everyday person with no clinical background but what I can do is change people and their preconceptions. I can – we all can.

But the opportunities expand well beyond just deconstructing stigma and establishing equality. We now also have the chance to start winning the fight against HIV and AIDS. It’s time to look to San Francisco for the beacon of hope and pioneering example.

San Francisco is the only city that have stabilised their number of new HIV infections. In the last 3 years they have delivered a 30% reduction. The reasons why are simple. TasP (Treatment as Prevention) where anyone diagnosed with HIV is on effective ART (Antiretroviral Therapy) and are therefore undetectable and non-infectious, combined with PrEP for HIV negative people. 

Always seemingly a step ahead, San Francisco embarked on their RAPID initiative, involving 39 men from July 2014 to December 2014, which implemented a process of treatment at point of diagnosis. This in effect speeded up the process of beginning ART (Antiretroviral Therapy), preventing people from falling out of the system by collapsing some of the steps of the care continuum. Thus reducing the window of onward transmission from infectious newly diagnosed patients.

In the UK the clinical benefits of earlier treatment were shown in an international study called START. It is undoubtedly one of the most important HIV studies of the last decade. It was designed to look at the benefits and risks of early HIV treatment (ART). The results were both exciting and reassuring for people living with HIV today. The following is from HIV i-Base.

Main findings include:

  • HIV treatment was safe for people starting HIV meds with a high CD4 count. Many people in START had a CD4 count above 800.
  • Early treatment led to fewer serious AIDS-related illnesses, even at high CD4 counts.
  • The biggest [negative/general health] impact from early treatment was expected to be on illnesses like heart, liver and kidney disease and some non-AIDS cancers. The opposite was true in that early ART reduced HIV-related illnesses. This is big news.
  • The results were similar in both low- and high-income countries. This should result in making HIV treatment more available in all countries.

Secondly, the results show that benefits of treatment and prevention overlap. Other studies have proven that treatment dramatically reduces HIV transmission. Now people using treatment as prevention (TasP) will know there are direct benefits for their own personal health as well as that of the community.

Ultimately, it’s not about us and our generation. I have two 5 year old nephews and I would love to think that by the time they are in their 20’s that we will have managed to reduce our number of new HIV infections in the UK to such a low level that neither of them need ever worry about contracting HIV as I have. It is for them and our children that we need to take responsibility and action now!

We need to manage and reduce this country’s alarming and unacceptably high number of new HIV infections. Let us put the focus back on the AIDS crisis. There is still an AIDS crisis. Not in this country, here in the UK we have a ‘new HIV infections’ issue – not an AIDS crisis. But in sub-Saharan Africa and even as close by as Eastern Europe and Russia they still have an AIDS crisis.

Our brothers and sisters before us did not die of AIDS so that we could become complacent with HIV and allow ourselves to be immersed in AIDS apathy. It started with them, it can end with us. We have the tools to stop and end HIV and AIDS. We need to use them. 

We can’t allow our privileges to diminish our responsibilities in this global healthcare issue.

Continue reading “The Year of No Fear – HIV today”

FUCK other STIs

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It has become clear to me over the last few months that we have a very real problem as gay men. We really don’t talk about our sex lives HONESTLY. Particularly with regards to sex and condoms.This is one of the main reasons why we have seen new HIV infections rise and rise – year after year. 6000 new HIV infections were diagnosed in the UK last year alone (and countless others that are yet undiagnosed). I’m going to go way out there and just state it as I see it. Put moral judgements aside and stop debating what we (gay men) should and shouldn’t be doing. The simple fact is that people do not always use a condom for penetrative sex all the time, every time. Yesterday I had a conversation with a friend of mine who had told me previously and several times that he ‘doesn’t really ever bareback’ but he did at the weekend. He’s now on PEP for the next month. In my own case, even though I had spells of busy sexual activity, I didn’t bareback that much or over a long period of time. And when I did have condomless sex I always tried to box clever. I of all people am very real proof that no matter how HIV aware and educated you are – you can’t outsmart HIV on your own.

If I had have been able to get PrEP I would still be HIV negative.

PrEP is only about HIV protection – it doesn’t claim to offer protection against any other STI. So it’s infuriating for me to constantly hear this ‘what about other STI’s?’ sensationalism and attempted counter claim to the benefits of PrEP. It’s like saying wearing a seat belt won’t stop you getting cancer! Of course it won’t! It’s not designed to protect you from getting cancer – it is designed to help protect you in a car should you have a driving accident. PrEP and HIV protection is exactly the same. PrEP is designed and is amazingly effective at protecting you from HIV – nothing else. Every other STI can be immunised against or cured – even Hep C (Harvoni is the new treatment). Yes, drug resistant gonorrhea is obviously a concern but you can catch that from oral sex. And realistically…how many people wear a condom for oral sex? Very few. You can catch every other STI from oral sex.

So please stop and think about this before screaming about ‘other STI’s’ when discussing PrEP.

In my experience people who want PrEP don’t want it to START barebacking – they want it because they ALREADY ARE barebacking.

They are aware that they are taking risks and they just want to protect themselves. Personally I think that is amazing and that these guys should be commended.

I have so much interaction with the users of our website. It’s incredibly inspiring and exciting. This has been an amazing year for HIV awareness, anti-stigma and HIV prevention developments. Next year is going to be a hugely transformative year in the HIV arena. The future is PrEP – the future is here!

Continue reading “FUCK other STIs”

Get free P(r)EP on the NHS – NOW

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You can get Truvada to use as PrEP for free on the NHS – NOW. Here’s how…

There IS actually a way to get PrEP for free on the NHS. It means working the system! And being a little bit dishonest. But if a little white lie is going to get you some free drugs to keep you HIV negative – is it forgivable? This process is called ‘clinic hopping’ more specifically ‘clinic hopping’ for PEP. And claiming a false risk of exposure to HIV

PEP is 4 weeks of treatment that is offered free if you have been at risk or exposed to HIV in the last 72 hours. They will test you for HIV at your appointment and do all the base line liver and kidney tests etc. Some sexual health clinics will give you the whole month of pills straight away at your first appointment. Others will give you 1 week of treatment and then you have to return for a check up at the end of that week and be given your remaining 3 weeks of PEP. So the system is simple. PEP consists of 1 Truvada and 1 Raltegravir pill in the morning and 1 more Raltegravir pill in the evening. So if you do the math and you are scamming the system for 3 pills a day and only taking 1…you are wasting 2/3 of what it costs the NHS to provide that. PrEP guys only need/want the 1 Truvada daily. So you can get PrEP on the NHS but you have to work them by getting them to give you PEP. This ‘clinic hopping’ is already a thing and is already happening in London (a lot) and with the rise of PrEP awareness and the knowledge of this method of accessing it…it will happen a lot more, at a lot of wasted expense to the NHS….Surely someone in the NHS can see this coming and behave proactively NOW to prevent this waste of much needed funds instead of reactively once we’re another year down the line….with thousands of pounds being wasted.

I know of people who will spend 1 day going around 2-3 clinics or A&E departments collecting 3 month’s supply in one day because sexual health clinics here in the UK operate a ‘confidential stand alone service’ and don’t communicate data with each other or your GP without your permission. You can in effect be anonymous at each clinic as you don’t need to provide any ID or proof of address. So at 1 clinic you could be John Smith at another you could be Peter Pepper. Some of these ‘clinic hoppers’ take their PrEP pill every other day so 28 pills actually lasts them 2 months.

I asked a representative from a leading London sexual health clinic about ‘clinic hopping’…

Are you as a clinic aware that ‘clinic hopping’ for PrEP is happening in London?

NHS availability (or otherwise) of certain drugs regarding Hepatitis C (Harvoni/Sofosbuvir ) and HIV protection in the form of PrEP have created a climate of people sourcing their own medicines their own way or sometimes ‘scamming the system’. This is entirely understandable; even heartening that people are being inventive and proactive in their desire to protect themselves and partners from infection. However, it can be dangerous when done in the absence of medical supervision, and so cannot be condoned.

So if a guy managed to get his Truvada as PrEP through this method but had queries or concerns about taking PrEP or his HIV status, what support is there for him?

What we don’t want to happen is for people to be frightened to tell us that they are scamming the system; because even though we may sometimes be limited in the medicines we can prescribe for PrEP and HCV treatment, there is still very helpful advice that our staff are able to give people doing that. No one is going to get reprimanded or told off for telling us how they’re ‘scamming the system’ or how they are trying to stay HIV negative. If someone has a supply of PrEP (regardless of how/where they sourced it) and they need advice then we can give that very practical, medical and lifestyle advice to people wishing to stay negative. We don’t want people to avoid us or omit truths because they are frightened they are going to get in trouble. We are aware there is a climate of  scamming or ‘clinic hopping’ for medicines and – though we can’t condone it – we encourage people – guilt free to come and tell us what they are doing to try to stay HIV negative. The desire to protect ourselves and our partners from infection,  is always an admirable and commendable one; full disclosure, can help us to help you.

Continue reading “Get free P(r)EP on the NHS – NOW”