A pill that stops HIV in its tracks

If I told you there was a pill that you could take every day that stops HIV in its tracks for those whom are HIV negative what would you think? What if I told you that recently you’d have to move heaven and earth to access information? That there were only one or two sexual health clinics in the UK that would provide the information? Astonished I’d imagine.

Well there IS such a drug. It’s available quite legally for anyone for those that want it – the patented drug (Truvada) for £400 a month – or the generic (Tenvir-EM) for £40. And I’m using the latter!

How did I find out about it? A friend told me about it after the election and that it was going to be a huge LGBT/ health prevention issue. The more I looked into it the more interested I became in its effectiveness and agreed with him.

How to access the information has become much easier. I found out about PrEP (pre exposure prophylaxis) that prevents HIV from replicating itself inside a persons body. See also http://www.thebody.com/content/art42460.html and https://www.vice.com/video/stopping-hiv-with-the-truvada-revolution-part-1-111.

A few UK men on a facebook group suggested that I could buy the generic drug Tenvir-EM online. To check if your body can cope with the drug they told me that the Dean Street Clinic in London (the most enlightened and friendly sexual health clinic I’ve ever visited) were giving free kidney creatine tests for those in the vanguard. (Guess where this doesn’t go on – the home of the Gay Village and Queer as Folk – Manchester!)

Thus, one mild November day I schlepped down from Stockport to Soho to meet Mark a friend on PrEP for support before attending the Clinic. Outside the door my hands were shaking and I gave a nervous glance back to him. No one likes the inevitable going to the clinic. Some of the questioning is pointless, the lectures about condom use are often misjudged, the fear as you watch for the results on the little dish as you sigh with relief to escape the building and the neatly concealed withering looks. Yet when I ask about PrEP the subject quickly changes. With Dean Street staff that `get you` you reveal a lot more and receive superb treatment – an examplar for other clinics! Younger men are put off testing and who have direct experience of the 80s are not using condoms as much.

Older Gay men who have lived through the Aids crisis have lived in the shadow of fear for decades. One wrong move you die a horrible death or under the first drug regimen (AZT) you lead a horrible life. Thankfully medication has improved in leaps and bounds. People live healthily with HIV. I salute those people as having survived the crisis.

People are needing PrEP now. Lives could be saved now.

It’s time to embrace the future, stop the shame, stop the blame and let’s have an NHS that serves people and assists them in health prevention.

* John Abrams is a member and activist in Stockport

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  • Andrew Martin 1st Dec '15 - 1:23pm

    Fantastic article John. It’s a scandal that the Government is failing to act now to reduce HIV transmission in this way.

  • SmokedKipper 1st Dec '15 - 2:45pm

    Good news for everyone, but why should the pills be provided by the NHS? This drug is cheap and freely available as a generic. By all means let the NHS recommend it but if people want it they should pay for it.

  • @SmokedKipper – From the article I took the reference to the NHS to mean, let people BUY this drug from NHS dispensing channels under doctor supervision, so they don’t have to take a gamble on largely foreign internet suppliers.

    I think there is a growing group of drugs that should be provided through prescriptions, only the patient pays either their full cost or a higher prescription charge. Obviously, there will be some who will be up in arms over this and make extravagant claims about ‘privatisation’ and the “end of a free NHS”, but if it enables more people to use these drugs, it will both incentivise R&D and help keep costs down for all.

  • Has it been approved yet by NICE ?

  • Henry Fisher 2nd Dec '15 - 11:22am

    Great article, the more this is brought to people’s attention the better.

    @David Raw – The drug itself has been approved as an antiretroviral for years, it is the repurposing of it as a preventative medication that is (or at least was, before the overwhelming evidence came it) the novel aspect that some have found controversial. This is s simply a case there the evidence should speak for itself. This drug saves lives and money.

  • There are a number of caveats to this strategy.
    Firstly, the recent PROUD study results showed it successfully prevented HIV infection, but three of the participants on the drugs did still become infected (equivalent to 1.2 infections per 100 people over a 1 year period).
    These drugs do have side effects, requiring regular blood and urine monitoring, and can cause significant kidney and bone damage taken long term.
    There is a real risk that if these drugs are widely used for this purpose, they will lead to increased drug resistance so they will become ineffective.
    They also will not prevent the several other sexually transmitted infections that people will be putting themselves at risk of.
    A condom still seems the best option. Go for it.

  • @Roland – I will offer a seperate blog posting LDV editorship willing on your points and to explain why I agree with Norman Lamb the Lib Dem Health spokesman.

    @Henry Nice – It has been approved by the US FDA and Centre for Disease Control as well as the World Health Organisation. France has now approved it and it will be dispensed through selective clinics from January.

    @Deetee – The people who became infected on the PROUD Study and I observe from the Three HIV infections were observed in the men allocated to start PrEP immediately but one of these almost certainly contracted HIV just before he started PrEP (he tested HIV-positive at his second visit a month after starting) while the other two had stopped taking PrEP months before they acquired HIV. (from aidsmap website).

  • @Deetee Problems with bone and kidneys in taking PrEP usually show up within the first six month and affect 1% of PrEP users when it’s discontinued due to adverse kidney complaints. The PrEP regimen requires creatine tests and full std screening including HIV every quarter. It’s a lot more regular than the usual testing partly due to the problems of stigma around the culture of the clinics.

    Resistance – it only occurs if an HIV infection occurred and the drug is taken after infection. If this wer every common, it would be rampant among those taking Truvada as part of their HIV treatment (don’t forget this is not a new drug but has been used by those living with HIV for years – but is now being used as PrEP for those whom are negative)

  • @James – I’ll keep a look out for your submission.

    A key question is just what Norman means by “HIV-preventing drugs must be made available on NHS”. Too many people will read that as being ‘free’ (I think this is what SmokedKipper thought from the tone of the comment), whereas I indicate it could mean something slightly different; which given how stretched NHS budgets are going to be, could be a way for the NHS to make some services and treatments available at relatively little cost to existing budgets. Hence I took my lead from John’s text, where he implies he is prepared to pay £40 pcm for his drug (although I’m sure he wouldn’t object to it being free), but is annoyed about how difficult it is to track down and obtain appropriate professional clinical consultation and support.

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