Prep HIV: Pre Exposure Prophylaxis for HIV Negative Patients

If you are a gay man in London, you are likely to have heard about PrEP and the widespread use as pre-exposure prophylaxis for HIV in the USA. With the results of the PROUD study due out early next year, we are now happy to offer PrEP in our clinic.

The 26th annual World Aids day was marked at the start of December, with events all over the UK to increase awareness and show support to people with HIV. Celebrities including Prince Harry launched a ‘Feel No Shame’ campaign to tackle the stigma still often attached to HIV, which aims to encourage people with HIV to seek medical support and education about their condition and the prevent the spread of the virus.

The availability of effective antiretroviral therapy has transformed HIV infection from a fatal illness to a chronic manageable condition. However, in the UK there were still an estimated 107, 800 people living with HIV in 2013, 42% who are largely gay men living in London.

Those most at risk of acquiring HIV in the UK are men who have sex with men (MSM), who engage in high-risk behaviours such as unprotected anal intercourse, and it’s estimated that many cases of HIV remain undiagnosed. Surveillance data from 2010 revealed that over 48,000 MSM of an unknown or HIV negative status attended a genitourinary medicine (GUM) clinic. 9000 of these were diagnosed with an acute sexually transmitted infection indicative of unprotected sex.

Apart from condoms – what options are available for these patients to prevent the acquisition of HIV?

This a question frequently posed by our patients. For HIV negative patients, post exposure prophylaxis (PEP) is widely used, especially among the gay community following a potential exposure to HIV infection. Few people in the UK have heard of Pre Exposure Prophylaxis or PrEP, which has been used in the USA since 2010 and can significantly reduce the risk of acquiring HIV. The doctors at ROC Private Clinic are frequently asked to prescribe it by gay men patients living in London.

The iPrex study found than men taking a daily dose of Truvada (a one pill combination of two antiretroviral drugs – tenofovir/emtricitabine) almost halved their risk of contracting HIV compared with men in the trial who received placebo, and no significant side effects were reported.

In the UK, PrEP is not currently available on the NHS, or at least until the results of the PROUD study are published. Over 500 gay men in England enrolled in this study and were randomised into 2 groups that were either given PrEP immediately for 2 years, or deferred to start PrEP after 1 year.

An interim analysis of the data showed that PrEP is highly protective against HIV, and as a result all enrolled participants in the study have been offered PrEP, leading to HIV activists calling for PrEP to be made available on the NHS. Critics of PrEP have raised concerns that it may undermine condom use and safe sex practices, leading to a resurgence in sexually transmitted infections. However with appropriate education regarding the use or PrEP and safe sex counselling at the point of prescribing, we believe PrEP offers our clients another choice in the prevention of HIV.

Here at ROC Private Clinic we are happy to discuss PrEP with anyone who believe they might benefit from this treatment. If you would like to know more about PrEP HIV treatment do get in touch.

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