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NHS to spend £10m on clinical trials for 'HIV prevention drug'

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The NHS will spend £10m on clinical trials for a drug that could reduce the chance of people contracting HIV while engaging in high-risk sexual activities.

NHS England initially resisted pressure to fund the drug but after losing a legal battle it has decided to go ahead with clinical trials.

Critics say the drug is ineffective, expensive and encourages dangerous behaviour.
 

Ineffective

Pre-Exposure Prophylaxis (PrEP) is a course of pills that tries to reduce the chance of people who do not already have HIV from catching the disease.

The pills contain two antiretroviral drugs which disable the HIV virus before it infects the body. Taking the pills every day has been shown to reduce the risk of contracting HIV by up to 86%.

But a Cochrane review found that in previous clinical trials the most at risk group (men who have sex with men) did not take the pills consistently. Overall, results from four trials showed a reduction in the risk of acquiring HIV infection of only 51%.

This raises serious questions about how effective the drug will be in practice.
 

High-risk behaviour

Men who have sex with men are at a very high risk of catching HIV. In the UK, 1 in 20 men who engage in homosexual sex has HIV. The ratio is 1 in 8 in London.

Among heterosexuals, only 1 in 500 has the virus.

Having anal sex, particularly with multiple partners, also greatly increases the risk of contracting many other sexually transmitted diseases such as syphilis, gonorrhoea, chlamydia and viruses such as Hepatitis A and B.

Dr Peter Saunders, Chief Executive of the Christian Medical Fellowship describes PrEP as "a harm reduction strategy aimed at lessening the damage that people addicted to high-risk sexual behaviours are doing to themselves", and compares the treatment to "giving clean needles to drug addicts".
 

Expensive

The clinical trial is expected to cost the taxpayer £10m. If judged successful, PrEP will be made available by prescription on the NHS with an annual cost of up to £5,000 per person.

The large-scale trial will take place over 3 years, and 10,000 subjects will be tested.

Because of the decision to fund PrEP, several treatments will now not be considered by the NHS, including adult stem cell transplants for leukaemia patients.

Conservative MP David Davis commented: "This is just ridiculous. There are lots of people suffering from cancer and other diseases who can’t get prompt treatment because of the cost. We really need to think about what the NHS is for. It’s a national health service, not a national have-it-away service."

'Special privilege'

Andrea Williams said: "This is an irresponsible use of resources by the NHS which gives special privilege to those who engage in dangerous sexual behaviour. These drugs are not a prevention strategy but rather a safety net for promiscuity and risk taking.

"We ought to be addressing the real cause and caring for those who have the HIV virus, instead of providing licence for the activity which is most responsible for its transmission.

"The safest and most fulfilling sex is had between a husband and his wife in a committed, life-long marriage relationship."
 

Related Links:
High Court rules in favour of NHS providing 'HIV prevention drug' but big questions remain (Christian Medical Comment) 
Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals (Cochrane Database of Systematic Reviews) 
HIV in the United Kingdom: 2014 Report (Public Health England) 
 

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