Experts: use of PrEP in Scotland is significantly higher than forecast

28 fevereiro 2019

According to the latest data, in Scotland today over 1.8 thousand people take the drug "Truvada" as a pre-exposure prophylaxis of HIV (PrEP). The country was the first part of Britain, which in July 2017 made DCT available for NHS purchases for free distribution to risk groups.

Nevertheless, the report of the National Health Service of Scotland states that the demand for the drug "exceeds the expected projections." According to experts, this is partly due to the fact that many PrEP users have never visited a sexual health clinic before.

One way or another, experts conclude, it is too early to draw any far-reaching conclusions.

Among the main points of the report:

  • Since 2017, PrEP has been accepted for distribution to 11 of the 14 Scottish Councils of the NHS;
  • During the past year, pre-contact HIV prevention was prescribed to 1 872 people;
  • 99% of those who take PrEP are men who have sex with men (MSM)
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Consultant epidemiologist of the Ministry of Health of Scotland, Professor David Goldberg, reading the report, said:

“We should thank the sexual health service for successfully introducing a new tool that can help Scotland eliminate HIV. The program is already running for the second year, and now the focus should be on other [besides MSM, - Ed.] Groups that can benefit from PrEP. First of all, these include some women and transgender people. ”

What is PrEP?

PrEP is taken by HIV-negative people who are at high risk of infection. Virus prevention has been shown to reduce the likelihood of transmission by approximately 86%.

Scotland was the first part of the UK to make Truvada available for the purchase of the National Health Service and free distribution.

Five years before PrEP appeared in Scotland, about 360 new HIV cases were diagnosed each year.

Claudia Escort, an expert on sexual health at the University of Glasgow, told BBC Scotland's The Nine that the drug had become a “milestone” in the fight against HIV.

“Most sexual health clinics throughout Scotland were incredibly pleased that people make the decision to switch to PrEP or ask for more about this type of prevention,” says Escort.

However, not all experts are so optimistic. Some of them have concerns that free access to PrEP may lead to a decrease in condom use.

A study by a group of scientists from the University of New South Wales in Australia found that HIV-negative men using PrEP are more likely to have unprotected sex.

Ged Kensley, public relations director at the Los Angeles Health Foundation, also warned that increasing the availability of pre-exposure HIV prevention can lead to a surge in sexually transmitted infections (STIs).

“PrEP does not prevent the transmission of other STIs, and here in the US, we have a surge of infections, especially among young people,” he warns.

About 99% of PrEP users in Scotland are gay, and up to 75% of them take the drug on a daily basis, often citing regular unprotected sex with several partners.

HIV Scotland CEO Nathan Sparling is not as critical in his approach:

“We know that people get access to PrEP for HIV prevention, and we see from this report that more and more people think about the importance of their sexual health. They tell us that PrEP is working, and we should be proud of our collective achievements. ”

Dex's story: “PrEP is your best and cheapest option.”

For a 31-year-old Scot, Deux de Cruz, the diagnosis of HIV infection was made before PrEP became available to MSM through the National Health Service.

According to him, by that time he had lived with two men for several years: Dave Scott and Jordan Gray McSherry.

“I was diagnosed before PrEP was truly available,” says Dex.

“For some non-traditional people, it would be much better to have access to something like PrEP [...], and I don’t think that [if I had this option,] I would be diagnosed.”

"There is nothing wrong with leading a life where you do not need to be afraid to have sex with your partner [...] As for whether the NHS should pay or not pay for it, there are studies that prove that HIV prevention is much cheaper than lifelong treatment of people, developing new ARTs, studying and everything else [...] Therefore, if you understand what human life is worth without a diagnosis, then PrEP is your best and cheapest option. ”