Why Weren't We Prepared for PrEP?
© Illustration by INJECTION - Mollie Sprigg
The ongoing stigma surrounding HIV is hindering the progress of its treatments.
In today’s sex-positive society, it is difficult to imagine what it is like for sex to be something that incites intense fear and anxiety. Not just because you are with a new partner in a different town, but because there is a genuine risk of fatality associated with an act that is supposed to be pleasurable. Yet, this was the terrifying reality for thousands of men in the 1980s, following the onset of the AIDS epidemic - and it still exists today.
Treatments or preventions for the stigmatically termed “gay plague” were practically non-existent until finally, in 2012, a lifeline came in the form of PrEP. Officially Pre-Exposure Prophylaxis, PrEP is a preventative drug taken by those at high risk of exposure to HIV. Though not a treatment for the virus, if taken as prescribed (as a pill, four times a week), PrEP is 99% effective in reducing the risk of contracting HIV through sexual intercourse.
Sounds great, right? Those unfairly condemned could finally experience the sexual freedom and liberation they had always deserved! Unfortunately, from conception to production, the PrEP process has been infiltrated with prejudice, such that both the virus and its treatment are taboo today.
When early clinical PrEP trials were underway, stigma and fear of discrimination were so rife that participants believed that the researchers were actually attempting to infect them with the virus deliberately or providing a drug that increased their likelihood of HIV contraction. This early distrust in the drug has resulted in widespread ignorance of PrEP’s potential.
While these initial fears luckily did not stop PrEP from making it to market, the drug’s struggle to reach its audience did not end here, again, thanks to societal judgement.
Following the COVID-19 pandemic, everyone in the UK was given the opportunity (quickly, freely, and easily) to be vaccinated against this horrific disease. In the two years following the outbreak in late 2019, some countries even boast upwards of 90% vaccination rates. Why, then, has a drug to treat an epidemic disease present for 40 years not had the same support?
Due to deeply rooted discriminatory views, we have adopted the unfounded belief that if you contract HIV, it is because you have taken part in “risky” sex and, as such, are irresponsible and deserve the consequences. If you catch COVID, on the other hand, it is deemed not your fault. This contradicts the fact that many positive COVID cases arose from illegal house parties - where attendance is undoubtedly an individual’s own responsibility.
This societal perception of queer sex, and its synonymity with promiscuity and carelessness, leads to stigmatised views of those who contract HIV. So while COVID and other common diseases such as the flu are considered societal issues that deserve a societal solution, we have a ‘not our problem’ attitude about HIV.
Another roadblock to rollout is that medical professionals are not free of discriminatory opinions. Many hold the same conjecture that those at risk of HIV are in such a position because they “cannot be trusted” and, therefore, won’t take PrEP as they are supposed to. Why can we not afford the same trust to people living with potential HIV as we do to the millions of others who take a daily drug? In society, there is a perception that something inherent to the lifestyle and character of men who have sex with men is not compatible with taking a daily drug. This unfairly undervalues individuals’ autonomy over their own lives and their own diagnoses.
Allowing assumptions to seep into the medical mindset and societal psyche has resulted in a process driven by prejudice, reaching the point that for many at risk, the simple thought of having PrEP pills in their medicine cabinet makes them unwilling to take it.
Medical progress has happened far faster than societal progress - and we can’t keep up.
So how do we change the fate of PrEP and the thousands of people who may be at risk of HIV? The UK government has pledged to end all new cases of HIV by 2030, but this can and will only be the case if we start tackling the stigma now.
While TV shows such as ‘It's a Sin’ and the openness of gay celebrities surrounding the topic of HIV are huge pushes forward in the discussion surrounding HIV, the only way to encourage PrEP to reach its audience is for this topic to infiltrate general conversation. Talk to your friends, those in the LGBTQ+ community, and allies to encourage education and empowerment surrounding HIV and its preventative treatments.
Further reading about HIV and PrEP Treatment:
Terrence Higgins Trust: https://www.tht.org.uk/hiv-and-sexual-health/prep-pre-exposure-prophylaxis
National Aids Trust: https://www.nat.org.uk/
Centre For Disease Control and Prevention: https://www.cdc.gov/hiv/basics/prep/prep-effectiveness.html