A survey has found that nearly a quarter of gay men in England wanting PrEP are unable to access it.
The study, carried out by Public Health England, also found that men living outside of London faced greater difficulty obtaining it.
Unlike the US and Australia, PrEP is not widely available in England. There is currently an ongoing NHS Impact trial, limited to 10,000 participants, to determine whether to make the treatment available nationally.
Matthew Hodson of HIV awareness organisation NAM (National AIDS Manual) told Gay Star News: ‘The difficulties that some have had trying to get hold of PrEP demonstrates that the Impact trial in England is only a sticking plaster – and an inadequate one at that.
‘We know that PrEP is very effective at preventing HIV and we should now be moving as quickly as possible to full rollout to anyone who needs it. This could be done in parallel to the trial.
‘Already we are hearing stories of people who have been turned away from the trial and have acquired HIV since. That’s a lifetime of treatment that could have been avoided by access to PrEP for a season of risk. It’s frustrating that we have the tools we need to prevent HIV infections but we’re not making them available to all.
‘What we have observed in other countries where PrEP is available is that it is those who are otherwise marginalised by society who are the least able to access it, and these are often the same groups that have some of the highest rates of HIV: Black gay and bisexual men; trans women; Black women and migrants.’
Marc Thompson of educational charity PrEPster said: ‘It’s unsurprising that PrEP access is so geographically unequal. We need more targeted health promotion activity and advocacy in parts of the country where it’s hardest to access PrEP.’
The survey took place throughout May this year. It targeted gay men who had either taken PrEP, or attempted to access it, since January 2016. The survey was distributed via PrEPster and IWantPrEPNow, and received 1,711 responses, 1,565 of which provided demographic data.
Almost all PrEP users reported engaging in condomless anal sex, however three quarters of those not accessing it reported going without condoms too.
One major difference found between respondents was that those taking PrEP were much more likely to report being happy with their sex lives. 28% of respondents using PrEP strongly agreed that they were satisfied with their sex life, as opposed to the mere 9% of those not on PrEP reporting satisfaction.
The difference in responses concerning sexual satisfaction seemingly demonstrates the degree to which anxiety over HIV affects gay men’s sex lives.
‘This data confirms what we’ve been hearing directly from PrEP users,’ said Will Nutland of PrEPster.
‘PrEP has a bigger benefit than just preventing HIV. PrEP facilitates better sex, and is reducing fear, anxiety and stress.’
1 in 6 PrEP users have experienced stigma
The survey also threw up several concerning statistics:
- Nearly a quarter of participants reported that they were worried about people’s perceptions of their PrEP use.
- One in six respondents reported having actually experienced stigma as a result of their PrEP use.
- 90 people said they had experienced hostility whilst on dates after divulging their PrEP use.
- Almost as many as the above statistic reported encountering disapproval from friends.
One participant commented: “My family thought I had HIV, or was “sleeping about”. However I explained that regularly being checked and taking precautions makes me less likely to contract HIV.”
Whilst PrEP use in England has rapidly expanded over the last year, there still appears to be a large amount of misunderstanding amongst the general public regarding what PrEP is, and how and why it is used.
Greg Owen of PrEP access site IWantPrEPNow said: “This data shows how people are using PrEP in ways which suit their personal circumstances and sexual patterns. We need to be supporting people to use PrEP in ways that best suit them in real world settings”.
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