[Editor's note: PrEP stands for PRe-Exposure Prophylaxis and is an HIV prevention technique whereby people at heightened risk of contracting HIV are put onto a monitored programme of HIV medications to minimise the chances of the virus taking hold in their bodies.
It's being used with now-proven success in a number of countries or areas with similar, ie. predominantly gay and bi male, epidemics as New Zealand's but is, despite the urging of everyone from Body Positive, the NZ AIDS Foundation and even the World Health Organisation, still unavailable here except in the most extreme situations.]
This may be attributable to people being able to access PrEP through means other than regulated access through the National Health Service, argued one figure associated with the diversionary tactic, Will Nutland of the London School of Hygiene and Tropical Medicine.
Nutland established PrEPster, a website that provides British gay men and others with information about how to sidestep the cumbersome bureaucratic regulatory process and access PrEP when they need it. As for guilt-tripping about condom use, some HIV activists note that straight people never get asked these questions about their exposure to STIs, HIV and unwanted pregnancies, so why single out gay men?
However, the PrEP underground railroad networks cited in the New Scientist article have assistance from amenable UK medical practitioners, who provide blood and urine tests to insure that hasn't happened, and so far it hasn't. Moreover, the UK General Medical Council has provided support for such doctors, arguing that their first duty is to safeguard patient safety in this context.
Ironically, NHS England may be responsible for its own marginalisation in this context, given that its stonewalling may have contributed to the increased visibility and practical need for such websites as PrEPster and I want PrEP now. In some cases, PrEP can be urgently accessed through the NHS through provision of a free month's supply, and then 'clinic hopping' through false names to get additional free supplies from successive NHS outlets.
Greater condom use, more testing and treatment options could also be playing secondary roles in this encouraging turn of events, according to the National AIDS Manual, 56 Dean Street and Public Health England. Meanwhile, NHS England is providing a 10,000 place clinical trial within England, which will take care of more access needs amongst gay men and others at risk. However, the question remains what NHS England will do when those places are full.