Bafflingly, PrEP is still not available as part of the UK's National Health Service (NHS), and the date for a decision in the matter has now been pushed from April to June of this year. In the interim, gay men across the country have become creative in their efforts to obtain the HIV prevention drug Truvada.
Since the UK does make Truvada available as part of a PEP program after unsafe sex, gay Brits concerned about their health have begun visiting various clinics and A&E departments (the UK equivalent of the ER) to obtain Truvada along with partner drug Raltegravir, given together as a measure to stop HIV infection after exposure. The upside: this gives patients free access to PrEP, a month at a time, after visiting each clinic twice (a follow-up appointment is always necessary after receiving the first week of meds). The downside: to get enough of the drug to have a lasting and regular impact, it means having to visit various clinic locations, not to mention wasting the accompanying HIV drug and lying.
Greg Owen, a leading community activist pushing the NHS to catch up with the US in their policies concerning Truvada, even puts instructions on how to clinic-hop on his blog:
"There IS actually a way to get PrEP for free on the NHS. It means working the system! And being a little bit dishonest. But if a little white lie is going to get you some free drugs to keep you HIV negative - is it forgivable? This process is called 'clinic hopping' ... And claiming a false risk of exposure to HIV."
Owen goes on to describe men who will spend one day hopping around to two or three clinics to amass a stockpile of Truvada, then taking a pill every other day to make it last longer. The other drug administered, Raltegravir, conceivably gets flushed down the toilet. "Surely someone in the NHS can see this coming and behave proactively NOW to prevent this waste of much needed funds instead of reactively once we're another year down the line," Owen writes.
If PrEP were a viable option in the UK, the process would be streamlined, and those hoping to avoid the risk of HIV infection won't have to be so resourceful or creative in order to protect their health.