The issue with PrEP isn't whether or not it works. We know that it is 99% effective in preventing the transmission of HIV, as long as you adhere to taking that blue pill daily, and we know that increased access to PrEP decreases rates of HIV infections. Since Truvada was approved in the US by the FDA as a pre-exposure prophylaxis, the rates of HIV have steadily declined in metropolitan cities. In San Francisco, for example, HIV rates have dropped by roughly 15-20%, a year since the FDA approved Truvada for prevention in 2012.
The potential to end the HIV epidemic is possible because of PrEP. A large CDC study, presented in early 2016, revealed that PrEP can decrease HIV diagnoses by at least 70%, so PrEP's issue clearly isn't efficacy--it's access. Many doctors are still unaware of the benefits and some fear prescribing it. For many, PrEP is not covered by insurance, and the high cost is prohibitive. Some folks who're high risk for acquiring HIV still don't even know that PrEP exists.
London has found an unlikely way to circumvent access barriers by buying PrEP online. Since PrEP has been available to purchase digitally, four london sexual health clinics have seen a huge decline of HIV infections among gay men. More specifically, 2016 had roughly 40% fewer infections than 2015. But the relationship between buying PrEP online and the decrease in HIV infections is correlative, not necessarily causative. Researchers are reluctant to completely credit the decline in London HIV infections to online PrEP.
Related | Gay Men Aren't Finding Out About PrEP from Their Doctors
Will Nutland, from the London school of Hygiene and Tropical Medicine, said "We need to be very cautious at this stage, but I can't see what else it can be." Nutland is the starter of PrEPster, a website that provides information about buying PrEP online in a safe and affordable manner.
One of the main sites gay men use to buy Truvada inexpensively online in London is called, I Want PrEP Now, where you can buy generic versions of Truvada for roughly PS40 a month through international online pharmacies, instead of paying 10 times that monthly for the brand-name Truvada.
So far, purchasing PrEP online has been safe and equally effective. No pills have turned out to be fake, and a study revealed that there have been no new HIV infections or kidney issues among men who bought PrEP online. Some sexual health professionals are now actually encouraging high risk gay/bi men to purchase PrEP online.
Mags Portman works at the Mortimer Market Centre in London, one of the clinics that's seen large declines in diagnoses. He said the General Medical Council told health professionals that it's indeed under the ethical guidelines for clinicians to give patients alternative options to treatments that would otherwise be unaffordable.
Hopefully, the drug will become cheaper in the UK (and in the US, too), but in the meantime, it's good to know there are alternative, safe options to purchasing PrEP for folks in the UK.