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Learning lessons from PrEP will help in so many LGBTQIA+ healthcare battles
Queer Gaze Health

Learning lessons from PrEP will help in so many LGBTQIA+ healthcare battles


I’ve been taking PrEP for almost 7 years now. During that time, I’ve been crazy enthusiastic about making positive changes to reduce health inequalities. But I have seen how queer health has been mishandled time and time again.

PrEP, a drug that can prevent HIV when taken before and after sex, has been routinely available to access for free on the NHS for over four years now. 

In 2022, 86,324 people initiated or continued PrEP usage in England

It’s a game-changing drug, especially for queer communities who’ve lost so much in the HIV/AIDS pandemic. But, sadly, so many people who could benefit from taking it are still not on the drug.

HIV disproportionately impacts gay and bisexual men, Black African communities, trans people, sex workers and migrants. But statistics from the UK Health Security Agency showed that many of these communities don’t feel comfortable accessing the drug - or simply aren’t able to.

Why aren’t we doing everything possible to ensure that the most affected groups know about PrEP?

PrEP has revolutionised how people have sex. It’s been a crucial part of ending HIV and is helping people take control of their health. Knowing just how useful it is and knowing that not enough is done to educate as many people as possible about it enrages me.

I’m not alone in this anger. Many of my colleagues in the HIV and sexual health sector feel the same - I’ve seen many rants about it in meetings. It’s incredible that we can get PrEP in England, but I worry that we haven’t learned from the fights for HIV medication in the ‘90s, or from our victory in securing this provision in the first place. 

We’re seeing the same battles happen again currently with DoxyPEP. This drug to be taken after sex, can prevent bacterial STI infections - but it is not currently prescribed in the UK on the NHS.

But some people already use it, and have done for some time.  

This is exactly how things started with PrEP. Community groups and queer activists worked hard to get it into the hands of those who needed it. Meanwhile, the charity National AIDS Trust had to take the NHS to court - TWICE - before it agreed to prescribe it.

Does this all remind you of anything?

Those court cases took a great toll on those involved, but it’s fair to say that without them, many of us in England would not have access to PrEP on the NHS today. 

More recently, there were echoes of all of this in the mishandling of the MPOX outbreak in the UK. Typically, the virus occurs in Central and West Africa, but a global outbreak began in 2022. Though it can affect anyone, this particular outbreak primarily affected sexually active gay, bisexual, and queer men who have sex with men.

When the outbreak first hit the UK, calls for vaccines were ignored. When the vaccines were finally made available, official bodies did not distribute information about them. Many of the queer men who sought it had to find out about availability through their social and sexual networks - which is absurd. 

This is eerily similar to how so many queer men learned about PrEP all those years ago: through word of mouth. That just shouldn’t be the case anymore.

I find it so upsetting that since the start of this decade, we have had three different health issues affecting queer people that haven’t been taken as seriously as they should have been. 

We’re still making the same mistakes from the past and we’re still not learning from them. History is repeating itself. We have all the tools to better our sexual health and we’re not using them. This can’t keep happening.

The fight to get PrEP is steeped in a rich history of queer activism. To know where we can go in the future we must learn from our past.

You can listen to that history, and the phenomenal story of the battle for access to HIV prevention drugs in the UK, told by the health professionals, activists, and researchers who fought for it now alongside stories from the PrEP generation in The Other Blue Pill, in our new documentary podcast for the Love Tank supported by National Aids Trust.