Pre-Exposure Prophylaxis: Identity Stigma and Activism. In P. Reilly, A. Veneti & D. Atanasova (eds.), Politics, Protest, Emotion: Interdisciplinary Perspectives. Pressbooks

Abstract

Human Immunodeficiency Virus (HIV), which is the cause of Acquired Immune Deficiency Syndrome (AIDS), remains a major public health concern some 35 years after its first clinical observations. In the UK, men who have sex with men (MSM) are disproportionately affected by HIV. According to the Public Health England HIV Situation Report in 2015, approximately 43% of the 103700 individuals living with HIV in the UK are MSM, while 57% of the 5850 new HIV diagnoses (through sexual exposure) were within this demographic group. In London, it is estimated that 1 in 11 MSM is living with HIV. These epidemiological data suggest that existing HIV prevention methods, such as condom use, have not been entirely effective and that novel approaches are needed in the fight against HIV/AIDS. This has led to discussions about the feasibility of pre-exposure prophylaxis (PrEP), which is a novel bio-medical approach for preventing HIV infection. The drug Truvada® (which consists of two nucleoside reverse transcriptase inhibitors, emtricitabine and tenofovir disoproxil fumarate) is currently used as PrEP in the US and was used in clinical trials in the UK. PrEP works by blocking a key enzyme that enables HIV to replicate once it has entered a human CD4 t-lymphocyte. As HIV is unable to replicate, infection cannot occur. Various clinical trials in several populations suggest that PrEP is highly effective. Data from the UK PROUD study, for instance, indicated an 86% reduction in HIV infection among individuals in the experimental group taking Truvada. Truvada as PrEP can be taken either on a daily basis or “on-demand” (that is, before and after a possible exposure) in order to prevent HIV infection.