BHIVA response to The Irish Times article 'Anti-HIV drug removes personal responsibility'

Friday 21 April 2017

On 20 April 2017 The Irish Times published an article titled 'Anti-HIV drug removes personal responsibility' which can be found at http://www.irishtimes.com/opinion/anti-hiv-drug-removes-personal-responsibility-1.3054235

BHIVA responded with a letter to the Editor of The Irish Times, as detailed below:

Dear Mr O'Neill

I am writing to you due to my concerns about the recent opinion piece ‘Anti-HIV drug removes personal responsibility’ by Derek Byrne published in the Irish Times on 20 April 2017. This piece has generated a considerable amount of concern in the HIV community already as its content is completely at odds with current recommendations by the World Health Organisation and NICE which recognise that HIV pre-exposure prophylaxis (PrEP) is an important component of HIV prevention.

Numerous studies have shown that PrEP is a highly clinically and cost-effective safe intervention which reduces the risk of becoming infected with HIV by around 90%. The dramatic reduction in HIV infections observed by several London clinics clearly shows that, when we get HIV prevention right, it works. PrEP is a vital pillar of HIV prevention. We know that on average 17 people are newly diagnosed with HIV each day in the UK to whom PrEP remains unavailable.

Prevention is routinely offered for conditions which can be caused by behaviours such as smoking or overeating, so why should the prevention of HIV be treated any differently?

This is especially illogical as hormonal contraception is offered to prevent unwanted pregnancies, an outcome also from unprotected sex.

Mr Byrne states that “PrEP…will, ultimately, be responsible for widespread liver disease among gay populations in 10-15 years from now”. This is a very strong statement, which we believe is not grounded in clinical or research evidence and may potentially deter people at high risk of HIV from seeking PrEP. We therefore request that you provide us with evidence for this potentially harmful assertion.

I would like to take this opportunity to work with you to redress this situation; as our prime concern as a professional body is to minimise the risk this article may have in discouraging PrEP use, thereby increasing the risk of HIV transmission and subsequent morbidity and mortality. I therefore propose that we submit for publication a letter of clarification to better inform your readership of the latest evidence and guidance around PrEP.

I look forward to hearing from you.

With kind regards

Yours sincerely

Prof Chloe Orkin
Chair, British HIV Association (BHIVA)