When a conservative Christian journalist writes a story about a highly-praised AIDS drug headlined “Killing Grandma for Gay sex” and an AIDS activist describes it as a “profit-driven sex toy for rich Westerners”, you know that you’ve uncovered an ethical controversy.
This month the UK’s National Institute for Health and Care Excellence (NICE) issued a published an evidence summary on the use of Truvada, a lucrative Gilead drug for HIV pre-exposure prophylaxis (PrEP). In a number of other countries, Truvada has already been rolled out as a way of keeping gay men safe from infection with HIV. If taken every day, it prevents infection – a kind of pharmaceutical condom.
The controversy in the UK is not so much over whether it works, but whether it should be government funded. “There is little doubt that Truvada is effective in reducing HIV acquisition in high-risk people who are HIV-negative,” says the NICE advice.. “However, issues relating to uptake, adherence, sexual behaviour, drug resistance, safety, prioritisation for prophylaxis and cost-effectiveness are also important to consider, especially at a population level.
In August, the High Court ruled that the UK’s National Health Service had to supply Truvada because children with cystic fibrosis, amputees and blood cancer victims could be disadvantaged. It would cost the NHS up to £20 million a year. Outraged critics said that the money would be better spent on treatments for sick people rather than healthy people engaging in risky behavior.
On a public health level, there are concerns about whether the men could commit to taking the drug regularly.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.