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© Dale Crosby Close for Mosaic

The Briefing: HIV prevention – could PrEP replace condoms?

A lot of research goes into our stories. Here are some of the resources we used to put together our story on the unexpected effects of the HIV prevention pill.

PrEP is great at blocking HIV, but as its use grows, so do fears that people will be more sexually reckless and spread other STIs. But researchers are coming to think that the opposite could be true. In this feature for Mosaic, Bryn Nelson explores how PrEP could in fact help control rates of other STIs as well as HIV.

If you want to know more, this reading list gets deeper into some of the themes from Bryn’s story.

The PROUD trial

This 2015 press release announces the initial findings of the PROUD trial of PrEP in the UK, showing that the drug is highly effective at protecting against HIV infection.

The full results were reported in this 2016 paper, which was also the first article to be published by the Lancet as open access.

For more information about the PROUD trial, check out its website.

The condom debate

This controversial op-ed in the New York Times questioned whether the arrival of PrEP would mean “the end of safe gay sex”. 

The NYT story was met with substantial criticism. This response, from HIV prevention specialist Grant Roth, describes the story as “an egregious and detrimental waste of space”, while insisting “safe gay sex is still happening”.

Jezebel mocked the piece with an article titled New York Times: won’t someone please think of the condoms?!?’.

This Guardian article from October 2018 once again addressed fears that PrEP is leading to a fall in condom use, and therefore an increase in other STIs.

Funding for PrEP

PrEP is available on the NHS in Scotland and Wales, but not in England. This i article addresses the inequalities that are caused when PrEP isn’t freely available. The only way for many to access the drug is either though participating in trials or turning to private healthcare.

NHS England announced its trial of PrEP implementation in 2017, and the most recent update on the trial was in June 2018.

Thailand has led the way in PrEP availability by rolling out the drug in higher-risk groups. This article explains how access to PrEP improved dramatically when it received backing from influential public figures.

The PrEP Watch website reviews access to PrEP worldwide using an interactive map. For each country, it lists eligibility criteria, who funds the drug, details of its policy framework and the types of delivery projects. In some countries, such as India, funding for PrEP is done entirely by charities, meaning uptake is extremely low.

PrEP and women

In our interview with PROUD participant Zia, he mentions that women are often marginalised in the conversation about HIV.

The I Want PrEP Now website offers advice specifically for women on how PrEP might help protect against HIV and how to get the drug in the UK, as well as more PrEP resources.

This video interview follows the story of Poppy, whose husband is HIV positive. Poppy explains how PrEP enabled the couple to conceive naturally, in spite of doctors being reluctant to prescribe it to her.

More from Mosaic

Françoise Barré-Sinoussi discovered HIV in 1983. In this interview, she reflects on the discovery, her Nobel Prize and how to manage HIV moving forward.

This gallery of posters tells the story of AIDS awareness around the world.

In ‘Wherever you are, time in running out for treating gonorrhoea’, Sophie Cousins investigates how scientists might treat the infection in cases where it is resistant to antibiotics.

Governments around the world were slow to get to grips with HIV/AIDS. In this Mosaic feature, Alexandra Ossola explores what happened when it started to be understood as a matter of international security.