HIV: Where There Is No Cure, There Can Only Be Prevention

With recent increases in HIV contraction rates in Ireland, COLMAN MOLONEY charts the HIV landscape and asks why the latest advance in preventative medicine, PrEP, is simply not available here.

1987 marked a crisis point. The world was undergoing an epidemic never seen before; thousands of otherwise healthy young people were being slaughtered, denied help and ignored. 1987 wasn’t an unique year in the 80’s, it was just another 365 days of loss and suffering caused by a plague. That plague was initially called GRID (Gay Related Immune Disorder) or “gay cancer” as it disproportionately affected the gay community. Thirty years later, we now know that disease as AIDS. And it does not just affect the LGBT* community, anyone is at risk of contracting it, regardless of sexual orientation.

HIV is a virus that attacks and breaks down the immune system, with AIDS being the final and potentially fatal stage of a HIV infection. People suffering from HIV/AIDS have long faced stigma and hardship. The first case of HIV in Ireland was documented in 1982, but only started gaining public awareness in 1984 with distinct tones of homophobia. In 1985 the Gay Health Action and AIDS Action Alliance formed in Dublin to campaign and raise awareness. Since then homosexuality has been decriminalised and drugs have been developed to ensure long and healthy lives for those with HIV. With advances since the dark days of the 80’s and 90’s, you’d be forgiven for thinking the rate of HIV infection has gone down. In fact, 2014 saw 377 new HIV diagnoses in Ireland, an increase of 11% compared to 2013. A year after that, another 491 were newly diagnosed.

Men who have sex with men (MSMs) are most vulnerable to infection, hence the tendency to associate the disease with sexual orientation. However, those who inject themselves with needles are equally susceptible. As students in university, we have a responsibility to educate ourselves on sexual health, and particularly HIV. While going to college students have many new experiences – first time living on their own, perhaps their first time drinking and first time having sex. Sex is liberating, but some of the side-effects are not. Whilst I’ll spare you the talk on unplanned pregnancy and STIs, HIV prevention cannot be stressed enough. Unprotected sex with someone who is HIV positive leads to infection, but that’s not the only thing.

Though it’s rarely touched on by media outlets, Ireland is heading towards another epidemic – chemsex. For those unfamiliar with the term, chemsex refers to the phenomenon of gay or bisexual men engaging in drug-fuelled sex sessions. Many of the drugs used such as GHB, Liquid E and crystal meth can lead to disinhibition and increased sexual desire, which together can be a recipe for fun, but also risky behaviour. Chemsex is becoming increasingly popular, but hasn’t been tackled head on by any studies or directed campaigns in Ireland. Unfortunately, this isn’t the only area where this country falls short.

There are drugs available to treat HIV infection, though only a few. Post-Exposure Prophylaxis (PEP) is a course of emergency medication that aims to prevent HIV infection following a recent exposure to HIV, for example following a sexual contact or a needle-stick injury. PEP is free and currently available through emergency departments and STI clinics such as the GUM Clinic in the South Infirmary in Cork. PEP needs to be taken within 72 hours of exposure. However, Pre-Exposure Prophylaxis, or PrEP, is a prevention option for people who are at high risk of getting HIV. It’s meant to be consistently used, as a pill taken every day, and to be used with other prevention options such as condoms. Think of it as being a type of contraceptive pill. PrEP is not currently available in Ireland, yet the World Health Organisation (WHO) recommends that  it should be available to MSMS in all countries, alongside other HIV prevention interventions. Through lack of availability in Ireland, many people are resorting to buying the drug online. However, this is potentially dangerous due to lack of regulation.

With the stigma surrounding HIV/AIDS still lingering, it is our responsibility as young people to get educated and get protected on these issues, to lobby for PrEP availability and demand the resources we need to live our lives freely. The WHO estimates 35 million people have died worldwide from AIDS to date. We need to act up, to stop the past from repeating itself.