The Campaign to Have PrEP Fully Funded on the NHS in England is a Feminist Fight

The following article is an excerpt from our latest printed Ecosprinter titled Reclaim Your Rights! – The Social Issue. We decided to bring you the articles from this edition in a digital form as well.

by Liam McClelland

It is widely accepted that the female contraceptive pill supported sexual freedom amongst women, enabling economic and social liberation. Whilst other alternatives such as the diaphragm existed, it is the pill that is credited with enabling women to have greater sexual freedom outside of the patriarchal confines of marriage. A holistic look at the 1960s also shows that a celebration of single life, and openness around sex and sexuality would lead to a number of pro-sex media publications and a huge shift in the previous morality rules that governed society. Simply put, individual sexual pleasure was accepted as a key facet of individual happiness and the pill enabled greater individual bodily autonomy to seek these pleasures.

Pre-Exposure Prophylaxis (PrEP) has been called a ‘promiscuity pill’ in some media publications, claiming that the preventative medication that could eradicate new HIV infections within the UK at the cost of £20million a year to the taxpayer could lead to more promiscuity between the MSM (men who have sex with men) community, de-creased condom use and increase of other sexually transmitted infections. The estimated cost of medication to treat people living with HIV to the NHS is currently estimated to be around £660mil-lion. However, this does not take into consideration the personal impact living with HIV has on a person such as the need to access mental health support which has been decimated under consecutive Conservative and coalition governments.

I feel uncomfortable making such an economic argument as numerous trials and research have been undertaken to show the effectiveness of PrEP and the long-term savings to the NHS. The purpose of this piece is rather to highlight the similar heteronormative patriarchal arguments against something that is now commonplace amongst the options for women to have better personal bodily autonomy and that of the potential options for people to protect themselves from the potential risk of HIV infection.

After originally being approved in 1957 for people with severe menstrual disorders, the pill was approved in America for contraceptive use in 1960. A large number of women in America, therefore, used to report to doctors with severe menstrual disorders. This is because, when patriarchal structures are in place that deliberately restrict a person’s bodily autonomy, people in need will find ways to circumvent these restrictions. This is similar for PrEP impact trials: working poor people can’t afford to buy generic versions and have them shipped into the UK. Hence, in order to get the pill, people are left with either lying to the NHS to be prescribed Post-Exposure Prophylaxis (PEP) as both medications use the same drugs, or they are left at risk.

An argument we see time and time again is that people should just use a condom. Condoms, when used perfectly every single time, are 98% effective, which means that 2 out of 100 people who use condoms as their only method of protection from STIs, HIV, or unwanted pregnancy will be at risk. People are fallible, so outside of such clinical set-tings, condom effectiveness drops to around 82%, meaning 18 out of 100 people who use condoms as their only means of protection are now at risk. This is an increase of 900%. This is why it is often suggested that those who want to avoid pregnancy also use a primary contraceptive that is more than 99% effective, meaning that fewer than 1 in 100 people will get pregnant whilst using it. The same advice is used for people who want to take PrEP.

The types of sex had and contraception used will vary from person to person, hence we need to have a variety of options that are suitable for each individual. My concerns moving forward is that with Brexit we will see further cuts to GU (Genitourinary) medicine and HIV research. Whilst the UK has met the UNAIDS target to end HIV through the 90-90-90 targets (90% of HIV positive people diagnosed, 90% of those diagnosed on HIV medication, and 90% of those on medication confirmed as being HIV undetectable), this could be at risk. Therefore, we need to ensure that when we are campaigning for a Feminist Europe we are including equal access to healthcare for all people.

Liam is a passionate eco-socialist with interests in environmentalism, sexuality and gender, as well as theology and philosophy. Having contracted HIV in 2012, they use their platform to raise awareness and challenge stereotypes associated with those living with HIV.

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