To think that the nhs should not pay for anti viral drugs for healthy gay men

[ReallyTired]

www.bbc.co.uk/programmes/p02ks961

Gay men who want to be promiscuous should use condoms to protect against AIDS and other stds. I don't see why someone choosing to have unprotected sex should have this drug paid for by the nhs. Is someone with a lifestyle chaotic enough to have unprotected sex with lots of partners likely to remember to take the pill every day? i feel that £420 per month is a lot to spend on a healthy person who chooses to indulge in risky behaviour.

If these anti vital drugs are used in healthy subjects is there a danger of complacency. I also think that the AIDS virus might mutate and become drug restistant like bacteria and antibiotics.

Why because they're gay? What about paying for abortions or child benefits for promiscuous straight heterosexuals? Does that froth you up too?

maybe women should pay for the pill as well

According to the national aids trust 1 in 20 gay men have HIV which is quite a lot and suggests that a gay man who only has a couple of partners over a few years is at high risk of contracting HIV if he has unprotected sex, so it isn't restricted to those who are highly promiscuous.
Of course the best solution would be for people to stop having unprotected sex with people who haven't been screened for STIs and HIV, but realistically both gay men, lesbians and heterosexual people have unprotected sex.
I'm on the fence because £420 per month is a mahoosive sum of money but how much does it cost to treat the 1in 20 gay men who already have HIV?

I couldn't listen to the clip, only read the text underneath but couldn't see a mention of NHS?

They've obviously thought about the difference paying for the cost of prevention compared to the cost of living with HIV. I don't see it as a bad thing. I do have a friend who had to take them after being exposed to the virus in her healthcare role. Said they made her feel very ill.

Just seen that the lifelong cost of treating somebody with HIV is up to £360,000. How much does that work out per month? Prevention is better than treatment / cure.
Hopefully in the future a cure for HIV will be found.

Nhs funds all sorts of preventive treatments why no this one?

Contracting HIV does not mean you are promiscuous.

Condoms break. People lie about their HIV status. Other groups of people get exposed to HIV.

Luckily for the us the NHS doesn't view disease as a punishment for lifestyle choices they don't agree with.

Where is your compassion OP?

What's the difference between this and the HPV vaccine for girls? Genuinely curious.

The NHS funds all kinds of preventative medicine. Why not this?

YABU.. Agree with other posters, women get all sorts of preventions for free and the cost of treating HIV is huge, people with it live to old age now. Prevention will save money in the long term.

well, if we do the maths, what do we save?

£420 per month is £5040 a year. Since they are talking for life, then you are talking what? average 60 years on it? From first becoming sexual active? That's £302,400 pp

So £302,400 for every person as preventative v £280,000 - £360,000 for the lifetime of each person diagnosed with HIV, which is one in 20?

Seems to me that it would cost a considerable amount more.

So from a cost pov, I reject her claim that it would save money.

From a health pov, is it worth the extra cost to protect people from hiv? Ideally, yes, people would use condoms but clearly they aren't. But would having the drugs cause more people to do without condoms? If we are then talking about gay men you have the possibility of gay men who are taking the drugs having sex with bi men who may or may not be then the bi men have sex with women who certainly don't have the protection of taking preventative drugs and what happens? And yes, would we see the virus mutate? I don't know.

I don't know. I think it's something that needs to be weighed up. Ideally, people should have free and unlimited access to condoms and be willing to use them. Perhaps massive campaigns and free availability of condoms?

Cheaper than treating HIV

www.bbc.co.uk/news/health-31601042

Promiscuous and lifestyle choice, I have never cheated on someone and never slept around but still caught an STD from a long term partner. Having HIV does not equate to your sexual promiscuity or lifestyle and I find that belief shows disrespect to gay men.

Well they're looking at the cost effectiveness of doing this anyway so if it's cheaper than treating HIV then they'll do it and if isn't then it's unlikely to get past NICE anyway.

FWIW preventative methods are considerably cheaper which is why there is so much focus on it. Of course this doesn't stop moralistic campaigners who would rather pay the exorbitant cost of treating someone with Hep C or HIV than pay the piddling costs of providing needle exchanges...

I also think that the AIDS virus might mutate and become drug restistant like bacteria and antibiotics.

What is your basis for thinking this?

I have no issue with it at all - prevention is far less costly than long term treatment

I feel that £420 a month is a lot. At a time when lots of a and e units are over stretched I don't see hoe it can be justified. lots of gay people have suffered long waits to see a hospital consultant or a much needed operation.

If the drug could be given by a slow release injection every 3 months I could see the point for high risk groups like drug addicts or prostitutes. Even then I still worry that they might think sex without condoms is safe.

I think the message needs to be got across that unprotected casual sex is dangerous. Diseases like syphillis can kill if not caught early. in the past syphilis was as much of a death sentence as AIDS. It is becoming more dangerous because of anti biotic resistance.

It's an interesting subject. Any sort of prevention is surely better than treatment?

But the group with the most new cases of HIV is the heterosexual community, partly due to the larger population size of course - so should we not be considering preventative measures there?

Or the Black African population in the UK have a 1 in 25 HIV rate I think (male and female) would they also be offered it?

I think the anger should be toward the drug companies who charge huge sums and make huge profits on drugs which they could often supply for a much lower cost. Of that £420, how much is profit for the drug companies?
There are countries in the developing world who could really really benefit from an HIV prevention drug but they will never be able to afford it so instead they have whole families infected with the virus and unable to get any treatment.

Co gain should the drug be available to heterosexual women?

I think the difference between this and HPV is that there is still a high risk of HPV infection when using condoms. Additionally there is a clear cost benefit as the cost of the HPV vaccine is much lower.

I'm on the fence about this, as anything which prevents the spread of HIV is a good thing. The drug is slightly less effective than consistent condom use however.

Also, it's clearly not only gay people who become HIV positive. Should this medication be available to everyone? Or only gay men who aren't willing to take responsibility for their own sexual health by using condoms.

also think that the AIDS virus might mutate and become drug restistant like bacteria and antibiotics.

What is your basis for thinking this?

Because it's what viruses do.

My daughter is travelling overseas in the summer and needs Yellow Fever, and Rabies jabs plus malaria tablets, none of which are available on the NHS. But they would treat her for free if she caught any of these diseases.
Looks like the NHS is selective about the diseases they are interested in preventing.