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 beencalled a ‘promiscuity pill’ insome media publications, claimingthat the preventative medication that coulderadicate new HIV infections within the UK atthe cost of £20million a year to the taxpayer couldlead to more promiscuity between the MSM (menwho have sex with men) community, de-creasedcondom use and increase of other sexually transmitted infections. Theestimated cost of medication totreat people living with HIV to the NHSis currently estimated to be around £660mil-lion.However, this does not take into consideration the personal impactliving with HIV has on a personsuch as the need to access mental health supportwhich has been decimated under consecutive Conservative and coalitiongovernments.
I feel uncomfortable making such aneconomic argument as numeroustrials and research have beenundertaken to show the effectiveness of PrEPand the long-term savings to the NHS. The purposeof this piece is rather to highlight the similarheteronormative patriarchal arguments againstsomething that is now commonplace amongstthe options for women to have better personalbodily autonomy and that of the potential options for people to protectthemselves from the potentialrisk of HIV infection.
After originally being approved in 1957 forpeople with severe menstrualdisorders, the pill was approved in America for contraceptive use in1960. A large number of womenin America, therefore, used toreport to doctors with severe menstrual disorders. This is because, whenpatriarchal structures are inplace that deliberately restrict aperson’s bodily autonomy, people in need will findways to circumvent these restrictions. This is similarfor PrEP impact trials: working poor people can’t afford to buy genericversions and have them shippedinto the UK. Hence, in order to get thepill, people are left with either lying to the NHS to be prescribed Post-Exposure Prophylaxis(PEP) as both medications usethe same drugs, or they are leftat risk.
An argument we see time and time again isthat people should just use acondom. Condoms, when usedperfectly every single time, are 98% effective, whichmeans that 2 out of 100 people who use condomsas their only method of protection from STIs,HIV, or unwanted pregnancy will be at risk. Peopleare fallible, so outside of such clinical set-tings,condom effectiveness drops to around 82%, meaning18 out of 100 people who use condoms astheir only means of protection are now at risk. Thisis an increase of 900%. This is why it is often suggestedthat those who want to avoid pregnancy also use a primary contraceptivethat is more than 99% effective,meaning that fewer than 1 in 100people will get pregnant whilst using it. The sameadvice 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.