PEOPLE exposed to HIV are being denied access to a lifesaving treatment that acts like a “morning-after” pill and can prevent infection by the virus.

In a landmark legal action, two HIV-positive men are to sue the Government for failing to implement a proper national policy for the treatment, which it is claimed could have prevented hundreds of people from contracting the disease.

The therapy, known as post-exposure prophylaxis (PEP), consists of a month-long course of antiviral drugs similar to those given to people with Aids. If started within 72 hours of exposure, the treatment has been shown to reduce the chances of infection by more than 80 per cent.

PEP is routinely available to health workers in Britain who are accidentally exposed to HIV. However, it is available in only a handful of specialist clinics in London and Brighton for those who contract the virus sexually, while public awareness of the treatment remains almost non-existent.

A study published in the British Medical Journal revealed that only 1 of 151 people in Amsterdam given PEP after HIV exposure through sexual contact went on to contract the virus. The one individual who tested positive admitted to having unsafe sex after completing his course of treatment.

The two men who have launched the action against the Department of Health say they knew exactly when they were exposed to HIV, but neither was aware of PEP’s existence.

The BMJ study increases pressure on the Government to introduce a national policy to improve access to PEP, which is widely available in the United States, Australia, France and the Netherlands.

Campaigners say that the failure to provide PEP in Britain stems from fears about increased promiscuity, particularly among gay men, and a lack of scientific evidence on the treatment’s efficacy. Frances Swaine, of Leigh Day solicitors, told The Times that such reticence and lack of research was inexcusable. The lawyer, who is seeking a judicial review and damages for her two clients, said the Government could end up facing thousands of cases.

“All sexually active people would want these drugs to be available to them if they knew of their existence,” she said. “This treatment could act as a morning-after pill to a deadly disease.”

Martin Fisher, a specialist in sexually transmitted diseases, said that PEP, which carries some unpleasant side-effects such as nausea, deserved a place in HIV prevention strategies. He said that there was still a lack of research into its use after sexual exposure, but recent studies did indicate high success rates.

Guidelines for PEP were introduced in 1997 for health staff exposed to HIV during their work, while recommendations published last year recognised that some doctors have prescribed it for people infected during sexual contact. However, the Government’s medical advisers “cannot recommend in favour of, or against, its use” because of lack of research.

“It is logical to promote PEP to those groups that are most at risk,” Dr Fisher said. The consultant added that while the course of treatment costs around £1,000, it was nothing compared to the estimated £1 million per patient for a lifetime of Aids drugs.

“Of course, you do not want to institute anything before you know it works, but trials are showing that PEP works in a sexual setting,” he said.

Paul Ward, deputy chief executive of the Terence Higgins Trust, the sexual health charity, said that PEP should be offered by all primary care trusts. He said that only a small minority of trusts so far provided such a service. The charity launched a PEP awareness campaign last July after becoming frustrated at the lack of action on the therapy.

A Department of Health spokesman said that the pilot campaigns, run in conjunction with the Terence Higgins Trust, were being evaluated pending any policy decisions: “PEP is not a substitute for safer sex. Condom use remains the main message of HIV prevention. However, the Department . . . acknowledge(s) that we need to consider other interventions, including PEP.”

Andrew Lansley, the Tory health spokesman, called for an urgent appraisal of the prescribing of PEP by the National Institute of Clinical Excellence, the Government’s drug watchdog. “This case highlights a real issue,” he said.

“There are many people who are leading responsible lifestyles but, if they have an accident, we must protect them rather than expose them to a lifetime with HIV.”

www.timesonline.co.uk/health
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HIV COUNT

• About 50,000 Britons are HIV-positive, of whom at least one third are not aware that they carry the virus. About 7,000 HIV-positive diagnoses are made every year
• Since 1982, 59,497 people in Britain have been found to be HIV-positive and 12,760 people have died of Aids
• HIV attacks the white blood cells responsible for setting the body’s immune system in motion, making it hard to fight off infections

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