When it comes to the NHS, sexual health and safer sex, there is more we can be doing to help people make healthy choices. More importantly, to make the choices that are right for them and that makes their lives easier, safer and better.

Over the past few months there has been story after story, particularly in the LGBT press, about the potential impacts of Pre-exposure Prophylaxis on sexual health and in particular in cutting the number of HIV infections in the United Kingdom.

PReP is a drug that is given to people who are HIV negative, but are perceived as having a high risk of exposure to HIV, to stop them getting HIV. That could be for example, someone who has sex with their HIV-positive partner or someone who regularly has sex with multiple partners. Trials and its implementation in other countries has had stark results – in essence, PReP works – it stops people getting HIV.

But because we are talking about HIV, the impact here for LGBT people, and in particular gay men, is not something we should be afraid of talking about. In fact the complete opposite is true – we need to talk about it an awful lot more. We cannot hide from the facts and the growing figures of people, again in particular gay men, contracting HIV. This is a challenge for the LGBT community but that it is also for our NHS.

Regardless of the politics – our NHS is under strain. Because of the politics ­– that is not getting better. That is our challenge: to ensure the NHS can cope and can do better as demand increases and as needs, technology and priorities change.

So it came as a surprise and a shock earlier this week when NHS England announced it was to drop its plans to bring PReP into mainstream use.

This was a bitter pill for an LGBT community that has been leading the way in acknowledging the results of and championing the use of PReP. With an NHS under strain, moving to prevention of illness and infections is just obvious common sense. Instead, we are seeing a health service choosing to and sometimes forced to pass-by on life changing drugs, at the same time as also cutting the support given to treat and care for people during their illness. This is a toxic prescription for the future of the NHS.

In this case, with PReP, the NHS led people on. It made them believe that PReP was being considered – and that its use would be seen as a productive and necessary step in supporting people living with HIV – regardless of their individual status. Officials sat with the community and experts and listened. The statistics were presented, clear as day: trials in the UK have shown that PReP led to an 86 per cent fall in new infections. That is revolutionary – yet it is ignored.

The NHS is claiming that the responsibility here falls to local authorities. Preventative support, they say, is not the business of the NHS. That, in regulation and legislation, may be the case – but it is time things changed. Our NHS must be fit for the challenges of today. As local authority budgets are slashed, the picture is already getting worse and our health service overwhelmed. The NHS has to get into the business of prevention, otherwise it simply won’t be able to cope in the years and decades ahead.

Whilst the fallout from the NHS’ decision has divided the LGBT community, we cannot afford to let it do so – because the fight for PReP, is part of the fight for the future of the NHS.

We know that HIV infections are rising, we know support to people living with HIV is under strain, we know local authority budgets are being cut, we know PReP works in dealing with this growing problem. Yet we also know that that NHS is putting its head in the sand and saying it is someone else’s problem.

A £2m investment in PReP for local authorities is welcome but that £2m in practice, using the NHS’ own figures, will support just 500 people – at a time when nearly 10 gay men a day in the UK are being diagnosed with HIV.

If the argument is that there is not enough money to go around then we are missing the point. PReP will save money.

If the argument is that PReP will change behaviours and make risky behaviour more likely, then we are ignoring the statistics and trials that show the huge drop in people getting HIV when they take PReP

We also cannot ignore the statistics that show men who sleep with men are more likely to engage in unsafe sex, including with alcohol and drug misuse which again, is rising not falling. So this cannot be an either or. Behaviours, trends and statistics are not getting better so it is clear the current approach can be better.

So our community has to come together and make it clear that PReP can be part of a strategy to tackle problems that are affecting marginalised people in society who have been let down by a cocktail of failings in health and education policy. It is obvious PReP is not a silver bullet that will fix or stem the tide by itself. But ignoring advances in medicine and science that can make people’s lives easier and better is not the answer.

The NHS is the pride of Britain and we have to fight to keep it that way. That means moving with the times and listening to local people and the communities affected who know best. In this case that means the NHS should look again at its role and responsibilities to LGBT people where local authorities are under financial pressure or turn away. In the weeks and months ahead we should make it clear that the future of the NHS depends on the values of our movement: supporting people to take care of themselves and to make their lives better. There is no doubt that PReP meets that test – now it is time to do something about it.

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Robbie Young is NUS LGBT+ officer (open place). He tweets @Robbiie__

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