Soho clinic 56 Dean Street has launched Plan ZERO, an ambitious plan to end HIV transmission in London’s gay men. Dr Alan McOwan lead clinician at the clinic told us about their new exciting target and how Boyz readers can get involved.
The end of HIV transmission in gay men? Are you really serious Dr Alan?
Yes, totally. I’ve worked at the clinic for 19 years. Over the first 18 we diagnosed increasing numbers of gay men HIV positive every single year. Last year that went into sharp reverse. There was a 42% drop. In 2017 the numbers have fallen again. We used to diagnose 60-70 new cases a month, now we see around 15-20. The fall has been driven by a core group of men who’ve adopted the new strategies to end HIV. If we can get everybody else on board too we will drive the numbers down even further. Gay men have had to live with HIV for 30 years. We have the power to stamp out HIV transmission. Why wouldn’t we use it?
So what is Plan ZERO?
There are loads of ways we can stop HIV being passed on. Everyone is different. Plan ZERO is about matching people with the right option for them. We’ve made it really simple. Visit www.dean.st/zero You’re asked a maximum of 4 questions. It takes less than 30 seconds. There’s a plan designed for everyone. There are links to further information and resources if you need them. Even if you bareback and take no precautions at all, you can still help London get down to ZERO. We’re asking everyone to give us 30 seconds and share the link with their friends. We’ve tried to make it easy for everyone, so it’s also available in Spanish, Portuguese and Italian.
What else is there apart from condoms then?
Well first of all we know that HIV positive people on effective treatment are not infectious. In the PARTNER study, no one with undetectable virus passed on their HIV during condomless sex. Not a single person. One of the most important things we can do is screen people frequently if they are at very high risk and then offer them immediate treatment if they test positive. This is particularly important as people are at their most infectious in the first couple of months. Levels of the virus are very high. That’s why it’s thought half of HIV in the UK is caught from someone recently infected themselves. Catching a new infection early prevents a cascade of transmission to other people.
What about PrEP?
Pre-exposure prophylaxis (PrEP) involves starting HIV meds before you have sex. It’s really effective if taken correctly. In the main studies of PrEP the only people who caught HIV were those who weren’t taking it correctly. For the last couple of years lots of gay men have been buying it online. It’s perfectly safe and legal to do it if you’re ordering the meds for personal use. If that’s right for you, the Project ZERO tool (www.dean.st/zero) guides you to the best online resources such as www.iwantprepnow.co.uk. It also has information about joining the NHS PrEP Impact study.
What is the PrEP Impact Study?
It’s an NHS funded study to work out how many people might need PrEP and what proportion decide to take it. Everyone on the study gets free NHS funded PrEP until at least September 2020. This is really exciting as it makes PrEP an option for the first time for people not able to buy it online. There are 10,000 places available across England. Nearly every GUM clinic in England will start offering it over the next few months. To find out more visit the study’s website www.prepimpacttrial.org.uk or join 56 Dean Street’s Facebook Live event on Thursday 21 September at 6pm www.facebook.com/56DeanStreet/
Wouldn’t it be simpler and cheaper if everyone just used condoms?
Condoms are a fantastic way to prevent HIV. They also help protect against loads of other infections too. The majority of gay men still use them for anal sex. If you’re using them, brilliant that’s great, carry on. However, we know that to beat HIV you have to attack it from all angles. If we were able to end HIV using condoms alone, the last case of HIV would have been 25 years ago.
The reality is that condoms won’t work for everyone. Some people were still barebacking in 1995 while there was no effective treatment and people were dying everywhere. We’ve got to get away from the idea that ‘one size fits all’. Plan ZERO embraces the fact that we’re all different. This is our chance to end HIV. Let’s grab it.
For more information go to www.dean.st/zero
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