The Boyz Doc Dr Laura Waters from Mortimer Market Centre writes about her colleague and friend Dr Mags Portman who died earlier this month.
If you have followed the trials and tribulations of HIV pre-exposure prophylaxis (PrEP) in England then Mags Portman will be a familiar name. Mags was an outstanding sexual health and HIV consultant at The Mortimer Market Centre who died of mesothelioma at just 44 years of age. She achieved more than many could in two or three lifetimes; a rainbow-hued whirlwind of passion, knowledge and determination.
Mesothelioma is a cancer of the lung lining – tragically it may be during her early career that Mags was exposed to asbestos, the main cause, in hospital buildings. After diagnosis she survived for 2 years – four times longer than predicted. She had some really tough treatments but continued to inspire and lead in the area she was most passionate about: HIV prevention. You can read more about mesothelioma here: nhs.uk/conditions/mesothelioma or my previous Boyz article (archive.boyz.co.uk/the-boyz-doc-dr-mags-portman-appeal-what-is-mesothelioma).
Mags was a great advocate for access to HIV prevention and her efforts campaigning for PrEP, educating about PrEP and ensuring people buying their own generic (unbranded) PrEP had the right monitoring and advice in clinic was trailblazing.
She worked with the community, particularly Greg Owen of iwantprepnow and Will Nutland of PrEPster, to hold our professional bodies to account and ensure sexual health professionals, and people needing PrEP, had the correct information and support. She co-authored national guidelines, ensured the strong arguments for access to PrEP were heard and gave the medical profession reassurance that getting PrEP online was not only legal but something they should tell people about if not available on the NHS.
Right now, whilst available in Scotland (Mags was part of the team that made that happen), and through unlimited trial places in Wales, PrEP is not available routinely in England. However, the number of places on the NHS-funded PrEP IMPACT Trial will increase from 13,000 to 26,000, and will reach clinics soon; this should bridge the gap for now.
How can you access PrEP now?
PrEP IMPACT trial: some clinics are closed to recruitment while extra places are come in; you can read more here: prepimpacttrial.org.uk
Buy online: iwantprepnow.co.uk links to websites selling genuine drugs. At the time of writing the least expensive generic PrEP is £19 a month
Terrence Higgins Trust’s Mags Portman PrEP Access Fund: If you can prove you have low/no income they’ll send a code to access a 3-month’s supply of free generic PrEP, tht.org.uk
56 Dean Street generic PrEP service: dean.st/prepshop
Privately: for example from samedaydoctor site
To take PrEP you need a negative HIV test and some basic blood/urine tests to check your kidneys are OK; after that we recommend 3-monthly sexual health checks (including HIV testing) and a kidney check about once a year.
There are 4 ways to take it, all on the iwantprepnow website, and taken as advised it’s over 95% protective against getting HIV:
1. Every day: this is the most studied
2. Event base dosing: before and after sex; this a degree of planning that may be difficult so some people prefer (1.) or (3.)
3. Four pills a week: an easy way to remember is take PrEP on Tuesdays, Thursday, Saturdays and Sundays, also known as “the Ts and Ss”. You need to take PrEP every day for 7 days before you drop to 4 doses
4. ‘Holiday PrEP’: if you’re planning a short period of higher risk take daily PrEP during this time and for 7 days before and after
Options (2.) and (3.) are recommended only for anal sex; for vaginal or frontal sex (1.) or (4.) should be used.
We still have some way to go before PrEP is as easy to access as it should be but thanks to Mags, and the people she collaborated with, inspired and educated, we are further ahead than we could be.
Mags was an incredible colleague, a caring friend and a sexual health pioneer – she never stopped smiling and that’s a smile I will remember always. My love goes to her husband and sons, Martin, Freddie and Edward.
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