Imagine: you’re healthy, and your GP prescribes you antibiotics, telling you that if you take them for the foreseeable future you won’t get a chest infection.
Imagine further that you start taking the antibiotics and find that they give you diorrhoea (a not uncommon side effect). So you reduce the dose in order to mitigate the runs and everything goes swimmingly – until you contract an infection that has become antibiotic-tolerant because you weren’t taking enough to kill it, and end up with pneumonia.
It sounds far-fetched, but once older people were prescribed antibiotics prophylactically for a whole winter to stop them catching bacterial infections, which is partially the reason we have hordes of bacteria tolerant to antibiotics today.
And it’s about to happen again, in the field of viruses: HIV, to be precise.
It’s been announced that HIV treatment and care is now free for all undocumented migrants and non-UK citizens who wish to access it. And that’s only right: viruses don’t care about whether or not their carriers have passports.
What’s worrying, though, is that a head of steam continues to build for prevention of HIV transmission via Prep: pre exposure prophylaxis, meaning that antiretrovirals would be given to somebody who was liable to have unprotected sex with HIV-positive partners. Just like bacteria, viruses can become tolerant to medications, and antiretrovirals require over 90% compliance to prevent tolerance.
If Prep becomes recognised as HIV treatment, undocumented migrants will be able to access it as of right. It sounds sinister to wish to deny them this, but rolling it out would mean we create a reservoir of treatment-resistant HIV within our communities. And it would buy into the racist lie that men of certain ethnicities have trouble keeping it in their trousers.
Let’s learn from medicine’s recent past.
Former BBV worker