PrEP, or pre-exposure prophylaxis, is a relatively new medication that prevents its users from contracting HIV. It has become increasingly popular within the MSM (men who have sex with men) community, which includes gay, bisexual and trans men. The devastating consequences of the AIDs epidemic, which has the largest effect on the LGBTQ+ community, is one of the reasons for rapidly increasing usage levels of PrEP. According to HIV Ireland, 8,826 people have been diagnosed with HIV in Ireland since the early 1980s. The most recent annual report, with data compiled by the Health Protection Surveillance Centre, stated that 492 people were “newly diagnosed with HIV” in 2017. However, affordably accessing PrEP remains difficult for certain members of society. In particular, the student population is underrepresented as users. While there are free resources to obtain STI and HIV testing in the Gay Men’s Health Centre and St. James’s Hospital, the medication itself can cost around 60 euro for every three month refill from the pharmacy.
The health and well-being of the student body at Trinity should be of paramount importance to the College and the welfare team of the Students’ Union. So why is affordable access to PrEP not being addressed? This question seems especially pertinent following the announcement from University College Dublin (UCD) in July that they are providing PrEP to students in need for lowered prices and even for free.
In response to UCD’s announcement about lowering PrEP prices for students, Aisling Leen, TCDSU Welfare Officer, says: “The issue with PrEP is obviously the price of it. UCD has a pharmacy on campus, so they’re trying to get [PrEP] for free or for very cheap. We don’t have a pharmacy on campus…” Trinity does have two affiliated pharmacies, Trinity Pharmacy and Lombard Pharmacy, but UCD has more pricing flexibility because it owns the pharmacy on its campus. The Trinity Health Service is able to prescribe PrEP following an HIV test, but waiting times for appointments can sometimes be up to a month. In addition to the lengthy process, the prescription comes with no financial aid for students.
“PrEP is readily available, it’s just very expensive… Students are less likely to be able to afford it than working professionals.”
Leen, speaking more generally about PrEP access, says that “PrEP is readily available, it’s just very expensive… Students are less likely to be able to afford it than working professionals.” Pressed on whether affordable access to PrEP would be more of a priority if it was popular among heterosexual students, she concedes that she “suppose[s] it might be fair to say that if PrEP was widely used by everyone, then maybe it would be easier to get people on board.”
So what, according to Leen, are Trinity and the Welfare team doing to solve this problem?: “The SU’s focus is always on lobbying the government. There was a motion passed a few years ago so [lobbying the government] became the focus.” Asked about the relationship the SU has with the government, she states that “we work mostly on the government level with Mary Mitchell O’Connor. She’s Education, but we haven’t worked with the Minister for Health because he’s quite busy… We have a great relationship with the HSE, who are doing a big push on sexual health at the moment.”
However, it’s not all bad news. Right now, says Leen, “…what the Health Service in Trinity provide are the basics. And that does happen to be heteronormative…but it’s still the basic for everyone, I think is fair to say. Everyone can benefit from that basic STI test, which does test for HIV… it tests for everything.” On the PrEP access front, she explains that she has “a three pronged approach to this, where I want to work with Trinity to see what we can do within the college. But I also feel like that’s useless if we’re not lobbying the government and putting pressure on the government to allow PrEP to be obtained with a medical card and to make it cheaper all round. And then just awareness, people still need to know what PrEP is before they try to access it.”
Asked about whether conservative attitudes towards LGBTQ+ inclusion or sexual promiscuity might be hampering their attempts to provide more affordable PrEP access for Trinity students, Leen claims that “Those attitudes may exist but from my end it’s just financial.” Overall, Leen is aware of the problem and receptive to questions about it. Hopefully progress can soon be made to help give students a better chance to access this life-saving medication under her leadership.