As the NHS decides on whether to make PrEP available, some gay men are turning to the Internet to buy generic versions of Truvada, the HIV prevention drug. QX Magazine caught up with Yusef Azad, director of strategy at the national Aids Trust, to find out about the risks associated with buying PrEP online.
More and more, people are approaching doctors and asking them about or for PrEP. There is a demand for it and if people are not going to get it from their clinic, some people are going online. This carries risks. Here are some answers to frequently asked questions people have been asking doctors with regards to buying PrEP online:
Are You Actually Buying The Real Thing?
It is difficult to be sure that what you’re buying online is actually PrEP. Fake drugs have been on the rise in recent years, as counterfeiters have realised the ease with which they can sell forged pills through the Internet. Even when the drugs bought online are legitimate, they may not be transported correctly and as a result their efficacy could be impacted.
“We haven’t currently heard of any mass production of fake Truvada or anything like that,” says Azad. “But on the other hand as people become more aware of the value of generic Truvada, I guess it provides an opportunity for less scrupulous people produce counterfeit or less than fully active pills.”
If there is any doubt that what you have bought may not be the real thing then stop taking them and raise this with a sexual health clinic.
Are There Health Risks?
PrEP should be taken as part of a package of clinical care. First of all it’s very important that you don’t have HIV if you’re going to take PrEP. If you do have HIV and you start PrEP, you are in danger of building up drug resistance. Before you consider taking PrEP you need to think about window periods. There are also potential side effects of taking PrEP to consider and you should ask a clinician about these before taking anything.
“Only start PrEP after you’re confident and a sexual health clinic is confident that you’re HIV negative,” says Azad. “Routine sexual health check-ups and sexual health support are also valuable, especially to talk through with experts how it’s going in terms of taking PrEP.”
Is it legal?
“One of the first questions a lot of people have is: is it legal,” says Azad. “NAT have asked the UK responsible agency which is called the Medicines and Healthcare products Regulatory Agency (MHRA) whether it is legal and I got a very clear response from them. They said they can confirm there’s no requirement for a member of the public to notify the MHRA of the importation of medicines for personal use, and legislation doesn’t restrict such importation.”
This is only the case though if the PrEP bought is for personal use only. Usually, revenue and customs will consider up to three months supply to be an acceptable quantity for personal use. If you’re trying to bring over more than that as they might suspect it’s not for personal use.
“There’s no legal problem or issue in going online and ordering a generic version of Truvada from abroad as long as it is for personal use and isn’t sold or supplied to anybody else,” says Azad.
The MHRA also recommend that anyone posting packages to containing medicines should include a copy of the prescription or a letter form the patient’s doctor explaining why the product is required. This may help in demonstrating it’s for personal use.
Take Precautions
Neither QX nor NAT are advocating buying PrEP online, however if you are intending to it is worth taking the following precautions:
• Ask an established HIV or sexual health organisation whether they think the source you plan to buy from is itself reputable.
• Before you start taking PrEP make sure that you have talked it through with a sexual health clinician. It is recommended you maintain the support from a sexual health clinic throughout taking the drugs.
• If you are concerned that what you have bought is not PrEP, or worried about the efficacy and authenticity of the drug, then raise this with a sexual health clinic.
• PrEP only works if you take it daily. In clinical trials it was far less effective if people were not adhering to their daily dosage. If you intend to start on a course of PrEP then take it every day.
• It is vital that you are HIV negative before you start taking PrEP. Do not take PrEP unless you are absolutely certain you are HIV negative.
• For more information about PrEP, consult your GP or arrange to speak to someone at a reputable sexual health clinic.
