Why PrEP? For this guy (among others)• 1978 age 22: join London gay scene (and

activism)• 1979-84: chlamydia, HPV, rectal GC, syphilis• 1984: possible SC illness• 1985 age 29: HIV+

This is the difference PrEP+ CAN make

• PrEP (or its promise) ® more frequent testing

• More frequent tests ® earlier diagnoses + better PrEP adherence

• Earlier diagnoses ® quicker treatment

• Quicker treatment + PrEP ®fewer diagnoses (of GC too!)

Dean St HIV diagnoses. Number in Oct 2015: 70. Number in Oct 2017: four.

20 years of messages of fear

PrEP = sex without fear

• PrEP = removal of anxiety during sex• PrEP = agency over HIV• In PrEP the protective behaviour is

separate in time from the risky action• PrEP = the Shangri-La of HIV

prevention: a highly effective prevention method that enhances sex

• CF “Clean needle, clean hit”

PrEP is not enough

Neither U=U nor PrEP is working in (most of) central and eastern Europe

The Fermi paradox – where are the PrEP users?

“PrEP is a demand-driven intervention” – Bob Grant

A new AIDS activism - “Samidzdat PrEP” – and its supporters

Faced with the refusal pf healthcare systems to offer PrEP, some gay men (especially) took matters into their own hands

An only PrEP buying community emergedIts ‘underground’ nature familiar to the ways many gay men have to exist anyway

Crucially supported by sympathetic physicians

So welcome!

www.prepineurope.org