Getting HIV while waiting for the preventative pill: "I've been on the list for years"

Barcelona"I've had to completely change my life. It doesn't seem normal to me to have become infected after years of waiting for treatment. It's a problem with the healthcare system," complains Martí [a fictitious name to protect his identity], who has been on the waiting list for the HIV preventative pill, a treatment called "The Pill." Finally, he ended up getting infected, and like him, at least twenty other people have become infected because of him. lack of accessibility in treatment, according to the BCN Checkpoint, the leading center for infection control in Catalonia. Sources consulted by ARA warn that either there is greater investment to expedite access to PrEP, or there will be more cases.

"In the coming months, there will be a dozen more infected people. And that's just a sample," warns the director of BCN Checkpoint, Ferran Pujol, who explains that there are more than 4,000 people waiting to begin treatment. However, the center cannot cope. The Catalan government states that the waiting time for access is "variable," with "more delays" in Barcelona, but the reality is that it is unknown how many people are on the waiting list. "We can't know how many people are waiting because we are the only ones with a list; the rest of the centers don't have anyone registered," maintains Pujol.

Martí is 43 years old, has lived in Barcelona since 2013, and maintains that he doesn't engage in risky sexual practices. For work reasons, he began traveling widely outside of Europe in 2020 and signed up for the BCN Checkpoint waiting list to get PrEP. He also requested treatment through the public health system, but the healthcare professional who treated him considered him not a "priority profile" as he didn't engage in "risky practices" that would expose him to potential infection. So he decided to wait to receive treatment from the community center.

It wasn't until he had a routine checkup after years of waiting for preventative treatment that he found out he was HIV positive. "I did what I had to do. I was very surprised by the result; I didn't expect it. Now I'm adapting to my new life. It's been very hard," explains Martí, who is grateful for the support of his friends throughout this process, some of whom also have the infection and have helped him a lot since he received the news. Like him, at least twenty people have already become infected despite wanting to undergo treatment, and Pujol believes the number of those affected is higher. "Not everyone who wants to take PrEP is on the waiting list; there are surely many people who want to take it who risk getting infected right now," he warns.

The Government is "passing the buck"

The professionals at BCN Checkpoint complain that they don't have enough resources to treat everyone and accuse the government of "passing the buck" when it comes to access to PrEP. According to the Department of Health, the number of people waiting to access "could range between 3,000 and 5,000," but the expert questions the data. The government justifies not knowing the number of people who want to start treatment because "the same person can be registered at more than one center simultaneously and may even have already started it." However, many of these centers don't have waiting lists, and those that do, like BCN Checkpoint, have made sure to avoid these situations.

"We have compared the data with that of other centers to eliminate duplications and we can confirm that in our center alone there are more than 4,000 people waiting," says Pujol, who warns that if more resources are not allocated, the time to obtain PrEP will continue to increase. The Health Department estimates that 33,479 people live with HIV in Catalonia and highlights that, between 2020 and 2024, the number of people on treatment has quadrupled, going from 2,500 to 10,500. Pujol believes that if accessibility were improved, the data would be much higher, which is why he argues that "triumphant speeches" should be avoided.

Given this scenario, Martí recommends that all those still on the list travel to other places, outside of Barcelona, where access to PrEP is more flexible. "They should start as soon as possible," he says. He will have to take medication for life. Construction has already begun on the BCN Checkpoint. to move to a larger building Starting in February next year, the center is asking the Health Department for more resources to accommodate as many people as possible.

More healthcare spending

Infected people incur higher healthcare costs than people on treatment. According to a study on the cost-effectiveness of HIV preventive treatment published in the journalPLOS OneThe annual cost of PrEP per person in Catalonia is €1,433, while the annual cost for an infected person is €8,534 during the first year and €7,451 in the years following diagnosis. "But I don't want to look at it solely from an economic perspective; PrEP should be provided to everyone who requests it. Their rights are being violated," says Pujol.