Monthly Archives: February 2017

A New Miracle Drug: Campaigning for the Introduction of PrEP in Ireland

Note: This article was originally published in the University Observer, Vol. XXIII, No. 6. It was later published online.

With HIV figures increasing both at home and abroad, David Monaghan looks at the student-led ‘UCD for PrEP’ campaign and how effective the drug is in combating the disease.

 

RISING figures of HIV in Ireland have encouraged student activists to campaign for help in minimising its continued spread. ‘UCD for PrEP’ is a student-led initiative that aims to lobby the Students’ Union to take a proactive stance on introducing the drug ‘pre-exposure prophylaxis,’ or ‘PrEP’ for short. According to the American Center for Disease Control and Prevention, the drug is reported to reduce the risk of contracting HIV by up to 90% when taken daily.

PrEP is intended for people who are at high risk of contracting HIV. This includes individuals whose current partner is HIV-positive, as well intravenous drug users. It is a preventative measure that is readily available in some countries across the globe, and has been recommended by the World Health Organisation since 2015. It has been approved for usage by those at risk of contracting HIV in the United States, where depending on income it can be obtained for free, and France, where it was approved in November 2015 and introduced the following January.

However, the drug is not readily available in Ireland despite increasing concerns about rising HIV figures. According to Newstalk, 513 people were diagnosed HIV-positive in the country last year, a startling increase of 5.8% from previous recorded figures. Numerous factors have been suggested to explain such a jump in numbers: a failing sexual education system; dating apps like Tinder or Grindr; disconnect between LGBTQ+ individuals and the history of the virus. Whatever the reasons, it is clear that immediate action must be taken to combat the spread of disease.

“513 PEOPLE WERE DIAGNOSED HIV POSITIVE IN THE COUNTRY LAST YEAR, A STARTLING INCREASE OF 5.8% FROM PREVIOUS RECORDED FIGURES”

Finn McLysaght helped establish the ‘UCD for PrEP’ campaign with fellow activists. “There is a need [for PrEP]” they said. “HIV has reached a crisis point. There’s a new diagnosis every 18 hours.” The campaign was inspired by the work of ACT UP Dublin, a non-partisan group dedicated to using direct action against increasing HIV figures. “[It’s] a coalition to campaign for the introduction of PrEP and PEP [post-exposure prophylaxis],” McLysaght continued.

In Ireland the drug does not fall under the HSE’s Drugs Payment Scheme, and trials are ongoing to establish its effectiveness. “It would cost hundreds for a thirty day supply,” McLysaght says. “Most people don’t even know about it. I think only 51 people availed of it last year.”

The current actions of the HSE echo the debate surrounding the introduction of PrEP in the United Kingdom last year. According to the BBC, a trial was established to see how effective the drug would be in preventing HIV transmissions. The trial finished early when it became obvious that PrEP worked successfully.

“IT IS CLEAR THAT IMMEDIATE ACTION MUST BE TAKEN TO COMBAT THE SPREAD OF DISEASE”

Despite this, in 2016, the NHS decided not to fund the drug and said it was the responsibility of local councils to deal with its distribution. This was successfully challenged by the National AIDS Trust in the UK’s High Court.

McLysaght has met with Students’ Union Welfare Officer, Róisín Ní Mhara, and last week a motion relating to PrEP was passed by the SU council. The motion will see the Students’ Union campaign for the licensing of PrEP at the Dublin Pride Parade in 2017. Speaking to the Observer before the council meeting, Ní Mhara said: “My own personal belief is that, if you need it, absolutely you should take it. If you feel you need it and you warrant it in your life, who am I to say it’s not suitable for you to take?”

UCD Students’ Union currently has a plethora of information on sexual health on its webpage. How will the introduction of PrEP augment this current campaign? Ní Mhara continues: “I’m not sure how we’re going to slot it in just yet…because the drug itself isn’t licensed for use in Ireland [but] I would like to sign it into sexual health week somehow.”

“HIV HAS REACHED A CRISIS POINT. THERE’S A NEW DIAGNOSIS EVERY 18 HOURS”

Although the campaign is external to UCD LGBTQ+ society, the committee is still very much dedicated to campaigning for its licensing and usage. Philip Weldon, LGBTQ+ society’s auditor, states: “we took a vote last Monday [23rd], the first committee meeting of semester two, and we all voted in favour to support [the drug], by making the campaign visible at our own events. For example, simply things like stickers. We’re more than happy to display it on our own materials at coffee mornings and other events.”

At present, the campaign has not been met with opposition at any level. PrEP is known to create minor side effects, such as nausea and diarrhoea, but these are known to pass after a few days. “There are side effects,” McLysaght says, “but that’s part of the territory of taking any medication. They’re pretty minimal.”

With HIV diagnoses increasing, a trend that has not been curbed in recent years, it is becoming increasingly obvious that direct action must be taken to stop its escalation. Trials have shown that PrEP is effective in combating HIV, and so necessary measures are needed to see its licensing both at home and abroad.

At War With Yourself | The Invisible Enemy & Me

Note: This article was originally published on the HeadStuff website.

Imagine you were fighting an invisible war where the enemy could anticipate your every move and tactic. Worse still: imagine the enemy lived inside your head and was unrelenting in its fight against you.

I was around eleven when I first thought I might have OCD. By this time I was washing my hands so excessively that the skin around my knuckles regularly cracked, and I’d leave little traces of blood on the floor, couch or whatever book or magazine I happened to be reading at the time. Skin cream was bought, gloves were worn, but it didn’t matter; I’d either wash it away or simply grow irritated and take them off. Family members told me it was nothing to worry about: “I saw someone on the Late Late Show,” one said, “who claimed that teenagers and children worry about having OCD when they really don’t. I wouldn’t worry, it’s normal.”

I figured they were right and I’d grow out of it eventually.

Years later a counsellor would tell me that it was simply a way I’d learned to deal with stress: “Whenever you felt you weren’t in control of your environment you’d wash your hands. It was a way for you to gain control.”

It made some sense, but it didn’t account for the regular irritating thought patterns that had emerged when I hit puberty. Whenever I couldn’t play guitar like a musician I admired, write like a poet I loved, or learn to socialise like a boy of my age should, I’d analyse and overanalyse what I thought I was doing wrong and think about it repeatedly before trying again. If I didn’t make the self-established mark a second or third or fourth time, it would be back to square one in a cyclical pattern of blame and criticism that, over time, tore down my self-esteem.

Books - HeadStuff.org

These weren’t thoughts that could be dismissed: I couldn’t control them. They were negative, intrusive thoughts that bled into every aspect over my life, essentially paralysing me into a state of fear that inhibited my ability to function. They’d descend onto my mind like military paratroopers intent on ransacking and usurping all the rational, logical thoughts I’d stored over time, replacing them with anxiety and worry over the smallest details of my existence. Everything was up for scrutiny: the way I’d walk, talk, learn, write, and interact with others. I’d go into a state of dissociation and disconnect from my friends, making me feel isolated and alone.

Eventually these intrusive thoughts would lead to ritual behaviours: I’d think about something negative, and whether it be it truthful or imagined, if I didn’t enact the behaviours I’d fear they would make themselves manifest. If I didn’t tap my head three times with my knuckles, I’d fail my exams, my friends would fall out with me, my family would leave. I’d lose control of my life and all my fears would be free to wreak havoc on my existence. Illogical, I know, but inescapable all the same.

No one else I knew had a mind that worked like this, and so I felt like a fool. I’d lose sleep thinking and worrying about all the things in my life I was doing wrong and without any kind of guidance I felt scared. I’d fall into regular depression and spend periods of time feeling lost, sometimes contemplating self-harm.

Of course, despite my concerns, I wasn’t alone. Obsessive Compulsive Disorder affects one in every 33-50 people – essentially 2% of the Irish population. It is a tangible, real illness that studies suggest is caused by chemical or structural abnormalities in the brain, possibly as a result of environmental factors such as stress. It manifests as obsessive thinking and compulsive behaviours, and is often misrepresented by wider popular culture as a heightened ‘ultra-cleanliness’: an obsession with hygiene that has spun out of control. Although many who live with OCD do obsess over hygiene and sanitation, it is much more debilitating than is presented in the media: much less a quirk than a wearying, unavoidable illness.

Mental health - HeadStuff.org

In fact, as a direct result of inaccurate depictions, people have taken to using the term ‘OCD’ in such offhand and flippant ways to describe such quirks in their lives: when was the last time you heard a neat freak friend of yours describe themselves as “so OCD?” Or when you heard someone you know use the term to describe the way they organise their notes or work environment? Could you imagine if these people used other illnesses so flippantly in their day-to-day lives? What if they used cancer so flippantly, or heart failure? Naturally, your response would be one of condemnation, so why allow them to use OCD? There is a persistent stigma of not only OCD in our culture, but mental illness more broadly. If an illness doesn’t make itself physically manifest, we dismiss it off-hand without realising the impact that might have.

I was diagnosed with OCD in January of last year. Sitting in a psychiatrist’s office in UCD holding back tears, I listened intently as everything I’d suspected from a young age was confirmed. It was as if the woman speaking to me in that office retroactively validated the concerns I had when I was 11. She didn’t take the same route others had taken. She didn’t tell me it was all made up or in my head, or that I was simply being a worrywart. She looked at me and said, “you were right, this is OCD.” I was suddenly overwhelmed: I was not strange or a fool for feeling this way, and I was perfectly right in feeling concerned in the first place.This is what prevented me from seeking help for so long. If my anxieties had been validated and discussed from the start, I might have been presented with the tools towards dealing with my illness, but because it was presented as a quirk or a joke or something so rare and exclusively hygiene-centred, I figured I was simply damaged.

Counselling - HeadStuff.org

My medication was altered to better deal with my symptoms and once I discovered exactly what it was I was dealing with, I was able to take concrete steps towards living with my illness. I see a counsellor regularly and have alerted lecturers where necessary. Now that I have tangible proof of what it is I am dealing with, slowly but surely everything is falling into place.

However, as with all mental illness, there is no quick fix, and the symptoms detailed above will appear and reappear at the most inopportune of times: at family gatherings, when writing, or, worst of all, when I’m tucked up in bed trying to sleep. As ever, the worst thing about having OCD is not knowing what will trigger it in your day to day life. Any offhand comment could plague you for weeks. There’s no consistent pattern. Put simply: it’s like walking through the tall grass in Pokémon. And you’ve just got to live with it.

The difference in dealing with OCD post-diagnosis though, is that I have the tools necessary to wade through the battlefields of anxiety without getting completely lost.

It is worth bearing in mind that a multitude of supports are available for those suffering with OCD. OCD Ireland links to numerous networks on their website, and there is no shame in contacting a local doctor, psychiatrist or counsellor if you have any concerns. Although you may be fighting a war on yourself, you don’t have to fight it alone.

Featured image source