The HIV drug dispute highlights the danger of the conservative case for gay rights

As the NHS is set to appeal a High Court decision to fund PrEP, a drug that can prevent HIV, rhetoric shaming LGBT people has resurfaced.

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At his 2011 party conference, David Cameron made the Conservative case for marriage equality more effectively than anyone else, anywhere else, ever has.

“Yes, it’s about equality, but it’s also about something else: commitment. Conservatives believe in the ties that bind us; that society is stronger when we make vows to each other and support each other. So I don’t support gay marriage despite being a Conservative. I support gay marriage because I’m a Conservative.”

Now, as Cameron surveys the wreckage of his time in Downing Street, he’ll take comfort in that achievement, for which he was celebrated by the left, and won over a large swathe of the right.

But the problem with the Conservative case for equality is that it only protects you as long as you behave in a Conservative way – commit, get married, behave discretely.

If your sexual identity involves having actual sex, and maybe even being proud and open about it, you might have a harder time.

Indeed, the ongoing dispute over pre-exposure prophylaxis (PrEP) shows us just how shallow Britain’s commitment to queer equality is, and how close to the surface we can find the old prejudice and panic of the 1980s.

The fundamentals of the case are these: PrEP is a preventative treatment for HIV which, if taken daily by those at high risk of infection, can reduce the risk of transmission by more than 90 per cent.

It’s been endorsed by the World Health Organisation, and is used in the US, Canada, Australia and France. But earlier this year, the NHS declared that it did not have legal grounds to commission the preventative treatment, and that local councils should be responsible instead.

In a ruling this morning, Justice Green said that they had “erred” in this assessment. The High Court has told the NHS in England it can fund the drug.The NHS will appeal his decision, leaving many more people without access to the drug for many more months.

Of course, both the NHS and local councils face considerable financial strain. But is that really an excuse for refusing to deliver a treatment that is vastly effective and cost-efficient in the long-term? Why is it that when times get tough queer health becomes dispensable?

John Humphrys, presenter of the BBC’s Today programme, shared his own theory on this morning’s programme. “It’s not an easy argument to sell to an overstretched NHS, or to the taxpayers who are picking up the bill,” he said. “You’re going to have to pay £400 a month for this particular drug, for someone who may get drunk and have sex when he shouldn’t. It’s a tough moral call that, isn’t it?”

This is the rhetoric of the 1980s, the so-called “plague years”, when AIDS was widely perceived as a punishment for gay men’s sin, or at least for their promiscuity.

As Humphrys neatly summarised: “If you don’t wanna get AIDS, or become HIV infected, you should behave responsibly. It is down to you.”

This is the rhetoric that allowed the outbreak of the early Eighties to become a worldwide epidemic by the end of the decade, which convinced the populations of Western countries that it wasn’t up to them to save the lives of gay men who had only themselves to blame.

It’s rhetoric that was only beaten back by a generation of radical queer activists. And apparently, it’s rhetoric that is still acceptable on the BBC’s flagship daily programme.

This is a challenge to politicians who parade their commitment to equality, and to all of us who so enthusiastically embraced campaigns for equal marriage.

Almost every British politician will agree that you should be able to love whoever you want, and have that love respected. For that reason, plenty of people like to think that we live in a post-homophobic Britain.

But few politicians would say outright that gay men should be allowed to have consensual sex with whoever they want, whenever they want and however much they want, without risking chronic illness as a result.

That’s a problem. Marriage equality was an important achievement, but it should never have become our overwhelming goal, the relentless focus of a buttoned-up, sex-negative movement that undermined other modes of radical queer activism.

We do have a moral call to make with PrEP. But it’s not a tough one.

We have a treatment that can preserve health and save lives – one that can protect and empower groups that time and again have been stigmatised and betrayed by our political system.

To deny or further delay that treatment would, without question, be a moral failure.

Niamh Ní Mhaoileoin is the editor of Left Foot Forward. She tweets @niamhsquared.