21ST CENTURY MEDICINE: The ‘final nail in the coffin’ for Aids? A surge in the use of preventative drugs is reducing risk but with more than 36m people living with HIV a huge challenge remains.

Will Nutland is not infected with HIV, yet he has been taking an Aids drug for just under a year. As a doctor, he says his primary motive is to act as “a guinea pig” but as a gay man he is also taking it to prevent him contracting the human immunodeficiency virus that can lead to Aids. He takes Truvada, a pill introduced by the US drug company Gilead in 2004 as an antiretroviral treatment for people with HIV but since developed for pre-exposure prophylaxis — generally known as PrEP — for those at risk of infection.

Around the world, hundreds of thousands have been taking PrEP on a daily basis for several years, yet Dr Nutland, who bought his blue lozenge-shaped pills online, is only one of a handful of people in the UK taking the medicine.

The question for many — both activists and clinicians — is whether greater use of PrEP alongside more widespread diagnosis and early treatment could finally herald the end of HIV/Aids. The combination of the prophylactic for those who are HIV-negative with effective antiretroviral drugs, which suppress the virus in those who test positive, offers a chance to manage the disease out of existence, suggests Tony Fauci, director of the US National Institute of Allergy and Infectious Diseases.

That would be nice, but I fear it won’t be quite that easy.