Every day in Britain, around 14 people are diagnosed with HIV. And yet, in England, there still isn’t a national programme for PrEP (pre-exposure prophylaxis), a preventative drug that’s been described as ‘game-changing’ by leading HIV doctors.
When taken as it’s prescribed, PrEP is almost 100 per cent effective at preventing people from getting HIV. The PROUD trial, which finished in 2015, looked at the effectiveness of PrEP for gay and bi men. The trial found that it reduced the risk of HIV infection by 86 per cent and proved concerns that PrEP would not work in the ‘real world’ were unfounded. It also clearly demonstrated that providing PrEP would be cost effective for the NHS.
PrEP helps people live free of anxiety about HIV.'
While these clear public health benefits are important, participants in the PROUD trial often say that PrEP is also important for personal empowerment. PrEP helps people live free of anxiety about HIV and positively affects their wellbeing as a result.
The PrEP IMPACT trial, another large-scale study of PrEP, is now taking place in England. It means that PrEP is available to some people on the NHS, but participant numbers are capped. Last month, the news that NHS England is considering adding a further 3,000 places to the trial was welcome. But the limited number of spaces means that not everyone who needs access to PrEP is able to do so. Gay and bi men are being turned away from clinics – and some could get HIV as a result.
Any measures to tackle HIV transmission must incorporate the needs of all populations and communities.'
There is also another issue with how marginalised and sometimes more vulnerable communities can access PrEP. Some clinics have had good successes at a local level of engaging diverse communities who could benefit from PrEP, including trans and black, Asian and minority ethnic (BAME) communities. But nationally, not enough has been done to reach these populations, which means there are real accessibility and equality barriers with the current trial. Any measures to tackle HIV transmission must incorporate the needs of all populations and communities.
NHS England has already committed to the provision of PrEP, but only once the PrEP IMPACT trial has completed in 2020. This is far too late. There is nothing that prevents the trial from continuing alongside a national programme, which should make PrEP available to everyone who needs it as soon as possible.
NHS England and local authorities must work together to ensure that no one in need of PrEP is turned away.'
That’s why Stonewall is joining with leading HIV charities, including the National AIDS Trust and the Terrence Higgins Trust, in calling for PrEP to be routinely available from sexual health clinics by 1 April 2019 at the very latest. In the meantime, NHS England and local authorities must work together to ensure that no one in need of PrEP is turned away.
The fact that the trial is already oversubscribed shows there is a clear need. More needs to be done to ensure that it’s promoted to everyone at risk. Alongside the Government’s commitment to make Relationships and Sex Education statutory, PrEP could make a real difference to ending HIV. NHS England must commit to offering it now.
Find out more about PrEP and the organisations supporting the community statement.