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A proposal to double the number of people able to access PrEP (a highly effective HIV prevention pill) through the PrEP Impact Trial has been delayed by the trial oversight board.[i] This is despite the fact that NHS England has agreed to fund the additional 13,000 places. Currently, many clinics have no spaces for additional patients and are turning away people at high risk of HIV, some of whom are going on to acquire the virus.
Prescribing the drug has been shown to be cost effective, because it prevents HIV infections which require a lifetime of specialist treatment. Growing use of PrEP, and the increased engagement with sexual health services that often comes alongside PrEP use, have contributed to the recent steady decline of UK HIV infection rates.
Whilst supporting the new places ‘in principle’, no clear date is given by the board for final approval nor any clarity as to how any issues of capacity[ii] will affect the decision, or be addressed.
Deborah Gold, Chief Executive of NAT (National AIDS Trust), said: “This is an unconscionable failure of our health system. The Secretary of State must immediately get to grips with this dangerous muddle. The PrEP Impact Trial must have enough places now to mean no one is turned away. Sexual health clinics must be properly funded to promote PrEP to all communities and meet need effectively. A national PrEP programme must be commissioned as soon as possible.
“We urge all those involved in this decision to move to final approval of the new places as soon as possible. The case for PrEP makes itself, yet for years those at risk of HIV have faced one roadblock after another in trying to access PrEP on the NHS.
“We now face the imminent end of access to PrEP in England, in particular for gay and bisexual men. The consequence of today’s decision will be more examples of avoidable HIV. This is completely unacceptable.”