32 organisations demand PrEP for everyone by April 1, 2019

NHS England and local authorities must ensure PrEP is routinely available for HIV prevention by April 1, 2019, says a coalition of 32 organisations.

A GROUP of thirty two charities and community groups, including Terrence Higgins Trust (THT), National AIDS Trust, PrEPster and Stonewall have come together to demand NHS England and local authority commissioners ensure Pre-Exposure Prophylaxis (PrEP) is routinely available in sexual health clinics by April 1, 2019 ‘at the latest’.

A large-scale PrEP trial is currently taking place providing access to 10,000 people over three years.

However, within just eight months of this three-year trial starting, over 7,000 places have already been filled. A number of clinics have now closed any further recruitment of gay and bisexual men, who form one of the most at-risk groups of HIV transmission including in Brighton and Hove.

In June 2018, NHS England announced they were considering adding a further 3,000 places to the trial.

While welcome, according to the statement, “it only provides temporary relief. With continuing high demand for PrEP”, it continues, “clinics will again be full and turning people away within a few months”.

The group also calls out “a clear equalities deficit” within the PrEP Impact Trial, citing “limited efforts” to engage the likes of trans people and BAME communities.

According to the group, which includes LGBT Foundation, George House Trust and London Friend, “a national PrEP programme will not only meet actual need but also provide welcome assurance to those currently accessing PrEP through the IMPACT trial that they will be able to continue to access PrEP once the trial ends.

“Both NHS England and local authority commissioners should agree and disseminate as soon as possible a timetabled roadmap of the necessary decision-making process.

“In the meantime a solution must be found to mean no one in need of PrEP is turned away.”

The statement suggests that “there is nothing to prevent the trial continuing even while, in parallel, routine provision of PrEP begins.”

Furthermore it explains: “The trial is asking valuable questions and both interim analysis later in 2018 and then further results can inform ongoing planning decisions.”

Metro, NAZ and the African Advocacy Foundation have also co-signed the statement, which closes by reiterating: “NHS England must honour its commitment to commission PrEP in a national programme. The trial was never proposed by NHS England as a means to only partially meet need.

“PrEP has to be planned by NHS England and local authorities working collaboratively.

It will be as important for local authorities to plan the PrEP service to ensure it is integrated with other vital prevention and testing efforts, and is promoted to all those at risk of HIV, whether gay and bisexual men, trans people, BAME communities, women or heterosexual men.”

Matthew Riley, 25, has been taking PrEP via NHS England’s IMPACT trial for six months.

He said: “I started PrEP after doing a lot of research. It gives me control over my sexual health and gets rid of the shadow that HIV, as a gay man, casts over my sex life. Being more comfortable with yourself and your health essentially means healthier, better sex.

“Financially, I wouldn’t have been able to buy PrEP for myself because I just don’t have the disposable income. Without the PrEP trial I wouldn’t have been able to access PrEP and it’s awful that other people, just like me, are being turned away.”

Yusef Azad, director of strategy at NAT (National AIDS Trust), said: “Some people attempting to access the trial have been turned away from clinics with no places left, and gone on to acquire HIV. Those people will now be on medication for life when they could have been given a cost-effective prevention pill for shorter-term risk.

“There is no good reason to delay routine commissioning of PrEP so it can be accessed by all who need it.”

Ian Green, chief executive at Terrence Higgins Trust, said: “We have been clear that a 10,000 place trial was never going to accurately meet demand for PrEP – a highly effective way of preventing HIV. We know that some trial sites are full, some are yet to open and that eligible people are now being turned away.

“There is a clear moral, political and economic rationale for providing PrEP on our NHS to those who need it and that’s why a routine programme for PrEP on the NHS must happen as a matter of urgency.”

Will Nutland, co-founder of PrEPster, said: “With almost three-quarters of trial places taken, it is imperative that we now have a road-map for implementation of routine commissioning of PrEP. We know that PrEP works: now’s the time to make sure it’s available for everyone who needs it.”

The full list of signatories is:

♦ National AIDS Trust

♦ Terrence Higgins Trust

♦ PrEPster

♦ African Advocacy Foundation

♦ Avert

♦ BASHH

♦ BHA

♦ BHIVA

♦ CAPS (Catholics for AIDS Prevention and Support)

♦ Clinic Q

♦ Eddystone Trust