Community News

Stalemate finally broken as PrEP trial places in London clinics boosted by 60%.

Besi Besemar April 12, 2019

More Londoners to receive HIV prevention medicine PrEP.

IN a boost to HIV prevention in the capital, London boroughs have agreed to provide over 4,000 extra places on the PrEP Impact Trial.

The trial – a national programme led by NHS England in partnership with Public Health England and local authorities – supplies PrEP (an HIV prevention medicine) free of charge to people considered to be at high risk of exposure to HIV.

The expansion, which will take place over the coming weeks, represents a 60% increase in the trial places available to Londoners.

London already accounts for 7,609 trial places – a higher figure than the rest of England combined, however, two-third of sites in London are now closed to gay and bisexual men. The boost still leaves the capital lagging behind many other parts of England which have agreed to double places on the trial.

The PrEP trial expansion in the capital will also include the use of the innovative online service Sexual Health London, which will be an option for trial participants to use for their regular sexual health checks.

Cllr Ray Puddifoot MBE
Cllr Ray Puddifoot MBE

Cllr Ray Puddifoot MBE, London Councils’ Executive Member for Health & Care, said: “Boroughs have a proud record on HIV prevention and we want PrEP to be available to every Londoner who needs it. PrEP is hugely important for protecting people’s health and preventing HIV transmission.

“We’ve played a key role in the success of the trial so far, rolling out the programme in sexual health clinics across the capital to ensure thousands of Londoners receive PrEP.

“We’re pleased to announce that boroughs will provide these additional places on the PrEP Impact Trial. Looking to the future, we’re keen for national partners in the government and NHS to confirm funding arrangements for PrEP provision.

“While extra places on the PrEP Impact Trial represent a step forward, we ultimately want to see NHS-funded PrEP available to everyone at high risk of HIV exposure – as is the case in Scotland and Wales.”

PrEP is a key part of London’s HIV prevention strategy. Every time PrEP helps avoid a new HIV diagnosis, the NHS is potentially saved £360,000 in lifetime treatment costs.

The boroughs’ announcement follows discussions held with the NHS over resourcing of the additional places on the PrEP Impact Trial.

Boroughs had previously expressed concern that the trial was being expanded without any additional investment, with potential repercussions for boroughs’ other sexual health services.

However, boroughs have now agreed to accommodate 4,000 extra places at a collective cost of £2.6 million to their sexual health budgets. The sustainability of London’s expansion of the PrEP Impact Trial will be monitored and boroughs will continue to push for a long-term funding arrangement for future provision.

London is home to an estimated 39,000 people living with HIV. Since 2014, when boroughs established the London HIV Prevention Programme, the capital has made significant progress in addressing this public health challenge.

The most recent figures from Public Health England revealed a substantial decrease in London HIV’s diagnosis rates of 21% in 2016-17, compared to the UK-wide decrease of 17%.

This has been achieved despite reductions in London’s public health grant. Between 2015-16 and 2018-19, London’s grant was reduced by 15% per head of population – the most substantial reduction of any region in England.

Last year saw London join the worldwide Fast-Track Cities initiative. London became one of the first global cities to meet the UN’s diagnosis and treatment targets and has pledged to achieve zero new HIV transmissions by 2030.

Debbie Laycock
Debbie Laycock

Debbie Laycock, Head of Policy at Terrence Higgins Trust, said: “Finally the stalemate on PrEP has been broken and some leadership is being shown. This is a welcome step in the right direction that will provide some relief to those in the capital who have been denied access to the trial. We welcome the acknowledgement by London Councils that PrEP must be available to everyone at high risk of HIV exposure and as such withholding access is simply not an option.

“However this increase is still far short of the doubling of places we were promised by the Health Secretary Matt Hancock over 70 days ago and it won’t be long before we’re once again seeing gay and bisexual men being unable to access PrEP in the capital.

“London continues to outstrip every other part of the UK in the number of new HIV diagnoses each year so it’s critical a sustainable solution for PrEP is found. Today’s news is progress but this remains a job only half complete as places must be doubled to address the high demand seen for PrEP. We need urgent leadership on this from NHS England, the Department for Health & Social Care and councils across the capital because no one at risk of HIV should be turned away.”