HIV drug PrEP’s accessibility questioned as new study proves its effectiveness

The government are being urged to make the HIV drug PrEP more accessible nationwide as the largest ever real-world study has proven its effectiveness as a preventative treatment. 

Following a study across the UK involving 24,000 people, PrEP, which prevents people contracting HIV, has proven 86% effective, while taking into account incorrect or inconsistent use. 

This is the largest real-world study to show just how effective the drug is when used in everyday life. This comes following previous clinical trials, which proved the drug 99% effective.

The PrEP Impact Trial was carried out across 157 sexual health services by the UK Health Security Agency within the Chelsea and Westminister Hospital NHS Foundation Trust.

Deputy Head of Programme Delivery and Service Improvement for STI and HIV Division, from UKHSA, said: “Now we know just how effective PrEP is in real-world settings, substantially reducing the chance of acquiring HIV. It’s vital that all those who can benefit from PrEP can access it. HIV testing and PrEP is available for free from sexual health services.”

‘We think that there are certain communities and individuals at the moment who could benefit from PrEP but aren’t accessing it‘

Debbie Laylock, head of policy at Terrence Higgins Trust

Following the success of the study, the accessibility surrounding the drug has been brought into question given the lack of awareness in the public domain. 

Chief Investigator for the PrEP Impact Trial, Dr Ann Sullivan, said: “The PrEP Impact Trial has further demonstrated the effectiveness of PrEP in preventing HIV transmission and has provided key insights, including identifying subgroups where more work is needed to increase access to PrEP and prevent HIV transmissions.”

Awareness

Manchester’s LGBT Foundation Sexual Health Team said: “The encouraging news is that those who are aware of PrEP generally have a decent understanding of it. This suggests that our educational efforts are effective but need to be more inclusive and far-reaching.”

In a BBC Interview, head of policy for the Terrence Higgins Trust Debbie Laylock said: “We think that there are certain communities and individuals at the moment who could benefit from PrEP but aren’t accessing it. Many women just don’t know PrEP exists.”

Regarding the awareness and access to the drug, Manchester’s LGBT Foundation Sexual Health Team said: “There are opportunities to expand PrEP’s reach and truly make a difference in diverse communities now it is available on the NHS. By bringing PrEP directly into community spaces, we’re normalising HIV and helping to make it part of people’s wellbeing routines and reduce barriers to testing and talking about HIV.

‘To broaden awareness of PrEP in Manchester and the UK, a multifaceted approach is essential.‘

LGBT Foundation Sexual Health Team

“Our monthly PrEP Initiation clinic at GAY (@G_A_YManchester) in collaboration with The Northern (@TheNorthernISH) has shown us the power of community-based services as it gives a convenient alternative to accessing GUM clinics. Imagine the impact as we extend this proactive approach to other marginalised communities such as Black African and Caribbean groups as well as women.”

They highlighted the importance of educating the population with “the knowledge of U=U (Undetectable=Untransmittable)” and breaking stigma.

“To broaden awareness of PrEP in Manchester and the UK, a multifaceted approach is essential. Firstly we need to co-create advertising and promotions with a wide range of communities rather than guess.

“By tailoring our outreach to the unique needs and perspectives of various communities, we can ensure that our message resonates and educates effectively. Similarly, educating healthcare practitioners to advocate for PrEP can create a network of support for patients.

“Collaborating with organisations serving communities vulnerable to HIV is also vital. This partnership ensures that efforts are not only sensitive and respectful but also directly address the barriers these groups face,” Manchester’s LGBT Foundation Sexual Health Team said.

Accessibility

While de-stigmatising and educating all communities about HIV is incredibly important, PrEP is still only available at sexual health clinics.

The Sexual Health Team said: “PrEP access in pharmacies would massively alleviate some of the strain on sexual health clinics, which are already under considerable pressure whilst being underfunded. By diversifying the points of access, we’re not just easing the burden on these services but also potentially reaching a wider audience.”

It comes following Elton John’s address in parliament where he urged MPs to help eradicate AIDS by 2030 through hospital testing.

The government program began in April 2022 whereby opt-out testing for HIV was adopted by 34 A&Es around Manchester and London. 

More than 4,000 people have been identified with HIV since the scheme began across 34 A&Es, with 46 more A&Es just announced to carry out opt-out testing for HIV. 

This is a result of Sir Elton’s AIDS Foundation campaigning for the program to be extended long term after its success.

Sir Elton said: “Automatic testing gets to people earlier, which means less HIV transmission, less illness, less death and by the estimate of health economists, £50m saved for the NHS.”