PrEP In England Is Coming - We Must Now Make Sure No-one At Risk Of HIV Is Left Behind

We must not underestimate the power of PrEP. In 29 days time, we could be marking the beginning of the end for HIV transmission in England, once PrEP is being put to use alongside other HIV prevention tools, such as condoms, testing and treatment. Every day that passes without access to PrEP, more people are being diagnosed with a highly stigmatised and lifelong condition. They will need to take medication for the rest of their lives, and are likely to face stigma and discrimination because of their HIV status.
Terrence Higgins Trust

On Thurday, NHS England announced a start date for the much anticipated PrEP trial, which will protect 10,000 people from HIV infection over the next three years.

From 1 September, people at risk of HIV will be able to access the game changing HIV prevention drug, which has already proved highly effective both here in the UK and across the world. To begin with, it will be offered at sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield, before being rolled out across the country over the coming months.

We must not underestimate the power of PrEP. In 29 days time, we could be marking the beginning of the end for HIV transmission in England, once PrEP is being put to use alongside other HIV prevention tools, such as condoms, testing and treatment.

Both Scotland and Wales have already made PrEP available to those who need it, with NHS Scotland making history by becoming the first to make it routinely available on the NHS, and a large scale pilot swiftly followed this in Wales.

Here in England, the journey to providing PrEP hasn't been as smooth, with a hard-fought battle played out at the High Court following robust action from our friends at the National AIDS Trust. . But nonetheless, people at risk of HIV in London, Brighton, Manchester, Liverpool and Sheffield are expected to be amongst the first to get access to PrEP on the NHS, in less than a month.

The priority must now be to make sure that the trial reaches everyone at risk of HIV, and that it is rolled out speedily across the whole country, by the end of this year at the very latest. Spring 2018 - which NHS England say will be the deadline for full implementation - is not soon enough.

Every day that passes without access to PrEP, more people are being diagnosed with a highly stigmatised and lifelong condition. They will need to take medication for the rest of their lives, and are likely to face stigma and discrimination because of their HIV status.

Not only this, but for every person diagnosed with HIV, the NHS will fund an estimated £360,000 in lifetime treatment costs.

PrEP is a no brainer. It stops HIV transmission and saves money. We have all of the tools to stop HIV here in the UK, we now just need to the will to make it happen. We've already seen what can happen when we utilise all of these weapons - condoms, testing, PrEP and diagnosing and treating people as early as possible so they can become uninfectious - with the first ever drop in new HIV diagnoses in gay and bisexual men.

A 25% in HIV diagnoses among gay men in London is great news, but it's just the start. We've started something. Something that was unimaginable just 20 years ago when I was diagnosed with HIV, amid the crisis that showed no signs of slowing down.

Now we have a start date for the PrEP trial and we know that the drug has been procured, we're well on the way to protecting over 10,000 people at risk of HIV.

But to make the most of this major opportunity to change the face of this epidemic, we need to ensure all clinics across England are providing PrEP by the end of the year, and that Local Authorities who will be responsible for implementing, have all of the tools, resources and information they need to provide PrEP.

There are still many questions remaining about this trial too - how will the trial ensure PrEP is not a postcode lottery and is available no matter where you live? And how will the trial reach all people in need, not just gay and bisexual men?

We must make sure no-one at risk of HIV is left behind. And at the end of this three year trial, we can't stop there - PrEP needs a permanent home. We need a clear and agreed process for routinely commissioning PrEP on the NHS which includes everyone at risk, with those that won't be able to access PrEP once the trial reaches capacity.

We've come a long way in the journey to see PrEP available on the NHS for all those who need it. We're not there yet. But a world without HIV transmissions is one step closer today.

Ian Green is CEO of the Terrence Higgins Trust

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