Access to Pre-Exposure Prophylaxis (PrEP) in England continues to be a contentious issue as we mark one year since the release of the ‘Not PrEPared’ report, a collaborative effort by the National AIDS Trust, One Voice Network, Prepster, and Sophia Forum. The report shed light on the difficulties faced by individuals attempting to access this highly effective HIV prevention pill, particularly through NHS PrEP services. A staggering 65% of respondents surveyed were unable to access PrEP through the National Health Service, highlighting significant challenges.
In 2019, alarming data presented at BASHH revealed that nine gay men on a PrEP waiting list acquired HIV while awaiting trial spaces. Dr. Jewsbury from a Manchester clinic emphasized the preventable nature of these infections and raised questions about the disparities in access across the UK. One year later, the situation remains dire.
As we approach the end of 2023, it becomes increasingly evident that the full potential of PrEP is being stifled by a strained sexual health system. While 121,547 individuals could potentially benefit from PrEP, only 71% of them have been able to start or continue taking it. Encouragingly, the number of people having their PrEP needs identified during clinical consultations has risen from 79% in 2021 to 83% in 2022, but disparities persist.
These disparities become particularly pronounced when considering straight individuals and different ethnicities. Notably, only 36% of straight women and 39% of straight men have taken up PrEP, highlighting a need for more inclusive and accessible outreach. The forthcoming “PrEP roadmap” promised by the UK government must address these disparities, focusing on awareness, access, and reducing missed opportunities.
To ensure success, the roadmap must encompass efforts to raise awareness of PrEP among communities who stand to benefit from it, improve access, establish a national PrEP access target, explore emerging PrEP methods like injectables, and broaden PrEP access beyond sexual health clinics. Achieving the 2025 goal of reducing new HIV transmissions by 80% in England and the broader 2030 vision will require innovative solutions, funding, and accountability. The year ahead is crucial in determining whether England can make substantial progress in the fight against HIV transmission.