HIV advocacy groups have expressed their profound disappointment in the recent decision by the National Institute for Health and Care Excellence (NICE) to not recommend a long-acting injectable form of Pre-exposure prophylaxis (PrEP) for use in the National Health Service (NHS). The drug in question, Cabotegravir (CAB-LA), which is administered every two months, was seen as a pivotal step in expanding HIV prevention strategies. In its pill form, PrEP is currently available for free from sexual health clinics across England, Scotland, and Wales.
While oral PrEP has been a cornerstone in HIV prevention efforts, many in the HIV community argue that the availability of an injectable form could significantly increase accessibility and adherence, particularly for individuals who may struggle with the daily regimen. Advocacy groups such as the National Aids Trust and the Terrence Higgins Trust have been vocal in their disappointment, emphasizing that the current system already struggles to meet demand. Recent reports have shown that two-thirds of people in the UK cannot easily access PrEP, a critical tool in preventing the spread of HIV.
The decision not to recommend CAB-LA has also raised concerns about equity. The existing disparities in access to sexual health services, exacerbated by social inequalities, mean that many vulnerable groups have been left underserved by the daily pill option. CAB-LA offers a discreet and long-lasting alternative that could address many of these unmet needs, particularly among marginalized populations. The advocacy groups are now pushing for a solution, urging the manufacturer, ViiV Healthcare, to ensure affordable access to CAB-LA, so the UK can still aim to achieve its goal of eliminating new HIV transmissions by 2030.
This decision has broader implications for the LGBTQ+ community. While PrEP has been a life-changing intervention, limited access to the most convenient forms of this medicine could hinder progress in preventing new infections. The fight against HIV is far from over, and healthcare systems must continue to evolve and address the needs of at-risk communities.