Following the decision by NHS England to not make pre-exposure prophylaxis (PrEP) available to HIV-negative persons in England at risk of acquiring HIV, Dr Michael Brady, Medical Director of the Terrence Higgins Trust, in an editorial published today in the SAGE journal Therapeutic Advances in Chronic Disease responds and outlines how, "PrEP is undoubtedly an essential addition to our approach to combination HIV prevention and needs to be available now."
It has been estimated that PrEP, when used in combination with increased HIV testing and HIV treatment, could prevent 7400 new infections between now and 2020. Until recently, the best data has come from the USA and developing countries, but following the PROUD study, which found that PrEP reduced HIV incidence by 86%, we now have very strong evidence on the efficiency and cost effectiveness of PrEP in the UK. Yet, despite this, those most at risk in the UK remain unable to access this important HIV prevention measure. As Dr Brady continues in response to current NHS plans for the treatment:
"If this plan for limited access were to go ahead clinicians would have to provide PrEP on a 'first come, first served' basis and would very quickly find themselves having to deny access to PrEP to men who we know are at very high risk of HIV acquisition."
Following calls from clinicians, local authorities, directors of public health, politicians, activists and community originations, in a promising step forward in the campaign, NHS England have now said that they will carefully consider its position on commissioning PrEP, but as Dr Brady argues "the sector must maintain pressure to ensure PrEP is made available as soon as possible." He concludes:
"We have delayed implementing PrEP in the UK for too long and to continue to deny access to those who most need it will result in unnecessary HIV infections and avoidable costs to the NHS of life-time HIV treatment and care."
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