In a boost to HIV prevention in the capital, London boroughs have agreed to provide over 4,000 extra places on the PrEP Impact Trial.
The trial – a national programme led by NHS England in partnership with Public Health England and local authorities – supplies PrEP (an HIV prevention medicine) free of charge to individuals considered to be at high risk of exposure to HIV.
The expansion, which will take place over the coming weeks, represents a 60% increase in the trial places available to Londoners. London already accounts for 7,609 trial places – a higher figure than the rest of England combined.
The PrEP trial expansion in the capital will also include the use of the innovative online service Sexual Health London, which will be an option for trial participants to use for their regular sexual health checks.
Cllr Ray Puddifoot MBE, London Councils’ Executive Member for Health & Care, said:
“Boroughs have a proud record on HIV prevention and we want PrEP to be available to every Londoner who needs it. PrEP is hugely important for protecting people’s health and preventing HIV transmission.
“We’ve played a key role in the success of the trial so far, rolling out the programme in sexual health clinics across the capital to ensure thousands of Londoners receive PrEP.
“We’re pleased to announce that boroughs will provide these additional places on the PrEP Impact Trial. Looking to the future, we’re keen for national partners in the government and NHS to confirm funding arrangements for PrEP provision.
“While extra places on the PrEP Impact Trial represent a step forward, we ultimately want to see NHS-funded PrEP available to everyone at high risk of HIV exposure – as is the case in Scotland and Wales.”
PrEP is a key part of London’s HIV prevention strategy. Every time PrEP helps avoid a new HIV diagnosis, the NHS is potentially saved £360,000 in lifetime treatment costs.
The boroughs’ announcement follows discussions held with the NHS over resourcing of the additional places on the PrEP Impact Trial. Boroughs had previously expressed concern that the trial was being expanded without any additional investment, with potential repercussions for boroughs’ other sexual health services.
However, boroughs have now agreed to accommodate 4,000 extra places at a collective cost of £2.6 million to their sexual health budgets. The sustainability of London’s expansion of the PrEP Impact Trial will be monitored and boroughs will continue to push for a long-term funding arrangement for future provision.
London is home to an estimated 39,000 people living with HIV. Since 2014, when boroughs established the London HIV Prevention Programme, the capital has made remarkable progress in addressing this public health challenge.
The most recent figures from Public Health England revealed a substantial decrease in London HIV’s diagnosis rates of 21% in 2016-17, compared to the UK-wide decrease of 17%.
This has been achieved despite reductions in London’s public health grant. Between 2015-16 and 2018-19, London’s grant was reduced by 15% per head of population – the most substantial reduction of any region in England.
Last year saw London join the worldwide Fast-Track Cities initiative. London became one of the first global cities to meet the UN’s diagnosis and treatment targets and has pledged to achieve zero new HIV transmissions by 2030.
- PrEP stands for pre-exposure prophylaxis – a pill that substantially reduces the risk of HIV infection and without major side effects. The PrEP Impact Trial has seen PrEP given for free to people considered at high risk of exposure to HIV. PrEP is also available to buy online.
- England’s PrEP Impact Trial opened in October 2017 and is due to run until September 2020. The trial aims to address outstanding questions regarding PrEP eligibility, uptake, and duration of use – including the effect of PrEP provision on incidence of HIV and other sexually transmitted infections. Release of the additional places in London will occur over the coming weeks as the allocations are agreed with each individual clinic and their research departments. As clinics re-open to recruitment their status will be updated on the trial website. Potential participants should be directed to the PrEP Impact website (www.prepimpacttrial.org.uk) before contacting or attending their local sexual health clinic.
- Meanwhile, PrEP is available through sexual health clinics in Scotland to anyone meeting the ‘high risk’ eligibility criteria. Wales is also running a PrEP trial but has no cap on participant numbers.
- Sexual Health London (www.shl.uk) offers convenient online access to HIV and STI testing, with more than 180,000 kit orders since January 2018 and high user satisfaction levels. This online service is set to become an additional option for trial participants to use.
- Facilitated by London Councils following the transfer of public health responsibilities to local government, the London HIV Prevention Programme was established by the boroughs in 2014 in response to the previous decade’s increasing HIV rates in the capital. The LHPP oversees a free condom distribution scheme, provides outreach services targeting at-risk groups such as men who have sex with men, and runs the award-winning Do It London public awareness campaign which provides all Londoners with information about HIV prevention.
- London Councils represents London’s 32 boroughs and the City of London. It is a cross-party organisation that works on behalf of all its member authorities regardless of political persuasion. More about London Councils here: www.londoncouncils.gov.uk