U.K. to Make PrEP Available to Every English Person

PrEP, the daily antiretroviral medication that makes it virtually impossible to get HIV through sex, will soon be available to anyone in England who wants it, the United Kingdom's Department of Health and Social Care announced.

The medication will be available to the English public beginning in April (the statement does not offer specifics on Wales, Scotland, or Northern Ireland). Currently, the treatment is available only in the United Kingdom to participants in a limited PrEP Impact Trial that has reached over 20,000 people.

"So we are rolling out PrEP and making it available across the country - with evidence showing it almost completely eradicates the chances of getting HIV," said Health and Social Care Secretary Matt Hancock in the announcement. "This will benefit tens of thousands of people's lives, and drive us towards our ambition of zero HIV transmissions in this decade."

Using a PS16 million grant from the National Health Service (NHS), the drug will now be available to the individuals through their local providers. PrEP, also known as pre-exposure prophylaxis, is a daily treatment shown to be up to 99 percent effective in preventing HIV in tests. It is especially effective when used with safe sex practices such as condoms.

The United Kingdom is a participant in the United Nations 90-90-90 program. The goal is to achieve a 90 percent diagnosis rate for all people living with HIV, 90 percent of those diagnosed receiving HIV treatment, and 90 percent of those receiving treatment showing viral suppression. While the target date for achieving these goals is 2020, the United Kingdom achieved them in 2018 according to the National AIDS Trust. At that time, 93 percent knew they were living with HIV, 97 percent of the diagnosed were on treatment, and 97 percent of those on treatment showed viral suppression.

According to the National AIDS Trust, there were 103,800 persons living with HIV in 2018. As defined by medical authorities in the United Kingdom, cases were evenly divided among those who became positive as a result of heterosexual sex and from men having sex with men (MSM) at 46.2 percent and 46.4 percent respectively. Of the newly diagnosed MSM in 2018, nearly 74 percent were between the ages of 25 and 49. The younger 25 to 34 age group accounted for 42 percent. It is hoped these numbers can be dropped dramatically by making PrEP available to the general public.

"Rolling out PrEP will help prevent further transmissions," Health Minister Jo Churchill said in the announcement. "This is a crucial part of our work to tackle the condition and the stigma around it by making vital treatment more accessible and making national awareness better."

The decision was met with praise, but also calls for continued action.

"We're delighted PrEP will finally be freely available to all those who need it in England, with no cap on spaces," Deborah Gold, Chief Executive of the National AIDS Trust, said in a statement. "While we're relieved at this announcement, making the medication available is not the end goal - it's just one part of the struggle. The trial has successfully engaged with gay and bisexual men. However, very few other groups at risk - including women and non-binary people - are accessing places. We risk embedding inequalities from the outset if we fail to grasp this. We urgently need to see investment in engagement and community-based services to ensure no one is left behind."