UK HIV Prevention organisations issue statement in support of PrEP

A group of UK HIV prevention organisations have released today a statement calling for the NHS to make Pre-Exposure Prophylaxis (PrEP) for the prevention of HIV infection available as soon as possible.

This statement comes after two clinical studies investigating daily PrEP in the UK (The PROUD study) and intermittent PrEP in France (The IPERGAY study) had to offer Truvada, the antiviral used for PrEP, to all their participants. This, because an interim analysis showed that the drug was very effective at preventing HIV acquisition in HIV negative people.

This statement is not a new statement but an update of last year’s statement which offered a cautious support to PrEP, awaiting for the results of the PROUD study to “give us important information on the role which PrEP may play in HIV prevention.”

If a year ago that statement was already out of date (PrEP efficacy was already well documented and Truvada had been approved by the US FDA in 2012), it was at least an encouraging sign that UK Charities involved in HIV prevention were finally acknowledging the existence of a new HIV prevention alongside condoms.

This year’s update is not much different and would be rather dull if it wasn’t that it finally acknowledges PrEP as an HIV prevention in its own and on its own rights.

Gone “PrEP is not a replacement for condom use. Instead it is an additional method of preventing HIV transmission, to be added to the other strategies that gay men already use.”

Welcome “Condom use will remain a core strategy in HIV prevention. PrEP gives people who already find it difficult to consistently use condoms an additional way to protect their health.”

The statement even goes a few steps further stating that “Research suggests that PrEP is as effective as condoms in preventing HIV transmission, as long as the pills are taken regularly, as directed.”

This is a welcome departure from last year’s language, which may be the signal that leading organisations, and especially THT, are moving away from condoms only prevention messaging. This is further noticeable in an interview given by the new THT Chief Executive, Dr Rosemary Gillespie, who told Boyz Magazine that,

“All indications are that it’s going to be a really positive tool in the armoury against HIV. Particularly people who maybe find it hard to use condoms or for whatever reason are taking risks, it’s another tool in the toolkit against HIV and I think it will be a really powerful one.”

This statement follows that of other community-based organisations such as the Canadian HIV Community Link, which (in a rather lengthy 7-page statement) said that,

“With careful consideration, HIV Community Link supports efforts to enhance medically supervised access to Pre-Exposure Prophylaxis in Canada.”

Adding that,

“As a new tool in the HIV prevention toolkit, we recognize PrEP as a complementary approach to be used alongside existing scientifically sound HIV prevention strategies including: enhanced access to low barrier HIV testing; low barrier access to risk reduction tools such as condoms and safer injecting supplies; treatment as prevention; post-exposure prophylaxis; diagnosis and treatment of other sexually transmitted infections; and a suite of behavioural, psychosocial and structural interventions including education, outreach, support services, counseling and advocacy.”

In the US, AIDS United, the largest and longest-running HIV/AIDS coalition also called for scaling-up PrEP,

“Our scientific knowledge that PrEP works and is a substantial tool to prevent HIV just keeps getting stronger,” said Michael Kaplan, president and CEO of AIDS United.

Their statement also noted that,

“While the body of science showing PrEP to be effective has grown, it remains unknown and underutilized by people most likely to benefit from it” and that the “task must now be to educate people at risk of HIV infection, leaders and policymakers about PrEP and make PrEP accessible and affordable throughout the United States.”

Further statements are expected as we approach World Aids Day. It would actually be great if this year’s WAD would be about looking towards an achievable control of the HIV epidemic, driven by new approaches to HIV prevention whilst building on the old ones.

As Dr Gillespie noted, “There isn’t ever going to be a single answer in HIV, It’s going to be a whole portfolio of things which combined will have the impact. Some things work for some people, other things work for other people and PrEP is just going to add to that.”

Now will the NHS Commissioners hear the growing voice rising from the community? And if so, how soon will PrEP be made available for those who need it?

~rjt