More than a quarter of the sexual health clinics involved in NHS England’s PrEP [pre-exposure prophylaxis for HIV] Impact Trial are currently closed to some new recruits, despite a promised expansion, a health minister has revealed.
In a written parliamentary answer on the progress being made on doubling the number of places in the PrEP Impact Trial to 26,000, health minister Seema Kennedy said that 38 of the 147 sites involved are currently not open to recruitment for men who have sex with men. The sites remain open for other groups seeking access to PrEP.
“It is understood that the range of reasons [for the closures to new recruits to the trial] include temporary staffing or premise issues, capacity and local authority commissioner approval,” she wrote.
NHS England announced in March 2019 that it would start to expand access to the PrEP Impact Trial following a request to do so by the trial’s researchers.
This decision had been delayed from January 2019 as the trial’s oversight board wanted to obtain assurances from participating clinics they had sufficient capacity to take on more places.
Kennedy’s admission follows the publication of the the House of Commons Health and Social Care Select Committee’s ‘Sexual Health’ report on 2 June 2019, which warned that there is “huge frustration” around current inequitable access to PrEP.
“We note that NHS England has expanded its pilot sites to increase the number of people able to benefit from PrEP, but access remains a postcode lottery,” the report said.
PrEP involves users taking two medicines, tenofovir and emtricitabine (marketed as Truvada), which have been shown to protect HIV-negative people from acquiring HIV. The Terrence Higgins Trust, the UK’s leading HIV and sexual health charity, said there were particular issues around access to PrEP in London.
Debbie Laycock, head of policy at the charity, commented: “It has been nearly five months since health secretary Matt Hancock pledged to double places on the trial, but this has still not happened across all sites.
“In London, which continues to account for the largest number of new HIV diagnoses every year, councils have only agreed to an increase [in places] of 60%.
“This coupled with the fact that the city’s largest sexual health clinics are no longer accepting any additional places and therefore turning away people at increased risk of HIV, is simply unsustainable.”