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Unanswered questions about proposed PrEP trial

With 17 new HIV diagnoses made every day in the UK, we need to be bold and ambitious in our approach to HIV prevention — and this must include access to pre-exposure prophylaxis (PrEP) for all who need it.

For two years we have been calling for a long-term, stable home for PrEP within the NHS so it can be used as a vital tool in our HIV prevention armoury alongside condoms, regular testing and early treatment.

We welcome the fact that, finally, PrEP will be made available to 10,000 people who are at risk over three years in a trial funded by NHS England (The Pharmaceutical Journal online, 5 December 2016). Preventing the spread of HIV is good news for everyone. Not only will this make a life-changing difference to each of these individuals by protecting them from an incurable and highly stigmatised condition, but for every person who would have become HIV positive without PrEP, the NHS will save £360,000 in lifetime treatment costs.

However, there are many questions that need to be answered about the proposed trial. We need to know how it will work in practice and understand how those at risk, no matter where they live, will be able to access PrEP.

This trial alone does not provide the long-term stability that is needed. NHS England must make a commitment now that, when the trial ends, it will fully fund PrEP for all those who are at risk. Only then can we look forward to a future without HIV transmissions, which would be a stunning achievement in public health.

Ian Green

Chief executive

Terrence Higgins Trust

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20202059

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