A new study by the UK Health Security Agency (UKSHA) found that use of PrEP, also known as pre-exposure prophylaxis, reduced the chances of getting HIV by around 86% when used in everyday life – accounting for incorrect and inconsistent use.
Funded by NHS England, the study was carried out at 157 sexual health clinics on 24,000 people across England between October 2017 and July 2020. Clinical trials suggested the medication is 99% effective.
‘This trial has further demonstrated the effectiveness of PrEP in preventing HIV transmission and has, for the first time, shown the protective effect reported by earlier trials, but at scale, and delivered through routine sexual health services in England,’ said Dr John Saunders, a consultant in sexual health and HIV who worked on the study.
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PrEP, which contains existing HIV treatment drugs tenofovir disoproxil and emtricitabine, works by stopping HIV from entering the body and making copies of itself. It can either be taken as a daily pill or before sexual intercourse.
While the effectiveness of the drug would help the government achieve its aim of zero HIV transmissions by 2030, the UKSHA said more people needed to take it to be effective.
The clinical trials have helped identify ‘how many people want it, take it, or how long they would stay on it’ to determine ‘real-world effectiveness’ of the drug.
‘Now we know who is being prescribed it and we can work with clinics to try and get more people to take it,’ said Dr Saunders. ‘Gay and bisexual men were likely to use the drug’ but ‘many people from other groups, such as straight women would benefit from taking it,’ he said.
The drug has already benefited people from the gay community. Harry Dodd, 33, from north London who has taken part in several PrEP trials, said taking the drug has been ‘empowering’ for him as he no longer fears catching HIV. ‘I have had long-term partners who have HIV since [taking the drug] and that would not have been on my radar before. I now have the confidence to love freely,’ he said.
‘Not only did the trial directly prevent many cases of HIV, help normalise the use of PrEP, remove stigma and pave the way for a routinely commissioned clinically and cost effective PrEP service; but it also made a very real contribution towards our goal of ending new cases of HIV by 2030,’ said John Stewart, national director for specialized commissioning at NHS England and co-Chair of the PrEP Impact Trial Oversight Board.