No, universal access to PrEP hasn’t been ‘postponed indefinitely’ because of coronavirus

PrEP Impact trial: Man holding a pill used for Pre-Exposure Prophylaxis (PrEP) to prevent HIV infection

HIV advocates sought to clarify that the rollout of PrEP in England has not been “indefinitely postponed” due to the coronavirus pandemic.

The Government announced in March that PrEP – a pill, taken daily, that stops HIV taking hold in people who have been exposed to it – was to be made available across England freely on the NHS from April. Until then, it had been available as part of a trial.

On Friday (June 5), correspondence seen by i from England’s largest sexual health clinic, London-based 56 Dean Street, warned that the start of the rollout has been “indefinitely postponed”.

This sparked confusion and concern among healthcare circles. In interviews with PinkNews, activists emphatically clarified that the rollout is not being delayed “indefinitely”, seeking to reassure that the full commissioning of the rollout will still go ahead once the government provides a timetable.

Moreover, they said, users can expect a staggered rollout of the drug due to the coronavirus. They noted that some clinics will be providing people new IMPACT Trial places until mid-July and that those already on the scheme will be provided with “interim” supplies of PrEP.

Overall, access to PrEP will be kept buoyant through various stopgap measures throughout the pandemic.

Representatives at the Department of Health and Social Care stressed to PinkNews that government health officials are doing “everything possible to ensure the routine commissioning of PrEP”.

PrEP NHS rollout ‘hasn’t been delayed “indefinitely”, that’s one thing to make really clear’.

Dr Michael Brady, medical director at Terrence Higgins Trust, told PinkNews during a Pride for All panel discussion: “It hasn’t been delayed ‘indefinitely’, that’s one thing to make really clear.

“That language is very worrying,” he said, adding: “I think this is where the language of it being delayed [came from], the challenge is COVID.

“The announcement about PrEP being available on the NHS in England came just before COVID hit and just as lockdown started. So, for understandable reasons, everybody’s focus and resources have moved to COVID.

“So, the rollout has been delayed, but it’s not delayed ‘indefinitely’.”

Bradley anticipated a staggered rollout, with different NHS provisions of PrEP being available in different patches of the country.

This was echoed by PrEPster, a group at the frontline of urging lawmakers to rollout PrEP, who advised “caution” at the claim.

Clarifying on Twitter that while (according to a report issued by the group June 2) the rollout has been disrupted by the pandemic, it was not done so “indefinitely”.

PrEPster sketched out that the suggestion “does NOT reflect the information shared with the IMPACT community advisory group”.

The IMPACT trial, started in 2017, is a large-scale test run of PrEP which can enroll up to 26,000 people on the drug and is due to end in October.

Brady explained that those in the trial will, organisers aim, have a “seamless transition” into the NHS PrEP programme.

Coronavirus crisis has presented ‘once-in-a-generation opportunity in the fight against HIV’.

As much as the coronavirus rampaging England has roiled PrEP’s rollout, 56 Dean Street said HIV acquisition has “plummeted” during coronavirus lockdown.

“Even COVID clouds have silver linings,” it wrote on its website in May.

“Fewer hook-ups since lockdown has resulted in a huge reduction of HIV and other STIs. The chain is broken.”

“We may never get this chance again,” it continued, explaining that the coronavirus pandemic has presented a “once-in-a-generation opportunity in the fight against HIV”.

Ultimately, AidsMap executive director Matthew Hodson said to PinkNews, advocates must express caution when approaching this opportunity.

London Councils to add 4,000 new places to PrEP trial

(Justin Sullivan/Getty)

He explained how some are anticipating an increase in HIV acquisition rates as lockdown winds down, alongside “a massive spike” in STI rates.

“And,” he said, “if undiagnosed infections haven’t been reduced as much as hoped, that could be accompanied in a spike in new HIV infections.

“So, it is really urgent that people who need PrEP have access to it as lockdown relaxes.

“We can’t waste the opportunity that lockdown has given us to break the transmission chain, and what we need right now is great clarity from the government about the commissioning timetable.”

A Department of Health and Social Care spokesperson told PinkNews: “We know how important PrEP is and now we are through the peak of this global pandemic, we are doing everything possible to ensure the routine commissioning of PrEP.

“We will continue to work closely with Local Authorities so this happens as quickly as possible.”

PinkNews contacted 56 Dean Street for comment.