Urgent call for PrEP to be made more widely available

Joint statement from Terrence Higgins Trust, National AIDS Trust, Prepster and National Pharmacy Association calls for UK government to pilot PrEP in community pharmacies

Terrence Higgins Trust (THT) has joined forces with leading HIV charities National AIDS Trust (NAT) and Prepster, along with community pharmacy body the National Pharmacy Association, to demand PrEP (pre-exposure prophylaxis) be rolled out in new settings, including in pharmacies in England.

PrEP is a highly effective way to prevent HIV. However, currently it is only available via sexual health services and is largely used by gay and bisexual men only.

The independent HIV Commission, supported by THT, NAT and the Elton John AIDS Foundation, was clear that the potential of PrEP is not being fully utilised and communities that could benefit from PrEP are missing out. The Commission recommended that PrEP provision should be made available outside sexual health services.

A statement released last month by the consortium – some of which we have shared below – reinforces the role that community pharmacies could play in expanding access to PrEP. As the UK government finalises its National HIV Action Plan, the statement calls for the plan to include a commitment to pilot PrEP provision in primary care, including in community pharmacies.

Maximising the benefits of PrEP: The potential of community pharmacy

We believe that expansion of PrEP should be a key intervention included in the government’s upcoming National HIV Action Plan.

We would like to see the urgent initiation of a fully funded pilot that tests the ‘real life’ availability of PrEP via primary care including community pharmacies – ensuring a service that is joined up with other local HIV prevention efforts.

The end of new HIV transmissions is in sight

In 2019 the UK government committed to ending new cases of HIV by 2030 – an ambitious but achievable target. In December 2020, the HIV Commission published their final report which set out a blueprint for ending HIV transmission by 2030. The Commission highlighted that a key priority to ending new HIV transmission is to extend the provision of PrEP in settings beyond sexual health clinics.

The potential of PrEP

HIV PrEP is a proven highly effective method of preventing HIV transmission. After a large-scale trial in England, it is now available via level-3 sexual health services for anyone at risk of HIV. Public Health England (PHE) is clear that the availability of PrEP, alongside other HIV combination prevention tools, has been a factor in the incredible reductions in HIV cases seen in England – particularly in gay and bisexual men and other men who have sex with men.

PrEP has the potential to also be a valuable HIV prevention tool for other communities at risk of HIV – but this opportunity is not yet being realised. PrEP is still largely an HIV prevention intervention used by gay and bisexual men. Women and Black African communities are among those at risk of HIV but reportedly less likely to access sexual health services.

The potential of community pharmacy

Primary care, including community pharmacists, are well placed to support the expansion of PrEP to other communities who could benefit from it. Community pharmacists are at the frontline of healthcare, and are also taking on more clinical roles, such as the management and monitoring of long-term conditions. They already provide sexual health prevention and

treatment services and advice such as emergency hormonal contraception (EHC), chlamydia screening, signposting and referral.

The way ahead

These benefits and the prevention experience that already exists in pharmacies places them and their teams in a unique position for successful integration into PrEP care pathways to increase access to anyone that can benefit from PrEP.

As national community pharmacy and HIV organisations we want to further explore this potential. We believe that the expansion of PrEP access should be a key intervention in the upcoming National HIV Action Plan.

As a next step, we would like to see a timely, fully funded pilot that tests the ‘real life’ availability of PrEP via pharmacies (and other settings) and allows for lessons learnt and successful approaches to be quickly scaled up. This should see PrEP remain exempt from a prescription charge and ensure a service that is fully joined up with other local HIV prevention efforts.

The pilot should include a diversity of areas in England – both rural and urban – and covering different local demographic communities. The pilot should also incorporate a PrEP awareness campaign that is culturally appropriate and that challenges stigma around and misinformation about PrEP.

To see the full statement, visit: www.tht.org. uk/sites/default/files/2021-11/PrEP%20in%20 Pharmacies%20joint%20statement_0.pdf

For more info on THT, visit: www.tht.org.ukD For more info on NAT, visit: www.nat.org.uk

For more info on Prepster, visit: https://prepster. info