Gilead's Truvada (TDF/FTC) registrationApproved
Generic versions of TDF/FTC for preventionApproved
Viiv’s Apretude (CAB for PrEP) RegistrationNot approved
IPM’s Dapivirine Ring RegistrationNot approved
Types of Delivery Projects
- Implementation project — funded/implementer involvement and investment in some or all steps related to comprehensive introduction that may or may not use government clinics as the primary service delivery point.
- National level — PrEP availability in government clinics.
- BHIVA/BASHH Guidelines on the Use of HIV Pre-Exposure Prophylaxis (2018)
- Scottish Medicines Consortium Truvada Assessment (2017)
- Public Health England
From the Scottish Medicines Consortium:
PrEP should be available to people with greatest risk of acquiring HIV if aged 16 or over, tested HIV negative, able to attend the clinic for regular three monthly review including for monitoring, sexual health care and support and to collect prescriptions, willing to stop NHS-funded PrEP if the eligibility criteria no longer apply and resident in Scotland.
In addition at least one of the following should apply: current sexual partners, irrespective of gender, of people who are HIV positive and with a detectable viral load, MSM and transgender women with a documented bacterial rectal STI in the last 12 months, MSM and transgender women reporting condomless penetrative anal sex with two or more partners in the last 12 months and likely to do so again in the next three months or individuals, irrespective of gender, at an equivalent highest risk of HIV acquisition, as agreed with another specialist clinician.
There are important concerns, and we recommend that ad hoc prescribing is avoided, and that PrEP is only prescribed in the context of a clinical research study in the UK. Ideally, this would be a RCT, which is embedded in a broader concerted effort to intensify HIV prevention and implement the existing guidelines.
Health-care workers should note that PrEP is one of several prevention tools to aid discussion of the options available to their service users. The data in support of condoms and treatment of positive partners are too compelling to be ignored. While further evidence relevant to the UK setting is being gathered, validated behavioural interventions, regular HIV testing, the diagnosis and treatment of other sexually transmitted infections, and intensive health-promotion activities according to current BASHH-BHIVA guidelines should be implemented in preference to PrEP.
Resources for the United Kingdom
- A Framework for Scaling Up PrEP can help implementers, government and advocates begin planning for and implementing PrEP programs.
- Click here for the latest information from NHS Health Scotland.
- HIV Scotland – The national HIV policy organization for Scotland.
- Click here for the latest information from Public Health Wales.
- Click here for the latest information from the UK Department of Health.
- ACT UP London is a strong supporter of PrEP, organizing demonstrations in favor of access and vocal demand for PrEP is growing among gay men, with a strong local EATG presence.
- Prepster.info, a new PrEP website aimed to educate and agitate for PrEP access in England and beyond.