Gay men in England facing postcode lottery for HIV medication

Gay and bisexual men are facing significant issues when trying to access trial placements for PrEP medication, new research shows.

Research undertaken by online doctor Zava shows that almost a quarter (23%) of clinical trial sites offering the HIV prevention medicine PrEP are not currently accepting anymore gay or bisexual men.

NHS England’s PrEP Impact Trial was launched at the end of 2017 to measure the drug’s uptake and effectiveness across populations in England.

Now Zava is warning that men in England face a postcode lottery when it comes to accessing HIV prevention medication.

This is despite NHS England announcing earlier this year a recommended increase in placements from 13,000 to 26,000. Currently, over 15,700 people have received PrEP through NHS England’s Impact Trial.

PrEP is a combination of two antiretroviral medicines which reduce the risk of contracting HIV during sex. People have criticised NHS England for not supplying the drug through sexual health clinics as it is already available in Scotland and Wales.

Zava’s research shows that shortages of clinical trial placements are most common in London, where nine out of 24 clinics are not currently accepting men, and the east of England, where 10 out of the 15 registered clinics are full or ‘paused’ to men.

In October, the BBC reported that 15 men had currently contracted HIV while waiting for places on the PrEP Impact Trial, though Zava fears this figure may be higher. Zava reached out to individual NHS Trusts to find out how many men are currently on waiting lists for the trial but were told that the information was currently being withheld as it is set to be released at a future date.

With restricted access to PrEP, patients can legally import the drug from outside of the EU, though at a cost. Zava has just launched its service for PrEP in the UK which includes consultation, assessment, prescription, and aftercare. The service, which can be done without a face-to-face appointments includes follow-ups from Zava doctors to ensure patients are supported throughout their treatments.

Dr Babak Ashrafi, clinical lead for Service Expansion at Zava said: “There’s no doubt that PrEP has been instrumental in reducing HIV rates in the UK, but unfortunately access to the Impact trial remains a postcode lottery. This means that many people are on long waiting lists at their nearest clinic or forced to travel miles out of their way, and that’s unacceptable."

"If PrEP isn’t made easily available to those who could benefit most from it, then it would fail as a public health prevention program, as well as on an individual basis. Additionally, not having the right safeguards in place for testing would lead to an increase in drug resistance, and possible adverse effects from the drug."