Trial of HIV prevention drugs to start in five locations in England

A three-year trial of the pre-exposure prophylaxis (PrEP) for the prevention of HIV infection has been announced by NHS England and will be the largest single study of its type in the world with an estimated 10,000 people expected to be included.

Sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield are expected to be the first to enrol patients at high risk of HIV infection from early September. Further clinics will join the programme from October and a full implementation across the country is anticipated by April 2018.

This trial will allow the NHS to assess the full additional potential of PrEP by gathering clinical evidence at a large scale on the optimal targeting, uptake and implementation. The lessons learned from this trial will inform how follow-on commissioning should be implemented.

NHS England has signed a contract, securing the pricing of the PrEP drugs that is consistent with the allocated £10 million budget for the project. This budget also includes costs for local authorities and sexual health clinics to deliver and monitor the trial.

Additionally, NHS England has been investing in a ‘treatment as prevention’ (TasP) policy to start HIV treatment earlier for people diagnosed with the disease in order to protect HIV-negative partners. The combination of this programme with other prevention measures has seen a drop of 20% in new HIV diagnoses in large London clinics.

“This major new intervention should complement and supercharge the wide-ranging and increasingly successful effort to prevent HIV,” said Simon Stevens, chief executive of NHS England. “It’s another milestone in more than three decades worth of progress in tackling one of humanity’s major health challenges.”

“This is a pivotal moment in the fight against HIV,” added Deborah Gold, chief executive at NAT (National AIDS Trust). “PrEP, if targeted properly at those in need and at risk, offers the possibility of transforming the English HIV epidemic. From September, people at high risk of HIV will have access via this NHS funded trial in England to an empowering new tool that is truly individually controlled and not subject to negotiation with a partner, leading to the improvement of many, many lives. We warmly welcome this announcement.”