PrEP trial starts at last

After a lot of wrangling and delay, NHS England has announced the start of the pre-exposure prophylaxis (PrEP) HIV prevention pilot trial.

From September, PrEP will be provided by the NHS through an initial three-year trial to an estimated 10 000 people, in what NHS England says will be the largest single study of its type in the world.

The trial will assess the potential of PrEP by gathering clinical evidence on optimal targeting, uptake and implementation on a large scale.

Sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield are expected to be amongst the first to start enrolling people in the trial from early September. More clinics will join in October with full implementation across England by April 2018.

Clinics will identify eligible participants including men, women, transgender people, and individuals who have a partner whose HIV status is not known to be controlled by antiretroviral treatment. People living and registered with a GP in England will also be able to enroll for potential participation at their local participating sexual health clinic.

Simon Stevens, Chief Executive of NHS England, says: ‘This major new intervention should complement and supercharge the wide-ranging and increasingly successful effort to prevent HIV. It’s another milestone in more than three decade’s worth of progress in tackling one of humanity’s major health challenges.’

Professor Brian Gazzard, Consultant in Infectious Diseases, Chair of St Stephen’s AIDS Trust and Chief Investigator for the PrEP Impact Trial, says: ‘This is a hugely important and ambitious trial, and one which we need if we are to accurately translate the promising findings of earlier studies to a wider risk population. There is a more diverse population of high risk individuals for whom PrEP and its associated risk reduction support could mean the difference between staying HIV negative or becoming HIV positive. The data and evidence we generate will not only be of international interest but more importantly will enable commissioners in England to plan for a PrEP programme that benefits individuals and the taxpayer.’

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