PrEP trial expansion calls

Calls have been made for the pre-exposure HIV prophylaxis (PrEP) trial – looking at the effectiveness and practicalities of introducing a PrEP programme in the UK – to double in size from 13 000 participants to 26 000.

Some reports say that demand has been so high that centres are turning people away. Over 10 000 people have enrolled since the programme started last year.

Trial researchers asking for more places on the trial argue that recruitment needs to reach a ‘steady state’ in order to ensure the trial can robustly and scientifically inform the design and rollout of a full national programme. They also say that the increase will be important for addressing emerging questions from the trial about the need for PrEP amongst women and other groups.

NHS England is supporting the researchers’ proposal and has committed to fund additional places in line with existing trial funding arrangements. The Trial Oversight Board, which includes representatives from Public Health England, local authorities and community groups, alongside NHS England, considered the request in January and, while generally supportive, is consulting with the centres delivering the programme to ensure that they have the capacity to deliver on the numbers increase.

Debbie Laycock, Head of Policy and Public Affairs at Terrence Higgins Trust, says: ‘Every effort must be made by all parties to ensure access to these additional places happens as soon as possible because PrEP has a crucial role to play in ending new HIV infections in the UK.

‘This decision will be a decisive moment on the road to giving PrEP a long-term home and we are calling for common sense to prevail. This recommendation to increase places is undoubtedly the right move as PrEP is almost 100% effective when taken as prescribed, is a key part of HIV combination prevention and is far cheaper than providing someone with a lifetime’s worth of HIV medication.’

‘The original 10,000 places were never going to be enough, and since it started the trial has already had to be expanded from 10 000 to 13 000 places. Without an expansion, it’s likely all the places for gay and bisexual men will be taken imminently. That, coupled with reports of people becoming infected with HIV after being unable to access PrEP via the trial, is why we and other HIV campaigners have been shouting about this so loudly.’  

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