The Government is looking at making HIV pre-exposure prophylaxis (PrEP) available in settings other than specialist sexual health services, including GP practices.
Pre-Exposure Prophylaxis (PrEP) is used to reduce the risk of getting HIV and can currently only be prescribed on the NHS by specialist sexual services.
However, the Government is exploring opportunities for making it available ‘in a variety of settings’, including online, GP services and pharmacies.
Answering a question by Conservative MP for Carshalton and Wallington Elliot Colburn in Parliament last month, then-primary care minister Neil O’Brien said: ‘The HIV Action Plan Implementation Steering Group (ISG) is developing a roadmap to help guide our efforts to improve equitable access, uptake and use of pre-exposure prophylaxis (PrEP) to meet the needs of key populations at significant risk of HIV.
‘This forms part of the group’s work to monitor and drive forward the implementation of the HIV Action Plan.
‘HIV PrEP is currently only prescribed at specialist sexual health services, but as we work towards our 2030 ambitions we will explore opportunities for making it available in a variety of settings.
‘The PrEP roadmap considers actions needed to improve HIV PrEP access pathways in settings other than specialist sexual health services, including online, general practitioner services and pharmacies, to enable potential future delivery in other settings.
‘The roadmap is expected to be made available by the ISG by the end of the year.’
But Dr Toni Hazell, a GP in north London with an interest in sexual and reproductive health and HIV, told Pulse that the answer to concerns about access to PrEP is to improve access to sexual health services, rather than increasing GP workload.
She said: ‘This is complex – of course I’d like to see access to PrEP widened, but we are already overstretched in primary care, with insufficient time and resources.
‘I also worry that a move to primary care would mean that those taking PrEP would miss out on the wider sexual health care that comes with PrEP provision; on balance I think that the answer to concerns about access to PrEP is to improve access to sexual health services, rather than to move it to primary care.’
RCGP chair Professor Kamila Hawthorne said: ‘The evidence behind the efficacy of HIV PrEP in preventing the contraction of HIV is significant, and it’s important that those who could benefit from this intervention are able to do so.
‘We would need to know more about proposals to expand access to PrEP, including in general practice, before we are able to comment fully – particular consideration would need to be given to the funding, workforce and training implications involved.’
The Government has committed to ending HIV transmission by 2030, with an action plan set out in 2021 which committed to investment into HIV PrEP.
The latest data published by the UK Health Security Agency (UKHSA) showed that there were 3,805 new HIV diagnoses in 2022.
Last year, research from a coalition of charities revealed that two thirds (65%) of people who want to access PrEP are unable to do so.
The coalition called on the Government to urgently improve access to PrEP and to cut waiting times and expanding where the drug is available – including GP practices.
READERS' COMMENTS [1]
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This is a specialised service, not a part of geneal practice, and something which would require distracting GPs from GP-essential CME and from provision of main GP services. It is not just a matter of capacity in GP, but in capacity for a GP to maintain sufficient knowledge of all the specialised services that they are now being expected to provide cover for, due to lack of specialist services with appropriate specialist staff.
It is actually a move which will reduce availability of appropriate services overall to GP patients, INCLUDING the expertise in providing specialised sexual health services generally, including PrEP for HIV services. A backwards step indeed.