GP-level prescribing of HIV pre-exposure prophylaxis (PrEP) should be piloted to improve access, a Government-commissioned road map has recommended.
The drug, which reduces the risk of getting HIV, can currently only be prescribed on the NHS by specialist sexual health services.
Expanding access options is a key recommendation in the HIV Action Plan Implementation Steering Group’s long-awaited road map, published today by the Government, on achieving equitable PrEP access across England.
Currently, there are ‘significant differences in PrEP need and uptake by population group’, according to the Goverment.
‘For example, heterosexual women are much less likely to have their need identified at a clinical consultation at a specialist SHS and to start and continue using HIV PrEP than gay, bisexual and other men who have sex with men (GBMSM).’
In response, the steering group has recommended that ‘national health bodies, in partnership with local commissioners, should commission a series of pilots providing PrEP in a variety of settings outside specialist sexual health clinics, including online, pharmacies, GPs, a community setting, a contraceptive clinic and a non-specialist sexual health setting’.
National and local commissioners should also pilot ‘a national online PrEP clinic’, they recommended.
Pilots should be designed with input from stakeholders, and ‘populations who use or who could benefit from PrEP should be prioritised’, the steering group recommended.
‘Areas of high, medium and low HIV prevalence’ should all be represented and pilots ‘must be supported by funding for promotion and gathering learnings to expand PrEP provision nationally’.
Once piloted, the DHSC ‘must commit to swiftly consider the findings of PrEP pilots and, if successful, commission PrEP beyond sexual health services nationally,’ the report added.
According to a large English trial, which reported last year, PrEP is highly effective at preventing HIV acquisition but greater provision is needed to meet the ‘large unmet need’ and maximise the potential of a national programme.
However GPs have suggested to Pulse that the answer to concerns about access to PrEP is to improve access to sexual health services, rather than increasing GP workload.
Introducing the road map, the Government said: ‘We are committed to achieving equitable access, uptake and use of HIV PrEP for those who could benefit irrespective of their gender, age, ethnicity, sexual orientation, disability, geographic area of residence or socio-economic background.’
Also as part of Government measures to tackle HIV in England, millions more will undergo ‘opt out’ testing for HIV and other blood-borne viruses over the next year after a rollout of a national programme to more emergency departments.
It is hoped the £20m programme, which will extend testing to 46 emergency departments across the country, will identify a ‘significant proportion’ of the estimated 4,500 people living with undiagnosed HIV.
READERS' COMMENTS [3]
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This is how it goes: another ‘large unmet need’ identified. Instruction to GPs to meet need. Resources allocated to do so… none.
Actually I may be being unfair – the article does speak of “commissioning a service” so maybe it will be resourced.
More simply, I dont have the training or time to take over ANY new service dropped by the hospitals