How combination prevention is combating HIV in London

Data out earlier this month showed the huge success of HIV prevention programmes in London, with new diagnoses declining by 29 per cent last year in gay and bisexual men.

Since 2015, Do It London has been promoting HIV testing and safer sex. Its latest campaign moves the conversation on to focus on treatment as prevention, and includes PrEP – which stands for pre-exposure prophylaxis – a pill that can prevent you from getting HIV.

PrEP is becoming available as part of the NHS Impact Trial, which launched last week, and is being gradually rolled out across sexual health clinics, at no cost to people at risk. Research shows it can cut the risk of HIV infection by up to 86 per cent and without major side effects. Some people already buy PrEP online, but the three-year £10m NHS Impact trial means the drug will now be given to 10,000 people for free.

The timing of the trial coincides with the launch of the latest phase of the groundbreaking HIV prevention campaign by boroughs across the capital, known as Do It London. Running until early next year, this campaign promotes combination prevention as a key way of tackling HIV, with Londoners encouraged to recognise the multiplicity of options available to them: PrEP, using condoms, testing regularly for the virus and - for people who are HIV positive - becoming “undetectable” by taking antiretroviral medication.

Public Health England reports that combination prevention is working in London. It states that the decline in new diagnoses in gay men during 2015 and 2016 was driven by large increases in HIV tests, including repeat testing, as well as improvements in the uptake of antiretroviral therapy (ART) following HIV diagnosis. Other factors, including sustained high condom use with casual partners and internet access to PrEP, will also have contributed to the downturn in HIV diagnoses. The PrEP impact trial will make the drug available to other groups, including women, trans people and people regarded as being at high risk of infection.

Scientifically effective

PrEP can be taken in two different ways – either regularly (one pill per day) or through what’s called “event-based dosing” (taking pills both before and after condomless sex). Both approaches are likely to be used in the UK, depending on circumstances, having been found to be scientifically effective for men. Event-based dosing is only effective for men who have sex with men; daily dosing is prescribed for women.

PrEP is already available on the NHS in Scotland and Wales. In England, sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield are the first to offer PrEP to high-risk people this autumn, with the rest of the country taking part next year.

The new Do It London campaign emphasises the importance of combination prevention, which encourages Londoners to make the right choice for their circumstances – including the use of this exciting new drug-based prevention tool.

For more information on the campaign, visit doitlondon.org