The editors of the Lancet HIV contrast Dr K Rivet Amico and Professor Linda-Gail Bekker’s recommendations with the current state of PrEP policy in England. PrEP is only available through the Impact trial, which has been oversubscribed by gay and bisexual men, with capacity reached in many clinics and potential participants turned away. A proposal to expand the number of trial participants has been delayed while cash-starved local authorities (who pay for the clinical services providing PrEP but not the medication itself) are consulted on the impact this will have. PrEP knowledge and awareness is far higher among gay and bisexual men than in other social groups.
“Why is NHS England dragging its heels on universal access (that is, providing PrEP to all who would benefit regardless of membership of certain key populations) and instead capping the numbers of those who can access the trial?” the journal asks. “High coverage, rapid roll-out, and consideration of the health and geographical inequalities faced by many at risk of HIV, will be needed to maximise the preventive effects of PrEP.”