New UK HIV PrEP guidelines offer greater access and equity
New HIV PrEP guidelines, published by the British Association for Sexual Health and HIV (BASHH) and the British HIV Association (BHIVA), set out a framework for greater access and equity in the provision of HIV PrEP.
The guidance – of which PrEPster at The Love Tank was on the writing group – highlights the urgent requirement to meet the HIV PrEP needs of currently undeserved communities.
Dr Will Nutland, Director of The Love Tank says:
“The new guidance not only simplifies the criteria for HIV PrEP access in the UK, thereby removing a key barrier to accessing PrEP, it also simplifies advice on dosing for oral PrEP. Recommending quick-start dosing for all PrEP users means that individuals can start PrEP almost immediately – thereby offering the maximum protection against HIV.”
Dr Benjamin Weil, Head of Research and Community Knowledge Generation at The Love Tank says:
“New formulations of HIV PrEP, including injectable PrEP, offer options for a new generation of HIV prevention. Yet, barriers remain not only to the implementation of injectable PrEP, but with the current methods of oral PrEP. The guidance sets out to address those current barriers head on, by recommending how, where and when PrEP should be available, and to whom”.
The guidance includes:
A recommendation that HIV PrEP should be offered to anyone who requests it (a move away from former eligibility criteria based on clinical trial inclusion)
A recommendation that HIV PrEP can be started for everyone with a quick-start double dose 2-24 hours before potential HIV risk (previous guidance recommended this for only some groups of people)
No distinction made between the two most commonly used formulations of oral PrEP (TDF/FTC and TAF/FTC) for any risk exposure of demographic group with regard to dose timing, frequency or duration of use
A recommendation that TAF/FTC is used for oral PrEP users below the age of 18, and commences through to age 20 for those who started on it
Recommendations that specific reassurance be given to trans people that there is no significant expected drug interaction between HIV PrEP and gender affirming hormones
Recommendations that services, clinicians, managers and community organisations attend to both individual and structural barriers to HIV PrEP access
The updated guidelines have already been incorporated into the information about using PrEP on the PrEPster website. The website includes up-to-date information about starting, using, and stopping PrEP (including specific information for different groups of people), and answers to more in-depth questions about PrEP at: www.prepster.info