HIV infections among gay and bisexual men fell by 20 per cent following rollout of PrEP

HIV diagnoses in gay and bisexual men fell by 20 per cent following rollout of the PrEP drug programme in Scotland, a study has found.

The research, led by Professor Claudia Estcourt of Glasgow Caledonian University and funded by Public Health Scotland, also found a 43 per cent drop in HIV diagnoses among a group of gay and bisexual men who they followed between the pre-PrEP and the PrEP years of the study.

Pre-exposure prophylaxis, or PrEP, is a medicine that can be taken to prevent HIV infection. It involves taking anti-HIV pills daily or around the time of sex.

It was rolled out in Scotland in 2017 and is available free from NHS sexual health clinics.

Between 2017 and 2019 just under a fifth (19.5 per cent) of gay or bisexual men who attended clinics were prescribed PrEP at least once.

While the number of new HIV diagnoses in 2013-2015 and 2015-2017 was similar (234 and 229 respectively) it dropped by 20 per cent to 184 in 2017-19.

Among the 3,256 gay and bisexual men who were prescribed PrEP during this period, incidence of HIV infection fell by 75 per cent.

Cases of HIV also fell by 32 per cent among men who had never taken PrEP, suggesting that PrEP users remaining HIV negative have benefits for their sexual partners too.

However, the research found that the PrEP programme is not reaching people from other groups who could benefit, such as women, heterosexual men, people from some African communities, transgender people and those who inject drugs.

Only two per cent of the people who have taken PrEP so far are not gay and bisexual men.

Before PrEP, approximately half of Scotland’s HIV diagnoses were in gay and bisexual men, 30 per cent in heterosexual men and women, and 15 per cent in people who inject drugs.

Estcourt said: “We have shown that it is possible to achieve important reductions in HIV incidence in men who have sex with men when PrEP is implemented within routine care

“Our findings suggest that PrEP can make a wider contribution, alongside other prevention interventions, in reducing population level risk of HIV for those not on PrEP.”

Public health minister Mairi Gougeon said: “Scotland has made huge progress in detecting and treating HIV and was one of the first countries in the world to have an HIV pre-exposure prophylaxis service, offering free preventative medication to those deemed at highest risk of acquiring HIV.

“The success of the national PrEP programme is a credit to Scotland and Professor Claudia Estcourt’s research is an important milestone in our goal to eliminate new HIV transmission by 2030.

“These findings show what can be achieved by supportive policy, clinical vision and crucially, true collaborative working across public health, clinical care and community-based organisations.”