No plans yet for community pharmacy to provide PrEP despite low uptake rates in some groups

Community pharmacies could be asked to target high-risk or underserved groups with pre-exposure prophylaxis (PrEP) to prevent HIV infection, but only if it is demonstrated that specialist clinics are not able to do so. ‘reach everyone they should, The Pharmaceutical Journal has learned.

The English HIV and Sexual Health Commissioners Group (EHSHCG), a network of local authority and clinical commissioning group commissioners across England, said there was first ” work to be done” to fully understand the barriers to PrEP uptake in level 3 sexual health clinics before access is expanded to other settings.

In March 2021, the Department of Health and Social Care (DHSC) confirmed that it would consider providing PrEP outside of sexual health clinics and, within government action plan to end new HIV transmissions by 2030published in December 2021, it said the EHSHCG would explore the acceptability of delivering PrEP in settings such as drug and alcohol services and pharmacies.

However, a year later, progress remains to be made in expanding access to other health care facilities.

Asked by The Pharmaceutical Journal why it was, James Woolgar and Isabel Carrick and Sue Burridge, president and vice-presidents of the EHSHCG, respectively, explained in a joint response that the group’s goal was to determine why high-risk groups and populations who would benefit from PrEP were not accessing it and to identify potential barriers to access.

“We do this collectively to help inform PrEP uptake through sexual health clinics and potential targeted outreach and possibly beyond,” the response reads.

“Essentially, there’s work to be done to fully understand whether level 3 sexual health clinics are indeed ‘not’ the place for this, and if that’s apparent from our findings, we’ve also provided in the brief for asking people ‘where their ideal hotspot might be’ (thus an adventure in the settings to some extent). The whole evidence base needs to be built on all of this, consistently and clearly.

They also said there were also “other issues,” such as licensing (currently only Tier 3 clinics are allowed), that would need to be overcome to allow PrEP to be provided. in other contexts.

“So while our work may well highlight different locations, pharmacies, GPs, etc. for the key access points that people want, we cannot guarantee at this stage that we can achieve this 100% .”

Debbie Laycock, policy manager at the Terrence Higgins Trust, a leading HIV and sexual health charity, said she was “incredibly disappointed” to hear there could be a “return back” in the government’s commitment to expand PrEP to settings outside of sexuality. health clinics.

“The fight for access to PrEP has been long and difficult – it has taken years. But the fight is not over when its benefits are felt so unevenly,” she said.

“The drug has been a game changer for gay and bi men, but we need to do everything we can to increase awareness and access to PrEP in all communities. Access to PrEP among women and black people of African descent across [an] The NHS England-led trial showed worryingly low uptake, with data revealing just 4% of people accessing the drug were from groups other than gay and bisexual men.

Laycock added that it was “clear” that not all communities that could benefit from the HIV prevention pill had access to it through sexual health facilities.

“The HIV Action Plan is committed to creating additional pathways for access to PrEP,” she added.

“This must include provision through community pharmacists, GPs, community settings and specific settings, such as prisons.

“We call for the piloting of PrEP in other settings as a matter of urgency. Each delay is an additional failure to meet the needs of all who could benefit from PrEP and to address the inequalities that are already so glaring.”

The EHSHCG said “all key recommendations” would be communicated to ministries to help with next steps in improving access to PrEP.

The Royal Pharmaceutical Society said in November 2021 that there was a “clear opportunity” to bring down HIV infection rates by expanding the supply of PrEP to community pharmacies and GP surgeries as part of the government action plan against HIV.

Comments are closed.