A dramatic drop in the number of gay men with HIV could spell the end for Britain’s Aids epidemic, experts say.
Public Health England data has revealed that cases of HIV among gay and bisexual men have fallen for the first time since the epidemic began more than 30 years ago.
From October 2015 to September 2016, HIV diagnoses in five of London’s biggest clinics dropped by 32 per cent in comparison with the previous year.
Experts said that a mixture of more frequent HIV testing and faster treatment could explain the downturn in HIV cases among gay men.
And a rise in the number of gay men being offered pre-exposure prophylaxis (PrEP), a drug that can prevent those exposed to HIV from becoming infected, is also thought to have played a role.
WHAT IS PRE-EXPOSURE PROPHYLAXIS?
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day.
The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV.
When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.
When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92 per cent.
A ‘phenomenal’ result
Valerie Delpech, head of HIV surveillance at Public Health England, said London’s five largest clinics had seen a promising fall in HIV cases among gay men.
‘Basically we are witnessing a phenomenal experiment,’ Ms Delpech told the Guardian.
‘We are observing it. What we are seeing is the first downturn of the HIV epidemic in gay men.’
She said an increase in HIV testing could explain the drop in the numbers of men becoming infected.
Gay men at high risk because their partner has HIV are now tested every three months, and are immediately offered anti-viral drugs if they test positive.
Nationwide fall in HIV
‘There is absolutely no reason why we cannot scale that up to further reduce new infections in gay men – and also in all people who may be at risk of HIV in the UK, regardless of gender, ethnicity or sexuality,’ Ms Delpech said.
Gay, bisexual and other men who have sex with men make up half of people with HIV in England and are most at risk of contracting the virus.
Across England, cases of HIV among gay men dropped by 17 per cent, according to the new figures.
The five London clinics that experienced a 32 per cent drop in HIV cases had dramatically increased their commitment to testing for the virus in comparison to other clinics, the report found.
Role of PrEP
A rise in the numbers of gay men being offered PrEP is also thought to have contributed to the fall in HIV cases.
NHS England launched a trial of the HIV treatment in 2016 after losing a Court of Appeal battle over who should fund it.
In December, the NHS announced it would provide PrEP to 10,000 at-risk people.
The new Public Health England suggests a combination of testing and preventative treatment could pave the way to the end of the Aids epidemic.
‘Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable,’ the report says.
Author: Daisy Dunne