New diagnoses of HIV in gay and bisexual men have fallen by 20% since the introduction of the PrEP prevention pill programme in 2017, research shows.
PrEP (pre-exposure prophylaxis) uses anti-retroviral drugs – also used for treating people with diagnosed HIV – to stop those at highest risk from contracting the virus.
HIV negative people can take PrEP, available from NHS sexual health clinics, before sex to reduce their risk of getting the virus.
Researchers compared diagnosis numbers two years prior to the introduction of use of the drug in Scotland with the following two years.
They found new HIV diagnoses in men who have sex with men fell from 229 to 184.
Of the 16,723 gay and bisexual men who attended Scottish sexual health clinics between 2017 and 2019, 3,256 (19.5%) were prescribed PrEP at least once.
Among this group, incidence of HIV infection fell by 75%.
It also fell by 32% among men who had never taken PrEP, suggesting PrEP users remaining HIV negative has benefits for their sexual partners too.
However, the research found the drug programme struggles to reach other groups who could benefit, including women, heterosexual men, people from some African communities, transgender people and people who inject drugs.
Only 2% of people who have taken PrEP so far are not gay or bisexual men.
Before PrEP, approximately half of Scotland’s HIV diagnoses were in gay and bisexual men, 30% in heterosexual men and women, and 15% in people who inject drugs.
Claudia Estcourt, Glasgow Caledonian University professor of sexual health and HIV, led the study. She 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.
“All you have to do is watch ‘It’s A Sin’ to see the damage caused by sexual taboos – it’s gutting and chilling.
“For me, there’s no such thing as a taboo subject. HIV is simply an infection that is treatable today, with a normal life expectancy if medication is taken and you attend regular medical check-ups, but there’s still so much stigma around it.”
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.”
The research was funded by Public Health Scotland and published in the AIDS online journal.
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