UK: First year of PrEP in Scotland

The recent report on the first year of the implementation of  pre-exposure prophylaxis (PrEP) through the National Health Service (NHS) in Scotland concludes: “Year one has been a resounding success in terms of establishing a new nationwide service – the first of its type in the UK and one of the first worldwide.”

In total, 1872 people were prescribed PrEP in Scotland during the first year of the programme. If the same proportion of England's population had been prescribed PrEP, this would amount to over 19,000 people.

Between one and four were infected with HIV after being prescribed PrEP. The uncertainty is about the exact date of HIV infection; what is known is that none of the people concerned had preventative drug levels in their blood around the time of infection.

Because the majority of people had only taken PrEP for a few months before July 2018, when the last data in the report was collected, it is difficult to calculate an accurate reduction in HIV incidence, but the data suggest that people prescribed PrEP were up to 75% less likely to become infected with HIV than those not receiving it.

The Health Protection Scotland report says that this was achieved despite several factors that might have acted as barriers:

  • a mere four month gap between the Scottish Medicines Council approving PrEP and the start of its NHS rollout

  • the novelty of PrEP and the associated staff training needs

  • a greater than expected demand, including a high proportion of people who had never attended sexual health clinics

  • no extra public money allocated for it.

The introduction of PrEP necessitated administrative and structural changes, such as new IT systems and coding introduced into the sexual health surveillance system, and mechanisms for the reimbursement of costs from patients who attended clinics out of their area of residence, including England. New patient education materials also had to be developed. Read more via AIDSmap