First injection to stop HIV approved

A jab to prevent HIV is to be offered to NHS patients in England and Wales for the first time, bringing the policy in line with that in Scotland.

The long-acting injection, given six times a year or every two months, is an alternative to taking daily pills to protect against the virus.

Experts hope cabotegravir (CAB-LA) injections will help meet the ambition to end new HIV cases by 2030 in the UK.

Meanwhile, early results from another shot called lenacapavir suggest it might even be possible to transition people to an annual HIV prevention vaccine.

Wes Streeting, Secretary of State for Health and Social Care, said: “The approval of this ground-breaking injection perfectly embodies what this Government is determined to deliver: cutting-edge treatments that save lives and leave no one behind.

“For vulnerable people who cannot use other HIV prevention methods, this represents hope.”

HIV prevention treatment, known as PrEP (pre-exposure prophylaxis), is taken by HIV-negative people to reduce the risk of contracting HIV.

The pills have been available for years and remain extremely effective in stopping HIV infections, but they are not always easy for some to take.

This may be difficult to access, inconvenient or embarrassing. For example, people might worry that someone like their parents or roommates will find their pills.

Homelessness and domestic violence can make it difficult to take oral PrEP every day.

An injection that lasts for months offers convenience and discretion.

HIV is a virus that damages immune system cells and weakens the body’s ability to fight everyday infections and illnesses.

It can be caught during unprotected sex or sharing needles. Mothers can also pass it to their babies at birth.

Cabotegravir should be used in combination with safer sex practices, such as using condoms.

The NHS receives an undisclosed discount from the manufacturer for the treatment, which has a list price of around £7,000 per patient per year.

The vaccine will be considered for adults and adolescents of healthy weight who are at high risk for sexually acquired HIV and are eligible for PrEP, but for whom taking oral tablets would be difficult. It is estimated that around 1,000 people will benefit.

They will be able to get it from NHS-run sexual health clinics “in the coming months”, says the National Institute for Health and Care Excellence (NICE).

Charities say some people are facing long waiting times for an appointment at clinics and the rollout needs to happen quickly.

Richard Angell, of the Terrence Higgins Trust, said it was time to explore the possibility of offering “transformative therapy” in other settings, not just sexual health clinics.

“It is a highly effective and acceptable tool for patients, and an essential tool to address inequalities – with the potential to reach those who do not currently have access to other means of HIV prevention.”

Official figures for England show that the number of people taking PrEP in sexual health services is increasing.

Last year, 146,098 HIV-negative people accessing sexual health services needed PrEP because they were at significant risk of contracting HIV.

Of these, approximately 76% (111,123) started or continued PrEP, an increase of 7.7% from 2023.

However, PrEP needs are not equitably identified and met.

Access to treatment varies considerably by group, with a higher uptake rate among white (79.4%) and minority ethnic (77.8%) gay, bisexual and all men who have sex with men, but much lower among black African heterosexual women (34.6%) and men (36.4%).

At the same time, HIV testing expanded to hospital emergency departments in England. Currently, 89 people systematically test everyone who has a blood test, particularly in towns and villages with high HIV prevalence.