Long-acting injection for HIV prevention to be rolled out

A new long-acting injection will be offered to around 1,000 people at risk of HIV on the NHS, it has been announced.

The cabotegravir injection will be available to people in the coming months who cannot have pre-exposure prophylaxis (PrEP) tablets, following approval by the National Institute for Health and Care Excellence (NICE) today.

It is the first injectable PrEP option, and the first PrEP medicine, to be appraised by NICE.

The new preventative therapy, given every two months, will be provided at sexual health clinics across the country.

Related Article: Beyond the scales: reframing eating disorder recognition in primary care

NHS England said the rollout brings the NHS ‘one step closer’ to being the first country in the world to end HIV transmissions – a goal hoped to be achieve by 2030.

Health secretary Wes Streeting said: ‘The approval of this game-changing 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 are unable to take other methods of HIV prevention, this represents hope.

‘We're making real progress on HIV, with PrEP use up by 8% this year, and our ambition goes even further. England will be the first country to end HIV transmissions by 2030, and this breakthrough preventative therapy is another powerful tool in our arsenal to reach that crucial goal.’

This follows reports that new HIV diagnoses have fallen by 4% from 2023 to 2024 – marking what the UK Health Security Agency (UKHSA) described as ‘encouraging progress’.

Deaths among people living with HIV also decreased by 14% from 751 to 643 between 2023 and 2024.

National advisor for LGBT+ health at NHS England, Dr Michael Brady, said that cabotegravir is a ‘powerful’ new option for people who are at risk of HIV but cannot take oral PrEP tablets.

PrEP drugs – whether oral or injectable – is almost 100% effective at preventing people who are HIV-negative from acquiring the virus. The injection works by blocking an enzyme called integrase, which HIV needs to make copies of itself. This stops the virus from multiplying in the body and becoming an established infection.

Related Article: Sharp rise in diabetes cases prompts call for better postnatal support

Chief executive of the Terrence Higgins Trust, Richard Angell, emphasised the importance of injectable PrEP for tackling inequalities.

He said: ‘The system must now roll it out quickly and ensure everyone understands the HIV prevention options available to them. That's why the new HIV Action Plan for England must include action to ensure everyone can access PrEP in a way that works for them. That includes rolling out injectable PrEP and exploring the delivery of PrEP in settings outside of sexual health services.’

In a roadmap published in February 2024, the government said it would continue exploring whether PrEP could be made available in primary care settings such as community pharmacies.

However, ‘more evidence’ was needed ‘on the effectiveness’ of providing PrEP outside sexual health services.

President of the Royal Pharmaceutical Society (RPS), Professor Claire Anderson, urged ministers to widen access to PrEP via community pharmacy and ensure that this is included in the forthcoming HIV Action Plan.

Related Article: Novo Nordisk launch new 7.2mg single-dose Wegovy pen

The approval of this new preventative therapy on the NHS follows the expansion of HIV testing with 30 more A&Es testing for the virus in hospital emergency departments through the NHS Blood Borne Virus Opt-out Testing programme.

Health leaders predict that the expanded network of A&E sites will enable up to 1,900 more cases of newly identified HIV or previously diagnosed cases not linked to care to be identified each year.