Commenting on the publication of the Government’s roadmap for improving PrEP access, Richard Angell, Chief Executive of the leading HIV and sexual health charity Terrence Higgins Trust said:

'The Government’s first PrEP Roadmap is a welcome step forward, an important acknowledgement of the role PrEP must play in ending new HIV cases and a can-do attitude to what can be done within current resources and legislative challenges. Harsh realities of cuts to the Public Health Grant and its implications for access to sexual health services mean that the roadmap is an analogue solution for a digital world.

'We can and must go further than what has been published today. PrEP – the pill taken by people who test negative for HIV to stay negative – is a game-changer in the battle to end new transmissions of HIV by 2030.  However, not enough people are able to access it because currently the only way to obtain PrEP is through over-stretched sexual health clinics, which have had to absorb significant cuts in funding year on year. More than 60% of people trying to access PrEP are stuck on long waiting lists, raising the possibility of acquiring HIV in the meantime. Long delays in appointments for PrEP treatment have driven others to buying PrEP privately online. This is neither fair nor equitable.

'There are serious inequalities by race, gender and age in who is offered PrEP and who is accessing it. It is often not discussed in the right way and at the right time. We can and must be more ambitious in tackling this.

'Sexual health clinics must be properly funded to remain a primary route to PrEP, but for some people, starting or managing PrEP use through an app, online services or community pharmacies would suit them better, increase access and free up sexual health appointments for those who need clinician time.

'If the Government is to meet its own goal of ending new HIV transmissions in England by 2030, we have to stop treating PrEP like a special medication that can only be prescribed in specialist clinics. It should be available online, through pharmacies and potentially GP services too – and we must do better in promoting it to those who could benefit. This would go a long way in relieving pressure on sexual health services and provide a better service for many existing PrEP users. It would also make PrEP available to those population groups who don’t get what they need from under-funded sexual health clinics.

'Looking forward, people access services in ways differently, so now is the time for prioritising sustained investment in sexual health services which meet the demands of today’s digital age.'