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London’s largest sexual health clinic, Dean Street is on track to record a huge drop in new HIV cases for a second successive year. In light of this, Dean Street has set itself a target of zero new infections after witnessing a two-thirds fall in the number of new diagnoses since 2015.
So what’s happened? – PrEP has happened. PrEP is a HIV prevention, once a day pill which you take regularly, or semi regular (depending on your circumstances). For more information on PrEP please visit Prepster or The Terrence Higgins Trust
The reduction in new HIV diagnosis attributed to intensive testing of high-risk gay men, quick access to antiretroviral therapy and trials of PrEP which will be offered free on the NHS to 10,000 people from next month.
Dean Street diagnosed 136 people with HIV between January and July, putting it on course for a total of 233 by the end of the year. If achieved, this would be the second successive fall in excess of 40 per cent, down from 679 in 2015 and 393 last year, when clinicians first raised the possibility of defeating HIV.
Dean Street’s figures are notable as it is also the largest HIV clinic in Europe and typically accounts for one in nine of all new cases in the UK.
Lead clinician Dr Alan McOwan said the latest figures were “great but not good enough” and told the Standard: “It’s a very exciting time. Everyone is so motivated to make this work. In 2015 we were diagnosing about 60 to 70 people positive a month. It dropped dramatically last year, and it’s still dropping. Over the last few months it’s between 15 to 20 people a month.”
Public Health England figures show that the total number of HIV diagnoses in London has fallen steadily from more than 3,000 in 2006 to 2,603 in 2015. It has risen within the highest-risk group of “men who have sex with men”, who now account for more than half the cases. One in seven gay and bisexual men in the capital has HIV.
Figures published earlier this summer for London’s five busiest clinics, including Dean Street and Mortimer Market, also in Soho, showed a 32 per cent fall in new HIV cases, from 880 to 595, in the year to last September.
Dr McOwan said the initial fall in infections diagnosed at Dean Street since 2015 had been concentrated among “very well-informed, assertive people” who bought PrEP online and followed medical advice.
The clinic’s Plan Zero initiative, unveiled this week, will provide tailored advice online to “harder to reach” gay and bisexual men on how to reduce the risk of contracting HIV, and preventing onward transmission. “Shockingly, there are still groups of people who have very, very little awareness of even the basics of HIV,” Dr McOwan said. Participants are asked to answer five questions about their lifestyle, adapting the answers depending on whether they are HIV positive or negative, have sex with multiple partners, use condoms, or take PrEP.
“We finally have the tools to end HIV,” Dr McOwan said. “Plan Zero brings them together into one package. We will beat HIV if we all act together.”
Dean Street, part of the Chelsea and Westminster Hospital NHS trust, will be among the first London clinics to offer PrEP before it becomes available country-wide by next April.
The drug, previously available to about 1,000 gay men via the Proud clinical trial, cuts the risk of contracting HIV from unprotected sex by about 86 per cent.
NHS England decided to make it available under a £10 million three-year trial after being told by the Court of Appeal last year that funding PrEP fell within the health service’s remit. The trial will be the biggest of its kind in the world.
It is not yet known how Leicester & Leicestershire will be involved in the trial.
The introduction of anti-retroviral therapy two decades ago was credited with transforming HIV from a fatal infection into a chronic manageable condition. However, there were 594 deaths of people with HIV in the UK last year.
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