Superdrug is the first UK high street pharmacy to offer pre-exposure prophylaxis (PrEP) medication to protect at-risk people against the human immunodeficiency virus (HIV).
Off the back of this announcement, Superdrug now offers a UK-wide PrEP service via its Online Doctor clinic, enabling people without access to in-person sexual health centres to “more easily protect themselves”.
While the prescribing criteria is strict, PrEP may be suitable for HIV-negative people who are at high risk of catching the virus, for example those with HIV-positive partners.
Taken before exposure, the tablet “blocks” HIV from taking hold. Studies have shown the drug regimen reduces the risk of viral transmission via sex by around 99% when taken “consistently”.
In the UK alone, 103,800 people are thought to have HIV. Of these, around one in 14 are unaware they carry the infection.
HIV is treatable if caught early, with 97% of those on therapy in the UK being virally suppressed, meaning they cannot pass the infection on.
Left untreated, however, HIV can develop into acquired immune deficiency syndrome (Aids).
This occurs when the immune system is so severely damaged by HIV, the patient is at risk of life-threatening infections and diseases.
‘Another milestone to banish HIV epidemic’
The UK government has announced councils in England will be free to provide uncapped access to PrEP. This was delayed due to the coronavirus outbreak, however, the roll-out began on 1 October.
PrEP was previously only available in England for clinical trial participants. The medication has long been more readily accessible in the rest of the UK.
“Following the DHSC’s [Department of Health and Social Care] announcement, we’re further increasing PrEP’s availability and making it more easily accessible to people who need it most via our Online Doctor PrEP service,” said Michael Henry, healthcare director of Superdrug.
“We offer a fully remote service, where people who don’t have easy access to a sexual health clinic – due to their location, COVID restrictions or lack of appointments – can access a full PrEP service from home.
“Our aim is to enable people to make informed choices and assume responsibility for their own healthcare.
“Making PrEP more easily available is yet another milestone in the effort to banish the HIV epidemic.”
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The sexual health charity The Terrence Trust welcomed the department of health’s announcement.
“There should now be nothing standing in the way of this important HIV transmission prevention drug finally becoming a reality in England,” said Richard Angell, its head of policy and public affairs.
The charity has also praised Superdrug’s initiative.
“This move will also help raise awareness of this game-changer for preventing HIV; especially amongst groups that might not have heard much about PrEP before,” said Dr Michael Brady, medical director of The Terrence Trust.
“The majority of people currently taking PrEP in the UK are gay and bisexual men, but PrEP works for everyone at risk of HIV.”
Anal sex can lead to HIV transmission due to the lining of the anus being more delicate than that of the vagina. This means it is more easily damaged, allowing the virus into the body.
“We hope initiatives like this will result in more people learning about the benefits of PrEP, especially women, BAME [black, Asian and minority ethnic] communities and trans people,” said Dr Brady.
“While many people may prefer this service, it’s also important to point out that PrEP is currently available for free via sexual health clinics in Scotland, Wales and Northern Ireland – and this will very soon be the case across England too.”
PrEP, combined with condom use and regular testing, is said to be behind falling HIV transmission rates across the UK.
In November 2018, the UK achieved the United Nation’s (UN) goal of “90-90-90”.
With the target set for 2020, the UN wants 90% of all people living with HIV to be aware of their infection, 90% of all people with diagnosed HIV to be on sustained antiretroviral therapy and 90% of all people receiving these drugs to have viral suppression.
What does the Superdrug service involve?
Superdrug’s PrEP service is available to those over 18 who are HIV-negative and consider themselves to be in a high-risk group for catching the virus. Prescribing PrEP to an HIV-positive person may encourage drug resistance.
Would-be patients also have to undergo tests that show a healthy kidney function, as well as testing negative for hepatitis B and C.
PrEP can lower kidney function in those with pre-existing problems. Coming off PrEP can also lead to hepatitis flare-ups.
Only one medication regimen is licensed for PrEP in the UK – emtricitabine 200mg combined with tenofovir disoproxil 245mg.
Superdrug’s services are made up of:
PrEP Basic Testkit: tests for HIV and kidney function £39.99
Full PrEP Testkit: tests for HIV, kidney function, and hepatitis B and C £99.99
Emtricitabine/Tenofovir 30 tablets £80
Emtricitabine/Tenofovir 60 tablets £155
Emtricitabine/Tenofovir 90 tablets £220
“Launching this PrEP service enables more people to more easily protect themselves,” said TV medic and Superdrug health ambassador Dr Zoe Williams.
“While PrEP is proven to be highly effective at preventing HIV infection when it’s taken correctly, it’s important to try to remember to use condoms when having sex as this will protect against other STIs [sexually transmitted infections].”
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