Four sexual health clinics serving large numbers of gay men in London have reported that they diagnosed far fewer gay men with HIV during 2016 than they did during 2015. Many doctors believe that the use of pre-exposure prophylaxis (PrEP) is part of the explanation for these reductions.
Such large drops in new diagnoses are unprecedented. 56 Dean Street had 40% fewer diagnoses overall, the Mortimer Market Centre 50% fewer, Homerton Sexual Health 40% fewer in gay men, and Barts Sexual Health Centre 36% fewer diagnoses in gay men. They noted that they were testing as many people as the previous year and that rates of other sexually transmitted infections were as high as ever. Getting people who have HIV diagnosed and on to treatment as quickly as possible is probably part of the explanation – but clinics have been working towards this goal for several years already.
What appears to be new in 2016 is individuals importing PrEP medication from abroad and getting support on using PrEP safely. The number of men taking PrEP may only be a few hundred or a few thousand, but these men may be key to slowing the epidemic. “The important thing is whether awareness and usage of PrEP is reaching the right people,” commented Dr Alan McOwan of 56 Dean Street. “If the ‘nodal’ gay men who have a lot of partners and who would have previously been at the centre of a cluster of infections are now not becoming infected, they are not passing it on to anyone else.”
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