Chelsea and Westminster sexual health services in ground breaking drug trial

Sexual health clinics at Chelsea and Westminster Hospital NHS Foundation Trust have been taking a leading part in a ground breaking drug trial which has proved highly effective in preventing HIV in gay and other men who have sex with men.

One hundred and fifty four of the 545 men who took part in the two year trial for pre-exposure prophylaxis (PrEP) attended Chelsea and Westminster clinics.

The PROUD study was led by the Medical Research Council at University College London and Public Health England. Chelsea and Westminster was the lead NHS site for the study and Consultant in Sexual Health Services, Dr Ann Sullivan, the lead NHS Investigator. Colleague Dr Alan McOwan led the communication strategy for the study and the Chief Investigator Sheena McCormack is a Consultant at 56 Dean Street as well as working for the MRC. The original idea for the study was from Prof Brian Gazzard and Dr Sullivan working with colleagues from Public Health England.

The study looked at whether offering daily HIV PrEP (in this case Truvada: a drug routinely used to treat HIV infection) to men who have sex with men (MSM) was a reliable way to prevent them from becoming infected by the virus. The results, presented by Dr Sheena McCormack at a Conference in Seattle USA this week, indicate that PrEP is highly protective for this group – reducing the risk by 86%.

Dr Sullivan said: ”This is a very exciting result, demonstrating that if PrEP was made available to at risk individuals we could dramatically reduce the current high level of HIV infections being diagnosed in the UK in this group every year (almost 3000 last year).

“Within the study taking a tablet daily was combined with a wide range of other risk reduction strategies, including condoms, sexual health screens and behavioural and counselling interventions. Particularly encouraging was that the vast majority of participants took the medication regularly, and there was no evidence that taking Truvada resulted in more risky behaviour as the rates of sexually transmitted infections were the same in both groups. This is the first trial carried out in a ‘real world’ setting (ie not a placebo controlled trial) and it offers another very useful tool for effective HIV prevention. “    

HIV Consultant Dr David Asboe said: "There can be no doubt that today’s announcement from the PROUD study heralds a significant advance in HIV prevention. The results prove the clinical effectiveness of PrEP, whose benefits are even higher than most HIV professionals expected.”

The PROUD study results, and subsequent cost effectiveness analyses, are to be included in the review underway by the PrEP Policy sub-group of the NHS England HIV Clinical Reference Group. This group is considering whether use of anti-retroviral drugs for PrEP should be commissioned, and is working with a range of stakeholders on how a PrEP service could be commissioned across NHS and local authority responsibilities.