PrEP - what's happening now?
In order for PrEP to be made available on the NHS in Scotland it needs to be approved by the SMC, and as part of the decision-making process the SMC will consider evidence in the form of Patient Group Submissions
An application for a drug to be used as PrEP was made to the SMC in December 2016. They have subsequently invited patient groups to make Patient Group Submissions by 6 February 2017, and on 10 April 2017 will announce whether they approve of providing PrEP on the NHS in Scotland.
HIV Scotland is writing a submission with the Terrence Higgins Trust Scotland, and SX (Waverley Care). We are conducting an online survey to inform our submission and to help us understand peoples’ experience of PrEP in Scotland, and to gather questions people may have. These responses will be brought together to shape our submission to the SMC.
If you would like to share your views on PrEP please take part in our short survey. All responses are anonymous. We will be submitting our evidence before 6 February 2017.
The PrEP story so far
Despite not being available on the NHS, there is a growing demand for PrEP in Scotland with people already accessing it through various channels. It is available at private clinics, and individuals are also able to purchase generic versions of PrEP online through international websites.
HIV Scotland recognised that people were already taking PrEP in Scotland and lobbied for a Short Life Working Group (SLWG) to be formed to ensure community members, service providers, and decision makers are informed about and prepared for PrEP in Scotland.
The expert group administered by HIV Scotland and chaired by Dr Rak Nandwani included membership of from a range of specialists including public health leads, HIV and sexual health doctors, a community member, pharmacy, third sector, social researchers, drug procurement, and observers from the Scottish Government and the Scottish Medicines Consortium (SMC).
In November 2016 the SLWG published a report recommending PrEP for use in Scotland. This report has been supported by the Executive Leads Network, who govern Scotland's Sexual Health and Blood Borne Virus Framework.
You can read the full report below:
PrEP in Scotland Report [PDF - 965kB]
Talking about PrEP - community information events
Regardless of whether PrEP does receive approval by the SMC, HIV Scotland have identified that there are already a reasonable number of people using PrEP in Scotland, by purchasing PrEP online from generic providers, from private GP practices, or visitors to Scotland from countries where PrEP is provided by their health system. Therefore there is an immediate need to make up-to-date information available to community members, and health professionals. For this reason HIV Scotland worked with NHS and third sector service providers to produce community information events in late November or early December. Events were held in:
In addition to our four face-to-face events we held an online Twitter discussion. People were able to engage with experts in discussion and ask questions or concerns they might have about PrEP. We captured the discussion in a Twitter Moment.
HIV Scotland also recognises that PrEP is having a significant impact on how people engage with HIV, and sexual health. If you consider that almost everyone knows fundamentally what a condom is and how it works, but few people as yet understand the basics of PrEP. This has implications not only for the people who PrEP, but also for their sexual partners, and other people who may be unsure what PrEP is and how it works. We are therefore also partnering with the University of Edinburgh to develop very basic PrEP information resources, using the HIV Literacy work developed by Dr Ingrid Young. We will be reaching out to sexual health and health promotion services to make this information available to their constituents.
Executive Leads consultation
The Executive Leads are undertaking further consultation at local board levels to give the group a further opportunity to seek local feedback from key stakeholders on the feasibility of implementation, in particular how to progress recommendations on the introduction of clinical monitoring within existing resources