First injection to stop HIV approved

The HIV prevention injection will be offered to NHS patients in England and Wales for the first time, bringing the policy in line with Scotland's.

The long-acting vaccine, given six times a year or every two months, is an alternative to taking daily pills to protect against the virus.

Experts hope the cabotegravir (CAB-LA) injection will help meet the target of ending new HIV cases by 2030 in the UK.

Meanwhile, early results from another injection called lenacapavir suggest it may even be possible to switch people to annual HIV vaccination.

Wes Streeting, Secretary of State for Health and Social Care, said: “The approval of this revolutionary jab perfectly embodies what this Government is committed to delivering – cutting-edge treatments that save lives and leave no one behind.

“For vulnerable people who cannot use other HIV prevention methods, this represents hope.”

HIV preventative therapy, known as PrEP (pre-exposure prophylaxis), is given to HIV-negative people to reduce the risk of contracting HIV.

The pills have been available for many years and are still extremely effective at stopping HIV infection, but they are not always easy for some to take.

This may be difficult to access, impractical or inconvenient. For example, people may worry that someone, such as a parent or housemate, might find their pills.

Homelessness and domestic violence can make it difficult to take oral PrEP every day.

The injection, which lasts several months, provides convenience and privacy.

HIV is a virus that damages cells of the immune system and weakens the body's ability to fight everyday infections and illnesses.

You can become infected during unprotected sex or through shared needles. Mothers can also pass it on to their baby at birth.

Cabotegravir, made by ViiV Healthcare, should be used in combination with safer sexual practices, such as using condoms.

The NHS has an undisclosed manufacturer discount on the treatment, which has a list price of around £7,000 per patient per year.

The jab will be considered for adults and adolescents of a healthy weight who are at high risk of contracting HIV through sexual contact and are eligible for PrEP, but for whom taking the oral pill would be difficult. It is expected that about 1,000 people will receive this opportunity. Many others will stay with or start using tablets.

Dom Baldwin, who uses PrEP tablets, says he is “over the moon” the injections are becoming available.

“I think the fact that there is still so much work being done in HIV treatment and prevention is fantastic.

“When you look at where we are now, compared to the epidemic in the '80s and the number of people we've lost due to lack of education, due to stigma, due to lack of resources and accessibility to where we are now, HIV is no longer a death sentence.”

People will be able to receive injections at NHS-run sexual health clinics “in the coming months”, he says. National Institute for Health and Care Excellence (NICE), which approved the treatment for use on the NHS.

Charities say some people face long waits for appointments at clinics and the rollout needs to happen quickly.

Richard Angell, from the Terrence Higgins Foundation, said it was time to explore the possibility of delivering “transformative therapy” in other places, not just sexual health clinics.

“It is highly effective and acceptable to patients, and is a vital tool for tackling inequalities – with the potential to reach those who currently lack access to other HIV prevention options.”

Official data in England show that the number of people taking PrEP in sexual health services is increasing.

Last year, 146,098 HIV-negative people accessing sexual health services needed PrEP because they were at significant risk of acquiring HIV.

Of these, about 76% (111,123) started or continued PrEP, an increase of 7.7% from 2023.

However, the need for PrEP is not being identified and equitably met.

Access to treatment varies significantly by group, with coverage rates highest among white (79.4%) and minority ethnic (77.8%) gay, bisexual and all men who have sex with men, but much lower among black African heterosexual women (34.6%) and men (36.4%).

At the same time, HIV testing has expanded in hospital emergency departments in England. Currently, 89 people are regularly testing everyone whose blood is drawn, especially in cities with high HIV prevalence.

Dr Michael Brady, national LGBT+ health adviser at NHS England, said: “This long-acting injection is an important addition to our HIV prevention strategies, giving us a powerful new option for people at risk of HIV who are unable to take oral PrEP tablets.”