'Game-changing' HIV protection jab approved in England and Wales

An injection to prevent HIV is to be offered to patients on the NHS in England and Wales for the first time, bringing the policy in line with Scotland.

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

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

Meanwhile, early results for a different injection called lenacapavir suggest it may even be possible to move people on to an annual HIV prevention jab.

'This represents hope'

Wes Streeting, the Secretary of State for Health and Social Care, said: "The approval of this game-changing injection perfectly embodies what this government is determined to deliver - cutting-edge treatments that save lives and leave no one behind.

"For vulnerable people who are unable to take other methods of HIV prevention, this represents hope."

HIV prevention therapy, known as PrEP (pre-exposure prophylaxis), is taken by HIV-negative people to reduce the risk of getting HIV.

Pills have been available for years and are still extremely effective at stopping HIV infections, but are not always easy for some to take.

It can be hard to access, not practical, or feel embarrassing. For example, people might worry someone like parents or housemates could find their pills.

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

An injection which lasts for months offers convenience and discretion.

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

It can be caught during unprotected sex or through sharing needles. Mothers can also pass it to their baby at birth.

Cabotegravir, made by ViiV Healthcare, should be used in combination with safer sex practices, such as use of condoms.

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

Dom Baldwin is glad injections will be an option now

The jab will be considered for adults and adolescents with a healthy weight who are at high risk of sexually acquired HIV and eligible for PrEP, but for whom taking oral tablets would be difficult. It’s thought around 1,000 people will be offered it. Many others will remain on or start tablets.

Dom Baldwin, who uses PrEP pills, says he is "over the moon" about the injections becoming available.

"I think the fact that there's still so much work being done on HIV treatment, HIV prevention is fantastic.

"When you look at where we are now compared to the epidemic in the 80s and the number of people that we had 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 get the injections from NHS-operated sexual health clinics "in coming months" says the National Institute for Health and Care Excellence (NICE), which approved the treatment for NHS use.

Charities say some people face long waiting times for appointments at clinics and the rollout must happen quickly.

Richard Angell, of the Terrence Higgins Trust, said it was time to explore delivering the "transformative therapy" in other settings, not just sexual health clinics.

"It's highly effective and acceptable for patients, and a vital tool for tackling inequalities – with the potential to reach those who are not currently accessing other HIV prevention."

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

Last year,146,098 HIV-negative people accessing sexual health services had a PrEP need because they were at substantial risk of acquiring HIV.

Of those, about 76% (111,123) began or continued PrEP - a 7.7% rise from 2023.

PrEP need is not being identified and met equitably though.

Access to the treatment varies significantly by group, with uptake highest among white (79.4%) and ethnic minority (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 across hospital A&E departments in England. Currently, 89 routinely test anyone who has blood taken, specifically in cities and towns with high HIV prevalence.

Dr Michael Brady, National Advisor for LGBT + Health at NHS England, said: "This long-acting injection is a significant addition to our HIV prevention strategies – giving us a powerful new option for people at risk of HIV who cannot have oral PrEP tablets."