Patients at risk of contracting HIV are sharing preventative medication and self-prescribing antibiotics as they struggle to access appointments amid a rise in STIs, sexual health organisations have told i.
Sexual health services are at breaking point, according to the Local Government Association, with cases of chlamydia, gonorrhoea and syphilis surging as a result.
Two leading HIV organisations have said they are increasingly receiving reports of patients sharing Pre-Exposure Prophylaxis (PrEP), which is used to reduce the risk of getting HIV, because they are unable to book appointments at sexual health clinics, due to the rising demand.
Concerns have been raised about this practice because such patients may miss out on wraparound care, risk infection if they cannot maintain high enough levels of PrEP in their body due to inconsistent access and not know their HIV status before starting or restarting the medication.
The NHS advises patients to have an HIV test before starting PrEP, and to have a check-up for all STIs including HIV every three months.
PrEP is only available on the NHS via sexual health clinics free of charge. It can be purchased privately, with prescriptions costs ranging from around £49.99 for a 30-day supply to £78.
The Department of Health and Social Care has today released a new roadmap for improving PrEP access with recommendations from organisations that the antiretroviral should be made available online, in pharmacies and at GP surgeries – not just at clinics.
Will Nutland, co-director of The Love Tank, a non-profit which runs the advocacy project PrEPster, said there has been “a big uptick” in PrEP sharing.
He said patients are also finding “temporary workarounds” by claiming they have STI symptoms to secure clinic appointments sooner or using antibiotics bought online or from previous infections to self-treat.
Mr Nutland said: “If someone feels that they might have a symptom of an STI and they can’t get an appointment, they might just be going online and buying antibiotics themselves, even if that’s the wrong antibiotics to buy.
“Or they might be sharing treatment, or they might be holding on to antibiotics from treatment courses that they haven’t completed from a previous prescription.
“But most commonly, we’re seeing a lot of HIV PrEP sharing. So lots of those of us who can’t get a PrEP appointment are either, if you’re able to, buying PrEP online – which is completely legal to do… or sharing PrEP. So someone might have a spare bottle or might have come off PrEP because their circumstances have changed.
“So we are absolutely seeing a big uptick in people who are telling us about the amount of PrEP sharing that they’re doing.”
Paul Bates, director of external affairs at the Terrence Higgins Trust, said the charity was also hearing stories of people sharing the drug, which is highly effective at preventing HIV infections.
He added: “We’re also hearing stories of people who have been waiting so long for an appointment to be approved for PrEP, treatment that they actually decide instead to stop waiting and go private, which is completely unfair.”
Mr Bates described the current climate of as “an absolute outbreaks of outbreaks”.
Over two thirds of council areas had seen rates of gonorrhoea and syphilis increase since 2017 and more than a third of local authority areas have also seen increases in cases of chlamydia, analysis by the LGA revealed last month.
Latest available data from the UK Health Security Agency shows the number of HIV diagnoses in England rose by 22 per cent from 3,118 in 2021 to 3,805 in 2022.
Mr Bates said: “Sexual health services in this country have become the new Cinderella service and effectively been cut back to such an extent that it’s now just about disease management rather than prevention or health promotion.
“So what we’re seeing effectively is a massive jump in terms of STIs right across the board and right across different population segments.
“The Government doesn’t appear to have any vision at all to solve this, but it has to be solved because otherwise we are going to have an entire generation of people who are not getting access to sexual health services. And that’s just absolutely unacceptable.”
Mystery shopper research published by the THT last year found that waiting times for face-to-face appointments available to book via telephone averaged 13 days, rising to 19 days in rural parts of England.
Mr Bates said that he believes the waiting times will have increased.
The Department of Health and Social Care has been approached for comment.
Maurice Saatchi: I used to adore capitalism – then I had lunch with Margaret Thatcher