Interim Head of Policy and Public Affairs, Richard Angell, at the Terrence Higgins Trust looks to the new ground on which the Big Tent pitched its post HIV Commission event

Steve Brine, the former public health minister turned Brexit rebel stole the show at the first in a series of events the Big Tent Ideas Foundation, Terrence Higgins Trust and Lloyd’s Pharmacy Online Doctor have embarked. The next event takes places in National HIV Testing Week.

Having turned the scientific possibility of ending new cases of HIV by 2030 into government policy in office, Brine has continued to champion his ministerial hobby horses even after his return to the backbenches. Most recently as a member of the HIV Commission – its final report, in December 2020, set out a road map to England being the first in the world to achieve this lofty ambition. 

It starts with everyone knowing their HIV status. In the run up the National HIV Testing Week (1-7 February), we are in the unique window when anyone in the country can get a free home HIV test. Go to startswithme.org.uk and order a test now.

PrEP, or pre-exposure prophylaxis, is the drug taken by people who test negative for HIV. It stops the user acquiring the virus. When taken correctly, it’s 100% effective and an important tool in stopping new cases of HIV. It, however, is not very well know beyond gay and bisexual men and currently only available in sexual health services. Considering all the challenges of Covid-19, these clinics have rolled out routine commissioning nation-wide pretty damn well. But this is simply not enough. 

‘In the same way availability of the contraceptive pill through GPs was a game changer, PrEP in the Core GP Contract is the holy grail of HIV prevention’

In the HIV Commission’s recommendations – Action 12 to be precise – the report demands, ‘There must be clear financial accountability and responsibility for PrEP provision beyond sexual health clinics, for example, in GP surgeries, maternity units, gender clinics and pharmacies.’

Steve Brine made this very clear. At last Wednesday’s event he became the first member of parliament to argue that PrEP should be added to the Core GP Contact – the document governing what doctors can give and critically how the practice gets paid for delivering it. He argued, ‘In the same way availability of the contraceptive pill through GPs was a game changer, PrEP in the Core GP Contract is the holy grail of HIV prevention.’

This is going to be crucial if PrEP is going to be known about by all those at risk of HIV and available if and when they need it. Sexual health services are brilliant but they are urban, over subscribed and under real pressure. Currently 250,000 who voluntarily refer themselves to a STI clinic leave without being offered a HIV test. These are disproportionately women and women of colour. If they cannot offer everyone a test, how can they talk to those who test negative about ways to stay negative. 

All good services go to the patient, not wait for the patient to come to them. It should be the same with PrEP. 

The government, in response to the aforementioned report, has promised a HIV Action Plan by summer. Amending the Core GP Contract needs to be in there. To everyone at the Big Test Ideas Festival event know this, the campaign started here. 

Richard Angell is Interim Head of Policy and Public Affairs, Terrence Higgins Trust. Know your HIV status. Order your free HIV self-test kit from Terrence Higgins Trust, available via the It Starts With Me website: startswithme.org.uk.

You can follow the Terrence Higgins Trust and Richard on Twitter: @THTorguk and @RichardAngell

Join us on Thursday 4th February at 5pm for our upcoming event: ‘Normalise Testing: Can England diagnose everyone living with HIV?’

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