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Pre-exposure prophylaxis (PrEP) for HIV has been shown to be an effective intervention to reduce the risk of HIV infection. A randomised controlled trial of PrEP in the United Kingdom found an 86% reduction in the risk of HIV infection in gay, bisexual and other men who have sex with men prescribed PrEP. A finding supported by data from New South Wales in Australia where a rapid decline in HIV diagnoses was seen in the 12 months following the introduction of PrEP.
With the development of internet self-purchasing in 2015, PrEP use in England is thought to have quadrupled during 2016 so that an estimated 3,000 gay and bisexual men were taking PrEP by year end. It is probable that this scale-up of PrEP use will have had an effect at reducing underlying HIV incidence, additional to the effect of intensified HIV testing and the immediate treatment of those newly diagnosed as living with HIV. However, it is too soon to estimate the size of this additional effect from available data. The HIV PrEP Impact trial funded by NHS England began in October 2017 to understand questions on PrEP eligibility, uptake and duration of use, and impact on HIV and other sexually transmitted infections.