SCOTLAND is leading the world in HIV prevention and is on track to end transmission of the virus by 2030. 

On World AIDS Day - December 1 - those working in sexual health want to raise awareness of the game-changing advance known as PrEP.

Scotland was one of the first countries in the world to roll out Pre-Exposure Prophylaxis, which involves taking anti-HIV pills daily or around the time of sex and is available free from NHS sexual health clinics.

PrEP users also receive advice on safer sex and regular tests for HIV and sexually transmitted infections, as well as vaccinations for Hepatitis B and the human papillomavirus.

Now, three years after it was first introduced in Scotland ahead of the rest of the UK, Glasgow Caledonian University (GCU) academics have researched how to make services for people on or considering PrEP as efficient and easy to access as possible, in research funded by the Scottish Government’s Chief Scientist Office. 

They will share their findings at webinars hosted by HIV Scotland with public health professionals, NHS staff, community health workers, international experts, and PrEP users at the Fast-Tracking Scotland Summit on December 7-9.

The report highlights the need to raise awareness of PrEP and make it a normal part of life to reduce stigma and reach people who don’t use sexual health clinics but could benefit from it. 

And it recognised that a key strength of the Scottish programme was partnership working and shared learning between public health professionals, NHS staff, community-based staff and representatives from different communities.

Claudia Estcourt, Professor of Sexual Health and HIV at GCU, said: “When PrEP was approved in Scotland in April 2017 it was up and running across all 14 health boards within three months. We wanted to evaluate how it’s being rolled out and used in the real world and see what does and doesn’t work.

“PrEP has been a great success in Scotland with 1,000 people benefiting from its use in the first year, and around 6,000 over the last three years. Now we want to extend these benefits to a greater proportion of the population. We want to normalise the use of PrEP so people realise that it’s one of a number of tools that they can use to have healthy sex lives.”

GCU Research Fellow Dr Jennifer MacDonald said: “The language around HIV prevention can be stigmatising. We recommend moving away from ‘risk-based’ language and for PrEP to be seen as just another way to enhance sexual health.”

Professor Estcourt is also keen to remove the stigma surrounding HIV prevention. “It’s unfortunate that the people who are doing the right thing to protect themselves from HIV by taking PrEP are sometimes stigmatised by others instead of applauded for being responsible and enjoying a fulfilling sex life without the worry of HIV.”

The researchers want to increase awareness of PrEP more widely in society, especially to bring its benefits to people who may be less likely to know about or access HIV prevention such as trans and transgender people, people who inject drugs, and women born in countries with a higher prevalence of HIV.

Professor Estcourt added: “There are still a number of misconceptions about HIV, despite all the medical advances. Many people still poignantly and sadly believe that HIV is a death sentence, but life expectancy for someone diagnosed with HIV in 2020 is the same as someone who doesn’t have it as long as they start treatment early and look after their health. HIV is treatable and can be easier to treat than common conditions such as diabetes. While it’s not curable, it is preventable.”