The Elton John AIDS Foundation (EJAF) is putting over £1 million into two pilot programs to get HIV prevention medication to people who need it most, targeting groups that have been left behind by current systems, according to a press release from the organization.
The programs will focus on reaching women and Black African communities who haven’t been well served by existing PrEP models, with the goal of bringing the UK closer to ending new HIV cases by 2030. PrEP, or pre-exposure prophylaxis, is a medication that prevents HIV infection and can reduce the risk of getting HIV from sex by around 99% when taken as prescribed. The Foundation is working with Fast-Track Cities, Gilead Sciences, and ViiV Healthcare on the 18-month project that aims to show investing in prevention is both lifesaving and cost-effective.
Anne Aslett, CEO of the Elton John AIDS Foundation, pointed to the group’s track record of turning small pilots into large-scale programs. Their HIV Social Impact Bond started as a one-week pilot in one hospital and now runs in 89 emergency departments across England, finding 1,000 new HIV diagnoses. She said these new pilots will show that investing in prevention reduces the long-term burden on the NHS by stopping new HIV infections before they happen. With public health budgets under pressure, the timing is important for the UK to meet its goal of ending new HIV cases by 2030.
The problem is clear: more than two-thirds of people seeking PrEP in the UK can’t get it, and more than half of those looking for clinic appointments wait more than 12 weeks to be seen. Access isn’t equal either. In 2023, women made up 30% of new HIV diagnoses, yet only 3.1% of PrEP users in England are women. Many people don’t know PrEP exists, don’t think they’re at risk, or don’t know NHS services are free. Others face barriers like insecure immigration status or bad experiences with healthcare.
One pilot will focus on North East London, using a digital platform paired with grassroots community work to reach residents in eight local authorities. The ExPAND-NEL pilot aims to provide PrEP to over 3,000 additional residents over 18 months, representing a 60% increase in current coverage. North East London’s two million people include many groups at high risk of HIV who have poor PrEP access, including Black African and Black Caribbean heterosexuals, migrants from at-risk countries, and young gay and bisexual men. New HIV diagnoses in the area increased from 193 in 2022 to 217 in 2023.
The second pilot will run in Brighton and Hove, Liverpool, and West Sussex, creating new pathways for at-risk communities like Black African women and refugee and migrant communities. This program will work PrEP into existing NHS services like women’s health hubs, prenatal appointments, cervical screenings, and community organizations that support vulnerable people. The goal is to reach underserved communities where and when they’re already using the health system, addressing inequities and raising awareness among people who might not typically visit sexual health clinics.
