Today NHS England has confirmed London has refused to double the number of places on England's PrEP trial, although it has agreed to accept some additional places to provide expanded access to the HIV prevention pill. 

Commissioners in London have offered no timeframe for confirming what proportion they are willing to accept. This comes as 11 out of London’s 23 trial sites (47% of sites) are already full to gay and bisexual men looking to access PrEP for HIV prevention.
 
Additional PrEP places have been accepted by the majority of trial sites outside London. This is welcome news but it leaves the capital lagging behind – despite the fact London sees the highest number of new HIV diagnoses in the UK (36% of all new diagnoses in 2017) and 41% of all new diagnoses among gay and bi men in 2017 were in London.
 
Ian Green, Chief Executive of Terrence Higgins Trust, said: ‘It is unacceptable that London has refused to double its places on the PrEP trial even though NHS England and the Secretary of State for Health have supported the action.

'Although we’re told the capital will accept some additional places, we don’t have a clue how many or a clear timeframe for a decision being made. How many more people need to needlessly contract HIV before the necessary action is taken?
 
‘We need urgent, decisive decisions rather than further unnecessary delays and disagreements as it won’t be long before once again places fill up in the capital. Last year Public Health Minister Steve Brine said that most trial sites will be full by this March – and March is now here.
 
‘Just last month the Government committed to ending HIV transmissions in England by 2030, but this won’t be achieved without vastly expanded access to PrEP for those who need it. Similarly, London was the first place in the UK to commit to ending transmissions by signing up to the HIV Fast Track Cities initiative. But today the capital’s status as a leader in HIV prevention has come into question with its inaction on PrEP. 
 
‘We applaud the decision by commissioners outside of London to put their local communities first and accept additional places to ensure those at risk of HIV are able to access PrEP. These places must be made available as quickly as possible to those who need them, as PrEP is almost 100 per cent effective when taken as prescribed.
 
‘However, we will now see unacceptable inequality in England where people outside of London can access PrEP as part of the trial while those in the capital continue to be turned away. It’s also a very confusing picture, which leaves many people unsure if they can or can’t access PrEP. 
 
‘We are now calling on local authorities in London to take their responsibility for HIV prevention seriously and urgently accept the double places offered to them. We look to NHS England Chief Executive Simon Stevens, Health Secretary Matt Hancock MP and London Mayor Sadiq Khan to step in and find an urgent solution.

'This is a sorry state of affairs and we need fast action to ensure PrEP reaches those who need it wherever they are in the country.’