Could PrEP drugs be the cause? Goodman/LNP/REX/Shutterstock

New HIV infections in gay men have fallen by nearly a third since 2015 across England, New Scientist can reveal. And it may be down to people buying medicines online, against mainstream medical advice.

A similar fall was reported by four London sexual health clinics in December. The new results, which are preliminary figures from all sexual health clinics in England for 2016, show the trend is happening across the country.

This data was presented on Wednesday at the HepHIV conference in Malta by Valerie Delpech of Public Health England. “Provisional data suggests that HIV diagnoses among gay and bisexual men in England has fallen, although it is not possible to confirm this at a national level until all data for 2016 have been received,” she told New Scientist


Until last year just over half of new HIV infections were in gay men in the UK, so a fall in this group will have a big impact on the course of the epidemic.

Valerie Delpech: all-clinic slide showing collective decline in gay HIV diagnoses in England last year #HEPHIV2017 pic.twitter.com/31yxXktOGO — Gus Cairns (@guscairns) February 1, 2017

(New Scientist has confirmed that this slide refers to STI clinics in England only, not the whole UK as indicated).

One explanation is that the drop is down to people taking medicines that slash their chances of catching HIV, known as pre-exposure prophylaxis or PrEP.

But these drugs aren’t available on the NHS and generally cost around £400 a month if prescribed privately. So growing numbers of gay men are buying generic versions from online pharmacies in India and elsewhere.

Buying abroad

Official NHS advice is that this is dangerous. “Medicines purchased in this way could have the wrong active ingredient, no active ingredient, or an incorrect dosage,” says a spokesperson for the UK Medicines and Healthcare products Regulatory Agency. “Prescription medicines are “prescription only” for good reason.”

But many are buying their generics through a website called I Want PrEP Now, which works with NHS clinics to check the drugs are genuine. Doctors also provide the generics users with urine tests, to check the medicine isn’t causing kidney damage, as this is a possible side-effect.

There are other explanations for the fall, however, including wider testing and encouraging people to start taking HIV medicines as soon as they’re diagnosed. This makes them much less likely to pass on the infection because it cuts the amount of virus in their genital fluids.

Whether it’s PrEP or more treatment that’s causing the fall is important, because the NHS is currently working out how to make the medicine available as part of a 10,000-person trial in gay and straight people.

The new figures for England are “great news” says Gus Cairns of the HIV information charity, NAM, who attended the conference. “Something is working.”