HIV prevention in London, UK, from 2017 to 2024: Outcomes, gaps and learnings
Members of the Dean Street Collaborative Group are listed in the Appendix.
Abstract
Objectives
HIV diagnoses at 56 Dean Street (56DS), a sexual health clinic in London, UK, have continued to fall from 2017 to 2024. We describe the evolution of HIV prevention at 56DS from 2017 to 2024, its impact on new HIV from 2017 to 2024 and gaps in its provision.
Methods
HIV tests, HIV diagnoses, numbers of individuals in HIV care and on antiretroviral therapy (ART), PrEP and PEPSE numbers from 1 January 2017 to 31 December 2024 were obtained from routine clinical coding. Characteristics of individuals diagnosed with HIV, including time to antiretroviral (ART), were obtained by notes review.
Results
The number of individuals newly diagnosed with HIV fell from 209 in 2017 to 82 in 2024, a decline of 61%. The quarterly number of HIV tests decreased from 21 704 (Q1 2017) to around 15 000 (Q1 2019). PrEP users increased from 170 (Q1 2017) and plateaued at 25 149 (Q2 2023). 211 (19.5%) had ever used PrEP prior to their HIV diagnosis. Among individuals diagnosed with HIV, previous PrEP use rose from 9 (4.3%) in 2017 to 50 (61.0%) in 2024. Median time from confirmed HIV diagnosis to ART initiation was 7 days (interquartile range 4–14) and has remained stable between 2017 and 2024.
Conclusion
The 56DS model of HIV combination prevention continues to work with HIV diagnoses in gay, bisexual and men who have sex with men falling over the last 8 years, although the falls appear to be slowing in the last 3 years. Strikingly, PrEP uptake has soared. We present gaps in prevention which pose the question: are we really going to get to zero HIV transmissions by 2030?
CONFLICT OF INTEREST STATEMENT
GW has received travel and research grants from and has been an advisor/speaker for ViIV and Gilead. MB has received travel and research grants from and has been an advisor/speaker for Janssen, ViiV, MSD, Pfizer, Gilead, Cipla, GSK and AZ. TS has been a speaker for Gilead and ViiV. All other authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
