Elton John AIDS Foundation launches pilot schemes to accelerate access to Pre-Exposure Prophylaxis (PrEP) and reduce new HIV transmissions in England

LONDON, June 19, 2025 /PRNewswire/ -- The Elton John AIDS Foundation, together with Fast-Track Cities, Gilead Sciences and ViiV Healthcare, is investing over £1 million in two innovation pilots designed to improve access to pre-exposure prophylaxis (PrEP) – a proven, safe, and effective medication that prevents HIV infection. The pilots will focus on reaching groups that have, to date, been underserved by existing PrEP models, including women and Black African communities, with the aim of bringing the UK closer to ending new cases of HIV by 2030.

PrEP, which can reduce the risk of acquiring HIV from sex by around 99% when taken as prescribed, was available in England through the PrEP Impact Trial from 2017 until 2020. Since then, it has been available free of charge from NHS sexual health clinics¹. However, multiple barriers continue to prevent people from accessing this life-changing medication. More than two-thirds of people seeking access to PrEP in the UK have been unable to acquire it, and half (57%) of those looking for clinic appointments have been waiting more than 12 weeks to be seen².

Additionally, there are significant inequities in who is accessing PrEP. For example, despite accounting for 30% of new HIV diagnoses in 2023, only 3.1% of PrEP users in England are women³. Many people don't know that PrEP exists, don't consider themselves at risk, or aren't aware that NHS services like PrEP are free. Others may not feel comfortable going to a clinic or may face additional barriers, such as insecure immigration status or past negative experiences with healthcare.

With the number of HIV diagnoses first made in England increasing by 15% between 2022 and 2023, it is imperative to address inequalities in PrEP uptake and widen access if the UK is to reach its goal of ending new HIV infections by 2030⁴. Over 18 months, the two PrEP innovation pilots will aim to increase awareness and uptake amongst communities at high risk of acquiring HIV through equitable, cost-effective approaches.

One pilot will focus on introducing a digital direct-to-consumer PrEP offering paired with targeted grassroots engagement for residents of North East London's local authorities (Barking and Dagenham, City of London, Hackney, Havering, Newham, Redbridge, Tower Hamlets, and Waltham Forest), with the aim of relieving pressure on sexual health clinics and attracting new users. The second pilot will run across three sites (Brighton and Hove, Liverpool, and West Sussex) and focus on incorporating PrEP into existing NHS services – such as women's health hubs, antenatal appointments, cervical screenings and community organisations supporting vulnerable people – to reach underserved communities where and when they are already engaging with the health system.

Both pilots will be championed by local authorities and integrated into the existing NHS architecture, facilitating the development of a sustainable blueprint for PrEP services that is scalable and transferable across the UK.

Expanding PrEP access through novel delivery in North East London (ExPAND-NEL)
The North East London pilot, ExPAND-NEL, aims to provide PrEP to over 3,000 additional residents over 18 months, representing a 60% increase in current PrEP coverage across all seven local authorities. It will achieve this by utilising a direct-to-consumer digital platform paired with community engagement and delivery in non-specialist healthcare settings, to reach populations that have so far been neglected.

North East London's population of two million people includes a high proportion of groups at increased risk of HIV who experience poor PrEP access – notably Black African and Black Caribbean heterosexuals, migrants from at-risk countries, and young gay, bisexual and other men who have sex with men (GBMSM). Although HIV incidence declined by about 60% between 2018 and 2021 in the UK, North East London incidence rates remain among the highest in the country with the number of new diagnoses among people first diagnosed in the UK increasing from 193 in 2022 to 217 in 2023⁵.

Incorporating PrEP into existing services
The second pilot, situated across three sites – Brighton and Hove, Liverpool, and West Sussex – will create new pathways for at-risk communities who may benefit from alternative approaches such as Black African women, and refugee and migrant communities.

By incorporating PrEP services into existing health services, such as antenatal care, women's health hubs, and targeted primary care initiatives, the pilot aims to address inequities, raise awareness and reach people who wouldn't traditionally access sexual health clinics.

Anne Aslett, CEO of the Elton John AIDS Foundation: "The Foundation has proven experience of designing and funding successful pilots that go on to achieve impact at scale. Our HIV Social Impact Bond, which proved that opt-out testing was a highly effective way of finding people living with HIV, started out as a one-week pilot in one hospital. Now, thanks to Government funding, the scheme is being rolled out to 89 emergency departments across England and has to date found 1,000 new diagnoses of HIV."

She added: "At a time when public health budgets are under pressure, we believe these pilots will show that investing in prevention is not only life-saving but also cost-effective, reducing the long-term burden on the NHS by averting new HIV infections before they occur. If the UK is to meet its goal of ending new HIV cases by 2030, it is essential that the new HIV Action Plan, set to be published by the UK government this summer, prioritizes PrEP access, along with HIV testing and strengthening high-quality HIV care."

Professor Jane Anderson and Professor Kevin Fenton, Co-Chairs, Fast-Track Cities London: "Fast-Track Cities London is proud to support this innovative digital PrEP pilot from the Elton John AIDS Foundation. Despite the progress we've made, too many people in our city, particularly women and communities not well reached by traditional sexual health services, still face barriers to accessing PrEP. This pilot is a vital step in changing that. By combining digital access with focused community outreach, we aim to create inclusive and equitable pathways for HIV prevention. This is about ensuring no one is left behind as we work to end new HIV infections in London."

Peter Wickersham, VP & General Manager Gilead Sciences, UK & Ireland: "At Gilead, we believe that everyone deserves equitable access to HIV prevention that works for them. These pilots represent a bold step toward closing the gaps in PrEP access and reaching communities that have been historically underserved—by meeting people where they are, whether that's online, in a sexual health clinic, or in their local community. We are proud to collaborate with the Elton John AIDS Foundation by providing grant funding, alongside other partners, to help bring the UK closer to ending new HIV transmissions by 2030."

Eduardo Peters, UK Medical Director at ViiV Healthcare: "PrEP is a critical tool to help the UK reach the ambitious goal of ending new HIV cases by 2030. By strategically expanding access to PrEP, these pilots address the pressing need for healthcare solutions that reach those most impacted by HIV, especially for underserved communities. At ViiV Healthcare, the only healthcare company fully dedicated to HIV, we believe in the power of partnerships to deliver impact at scale. This initiative highlights that and provides a blueprint for how we can offer PrEP options in a sustainable and effective way to help ensure no one is left behind."

Jason Strelitz, Corporate Director of Adults (DASS), Commissioning, Health & Social Care of London Borough of Newham: "We are deeply grateful for the support of the Elton John AIDS Foundation for this hugely important initiative across North East London. PrEP has made a significant difference in our ability to prevent HIV, but we know that not all parts of our population are sufficiently benefitting, and HIV diagnoses are rising among some communities. This initiative will directly tackle health inequalities and improve people's lives across our North East London communities."

Professor Matthew Ashton, Director of Public Health in Liverpool, said: "We are delighted to be partnering the Elton John AIDS Foundation, a global leader in the HIV response. This exciting and innovative PrEP service is a vital new tool in our efforts to eliminate HIV transmission in Liverpool. We hope that our pilot removes the barriers that prevent people from accessing the care they need and helps to ensure that this vital prevention tool is available to everyone, regardless of background or circumstance. This is another signal of our ambition in Liverpool to reduce inequalities, ensure equity and improve public health outcomes across the city. We will need to reflect on the successes and findings of the pilot and will produce a robust evaluation that helps to drive change across the country."

James Woolgar, Advanced Public Health Lead - Sexual Health, HIV & Women's Health lead for Liverpool & Chair of English HIV & Sexual Health Commissioners Group (EHSHCG): "The launch of these PrEP pilots marks a bold step forward in making HIV prevention more accessible, inclusive, and tailored to the needs of diverse communities. By embracing innovative digital pathways, we are helping to remove barriers, reduce stigma, and bring us closer to ending new HIV transmissions in England. The English Commissioners Group are excited to link more closely with the Elton John AIDS Foundation, welcome this development and hope to cascade some of the best practice involved."

Councillor Jacob Allen, Brighton and Hove Cabinet Member for Adult Social Care, Public Health and Service Transformation: "We're very pleased to receive this funding, which will help us reach underserved communities with life-changing HIV prevention. By expanding access to PrEP through women's health hubs and NHS services, we're taking a vital step toward tackling inequality and protecting more people from acquiring HIV."

Councillor Bob Lanzer, West Sussex County Council Cabinet Member for Public Health and Wellbeing: "We are delighted that West Sussex will benefit from this vital funding to create new ways to support our local communities to access PrEP. This will further support the ongoing work to address inequalities and make a difference to people's lives."

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About the Elton John AIDS Foundation:
The Elton John AIDS Foundation was established in 1992 and is one of the leading independent AIDS organizations in the world. The Foundation's mission is simple: an end to the AIDS epidemic. The Elton John AIDS Foundation is committed to overcoming the stigma, discrimination and neglect that keeps us from ending AIDS. With the mobilization of our network of generous supporters and partners, we fund local experts across four continents to challenge discrimination, prevent infections and provide treatment as well as informing government strategies to end AIDS. www.eltonjohnaidsfoundation.org

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¹ https://www.cdc.gov/stophivtogether/hiv-prevention/prep.html
² https://www.tht.org.uk/news/new-report-reveals-extent-barriers-prep-access-england
³ https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2024-report
⁴ https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2024-report#:~:text=As%20reported%20to%20UKHSA%20%2C%20the,and%20women%20(Figure%2011)
⁵ Office for Health Improvement and Disparities. Public health profiles. 2025 https://fingertips.phe.org.uk/ © Crown copyright 2025 [Accessed 29 May 2025]

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