Informing HIV policy formulation and prevention in Scotland

Men who have sex with men (MSM) are at the highest risk of contracting HIV in the UK. While changes in testing policy have reduced levels of HIV, around one-quarter of HIVinfected MSM remain undiagnosed. UofG research has shaped policy by supplying key data needed by Scottish Government policymakers to plan and fund pre-exposure prophylaxis (PrEP) for HIV prevention.  

The research

PrEP is a game-changing prevention tool that has the potential to significantly reduce HIV transmissions.  

However, UofG-led research among the communities most affected by HIV in the UK, found that understandings of PrEP effectiveness and concerns about maintaining regular adherence were barriers to PrEP uptake and use.  

The Gay Men’s Sexual Health survey, led by Professor Lisa McDaid, has been conducted in gay commercial venues every three years between 1996–2014. It has provided robust evidence on the sexual behaviours, prevention and testing activities of gay, bisexual and other men who have sex with men in Scotland and the wider UK.  

Together, these studies have furthered our understanding of how the effective delivery of targeted HIV prevention interventions might impact on populations at risk.  

The Impact

In April 2017, the Scottish Government agreed to make PrEP available to those considered to be at high risk of contracting HIV, and in July 2017 Scotland became the first UK nation to publicly fund PrEP on the NHS.  

The Chair of Scotland’s HIV PrEP National Coordinating Group confirmed that, ‘work undertaken by Lisa McDaid and her team has been critical in informing Government policy, strategic direction and the evaluation of interventions relating to transmission of HIV among MSM over two decades’ 

In the first three and a half years of policy implementation—between July 2017 and December 20204,100 people had one or more PrEP prescriptions in 11 of 14 Scottish NHS Boards. 

Based upon year one figures, HIV testing rates have also benefitted. Among MSM, there was a 32% increase in HIV testing in the year following PrEP compared with the year prior to PrEP. 

A study led by researchers at Glasgow Caledonian University found that, within the PrEP period, HIV incidence among MSM with high-risk behaviour attending sexual health clinics had reduced fivefold.