NICE recommends against six-monthly injectable PrEP for HIV prevention – Terrence Higgins Trust response

Terrence Higgins Trust, the UK’s leading HIV charity, believes Lenacapavir as PrEP is a crucial part of achieving the Government’s goal of ending new HIV cases by 2030 and in tackling the inequalities that continue to exacerbate the epidemic among some communities.

Lenacapavir is a game changing option for PrEP as it can offer fewer appointments for people who struggle to take tablets, have challenges attending sexual health services regularly and is proven to improve adherence. People can currently get PrEP as a pill or, if eligible, a two-monthly injection, however, these options aren’t working well for everyone due to a variety of reasons that include capacity in sexual health clinics, the taking of pills, fears about being seen with the pills or the requirement to get to a sexual health clinic frequently.

Lenacapavir can be that option that reduces the gap in PrEP usage among those who most need PrEP to eliminate their chance of acquiring HIV and end new HIV cases In the UK by 2030.

NICE will review this decision on 3 November 2026.

Richard Angell OBE, Chief Executive of Terrence Higgins Trust, said: “We are profoundly disappointed by this initial decision by NICE. Twice-a-year injectable PrEP is the most exciting innovation in HIV prevention for years. But history is repeating itself when it comes to PrEP access in England and Wales – clearly lessons haven’t been learned. PrEP is a game-changer for HIV prevention and innovations like this must be jumped on and maximised – not kicked into the long grass and squandered.

“But, as with access to oral PrEP a decade ago, it’s clear we have a fight on our hands to make sure it’s one of the tools in our arsenal for ending new HIV cases in the UK by 2030. Because time is ticking and that target will be missed unless we throw absolutely everything at it.

“That’s why our message to NICE, NHS England and pharmaceutical company Gilead is to urgently get around the table and find a solution. NICE need a better approach to preventative medicine and be transparent about what needs to happen for it to recommend Lenacapavir as PrEP, Gilead needs to move on price, and NHS England needs to be ready to order higher volumes.  

“The provision of twice-yearly injectable PrEP is crucial for properly maximising the potential of this game-changing HIV prevention tool, which has already had such a positive impact in this country as a pill. To date this has primarily been felt among gay and bisexual men, while the injectable option has proven an important innovation for enabling more women to protect themselves.  

“The injectable is an important way of increasing choice, particularly for those who cannot take PrEP in pill form. It will also benefit those who struggle with adherence, especially those in our military, people who are homeless or living in unstable housing, and our prison population.

“NICE has assessed the current numbers for Lenacapavir provision and said no based on its criteria. But the reality is that we need this innovation to end new HIV cases by 2030 and ensure nobody and no community is left behind. The numbers need to change and fast.”