56 Dean Street as a nurse-led PrEP clinic: >20,000 clients in 2021

Simon Collins, HIV i-Base

An open access letter published in the Lancet includes reports how the UK’s largest PrEP clinic is run as a nurse-led clinic, with 90% of the 40,950 consultations for PrEP conducted by nurses.

It also stresses that this is a central part of the service and that this level of service could not have been developed and run if it only used doctors.

Of the 22,938 individuals seen:

• 98% were men and 2% were women (only binary categories were used),
• 70% were white ethnicity, 6% mixed, 4% Black and 12% other.
• 84% resident in London.
• Age distribution was: 0.1% (<18), 12% (18 to 25), 44% (25 to 34), 26% (35 to 44), 11% (45 to 54) and 5% (>55).

The group are committed to broadening access to PrEP to people who are still underrepresented including women at risk of HIV, trans people, migrant populations, and minoritised ethnic groups who might not have attended sexual-health services previously.

One comment however, and it is important, is that data were not produced on how this service is used (or not) by people who are transgender and non-binary even though they are a key population. This is especially disappointing as Dean Street has provided specific transgender services for many years. Data from 2021 however, will include this level of detail.

It would be good to know more details about the upper age range but full details from this important group are likely to be reported in full later in the year.

Reference

Whitlock G et al on behalf of the Dean Street Collaborative Group. Nurse-led PrEP provision at 56 Dean Street. Lancet, letters. doi:https://doi.org/10.1016/S2352-3018(22)00364-2. (20 December 2022).
www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00364-2/fulltext